Bernie Sanders joins group seeking cheaper insulin in Canada

Toronto Sun ^ | July 28, 2019 | Canadian Press

[Brian Griffin]

“that’d be easy to do.”

Breaking into the $300 billion/year federally-regulated drug maker country club isn’t easy.

Bureaucrats fear risk. Newcomers are risky.

The US Patent Office is a monopoly.

The FDA is a monopoly.

‘No’ is always the safe bureaucratic answer.

[Brian Griffin]

“The supply simply does not, and will not, exist within Canada to meet such demands.”

Canadian regulatory law with respect to patented medicine supply is conditioned upon meeting “demand in Canada”, Canadian and otherwise.

The Canadian government isn’t in the market for excuses.

[Lou L]

As a drug company you would manufacture it. Charge less for it than what others are charging.

Are you the patent holder of this insulin, or are you talking about others simply copying the formula?

Even still, insulin manufacturing is a very complex process. It takes well over two months just to grow and make the API (active pharmaceutical ingredient.) It involves lots of customized lab equipment. You then have to aseptically make that into a solution and fill it into vials or pens, however you plan to deliver this to patients.

I would also remind you that insulin should typically be kept under refrigeration, in order to preserve its stability. That adds to the cost or both storage and distribution.

How much do you think you could sell a 10mL vial for, with all of those considerations? Could you be competitive and still make a profit?

[fruser1]

The original patent on insulin is expired. The current patents are on “improved” versions which is why the price is high - they are like any other new drug.

[butlerweave]

Canada negotiates it’s drug cost with the drug makers so you can’t just march into Canada and take Canadian’s drugs at their cost

[Lou L]

The original patent on insulin is expired. The current patents are on “improved” versions which is why the price is high - they are like any other new drug.

Yes, I understand that. Do you plan to sell the "old" version--one derived from cow pancreases, or will you manufacture a new version, one derived from recombinant DNA technology?

I'm just trying to understand your plan here, to corner the market.

[fruser1]

I’m not planning it, I’m providing a counter argument to the commie argument that if a drug price is high it means the government needs to control it, as Bernie would like to do. Get it?

So do you prefer the free market or socialist solution when it seems a particular drug price is too high?

[Lou L]

Sorry, I was just trying to understand your position, which I can now see.

I certainly agree with the free-market solution.

Working in the pharmaceutical industry and understanding how time-consuming and complex insulin manufacturing is, I was only trying to underscore that even with high manufacturing volumes, it's still expensive to make. It would be very difficult for a generic manufacturer to come in and make it cheaper.

That said, I do think there's an issue with diabetes' supply chain in general when it comes to pharmacy benefit managers, or PBMs. They claim to offer "leverage" by purchasing large volumes from wholesalers, and then they receive rebates--they never get passed onto customers. Something about the model just strikes me as wrong, and PBMs likely exist because of government regulations and licensing. I think insulin pricing could be made much cheaper by squeezing PBMs out of the picture.

[fruser1]

Then in that case, if no saving can be achieved by manufacturing an older insulin, and if the only thing keeping prices up are the PBMs you refer to, a possible “solution” would be through the pharmacy side - open one that actually passes on the discount.

The general problem I see in all these types of situations is that the US has already departed far from a free market. Whether caused by socialism or cronyism (market manipulation with government help) you get decreased competition and a situation where it’s almost impossible for someone to start up new.

Hence my generic (pun intended) answer to complaints of high price is a de facto “do it better yourself” type answer. If you can’t, maybe you shouldn’t be telling others how to run their business. If you could, were it not for gov, then gov is the problem, not the business. Those that point to the business as the only bad guy and ask for yet more gov control are only going to make it worse.

[Lou L]

Hence my generic (pun intended) answer to complaints of high price is a de facto “do it better yourself” type answer.

I've used the "do it better" answer before also, to lay people who know nothing about the pharmaceutical business, except they think they know how it should be run. They equate making pharmaceutical products to making candy or widgets--the first few you make are expensive, but quantity of scale takes over and the millionth one costs just pennies. That's not exactly the case with pharmaceuticals.

Unfortunately, the conversation around pharmaceutical pricing has become emotional, and those against the industry aren't willing to listen to rational arguments.

It doesn't help our cause that we do offer less expensive medicines in certain countries, but then keep the price higher in the US. If the President wants to look out for US businesses, I'd love it if he would ask other countries to pay a more fair share for US drugs.