{"id":35757,"date":"2016-09-01T03:00:20","date_gmt":"2016-09-01T07:00:20","guid":{"rendered":"http:\/\/quotulatiousness.ca\/blog\/?p=35757"},"modified":"2016-08-31T10:57:43","modified_gmt":"2016-08-31T14:57:43","slug":"dont-blame-the-market-for-the-epipen-price-hike-blame-the-fda","status":"publish","type":"post","link":"https:\/\/quotulatiousness.ca\/blog\/2016\/09\/01\/dont-blame-the-market-for-the-epipen-price-hike-blame-the-fda\/","title":{"rendered":"Don&#8217;t blame the market for the EpiPen price hike &#8211; blame the FDA"},"content":{"rendered":"<p><a href=\"http:\/\/slatestarcodex.com\/2016\/08\/29\/reverse-voxsplaining-drugs-vs-chairs\/\" target=\"_blank\">Scott Alexander<\/a> explains why &#8220;the market&#8221; has very little to do with the outrageous price hike for EpiPens:<\/p>\n<blockquote><p>EpiPens, useful medical devices which reverse potentially fatal allergic reactions, have recently quadrupled in price, putting pressure on allergy sufferers and those who care for them. <em>Vox<\/em> writes that this \u201c<a href=\"http:\/\/www.vox.com\/2016\/8\/23\/12608316\/epipen-price-mylan\" target=\"_blank\">tells us a lot about what\u2019s wrong with American health care<\/a>\u201d \u2013 namely that we don\u2019t regulate it enough:<\/p>\n<ul>\n<p><em>The story of Mylan\u2019s giant EpiPen price increase is, more fundamentally, a story about America\u2019s unique drug pricing policies. We are the only developed nation that lets drugmakers set their own prices, maximizing profits the same way sellers of chairs, mugs, shoes, or any other manufactured goods would.<\/em><\/p>\n<\/ul>\n<p>Let me ask <em>Vox<\/em> a question: when was the last time that America\u2019s chair industry hiked the price of chairs 400% and suddenly nobody in the country could afford to sit down? When was the last time that the mug industry decided to charge $300 per cup, and everyone had to drink coffee straight from the pot or face bankruptcy? When was the last time greedy shoe executives forced most Americans to go barefoot?<em> And why do you think that is?<\/em><\/p>\n<p>The problem with the pharmaceutical industry isn\u2019t that they\u2019re unregulated just like chairs and mugs. The problem with the pharmaceutical industry is that they\u2019re part of a highly-regulated cronyist system that works completely differently from chairs and mugs.<\/p>\n<p>If a chair company decided to charge $300 for their chairs, somebody else would set up a woodshop, sell their chairs for $250, and make a killing \u2013 and so on until chairs cost normal-chair-prices again. When Mylan decided to sell EpiPens for $300, in any normal system somebody would have made their own EpiPens and sold them for less. It wouldn\u2019t have been hard. Its active ingredient, epinephrine, is off-patent, was being synthesized <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/12806434\" target=\"_blank\">as early as 1906<\/a>, and costs about ten cents per EpiPen-load.<\/p>\n<p>Why don\u2019t they? They keep trying, and the FDA keeps refusing to approve them for human use. For example, in 2009, a group called Teva Pharmaceuticals announced a plan to sell their own EpiPens in the US. The makers of the original EpiPen sued them, saying that they had patented the idea epinephrine-injecting devices. Teva successfully fended off the challenge and brought its product to the FDA, which rejected it because of \u201c<a href=\"http:\/\/money.cnn.com\/2016\/08\/26\/investing\/epipen-price-hike-generic-alternative\/\" target=\"_blank\">certain major deficiencies<\/a>\u201d. As far as I know, nobody has ever publicly said what the problem was \u2013 we can only hope they at least told Teva.<\/p>\n<p>[&#8230;]<\/p>\n<p>Imagine that the government creates the Furniture and Desk Association, an agency which declares that only IKEA is allowed to sell chairs. IKEA responds by charging $300 per chair. Other companies try to sell stools or sofas, but get bogged down for years in litigation over whether these technically count as \u201cchairs\u201d. When a few of them win their court cases, the FDA shoots them down anyway for vague reasons it refuses to share, or because they haven\u2019t done studies showing that their chairs will not break, or because the studies that showed their chairs will not break didn\u2019t include a high enough number of morbidly obese people so we can\u2019t be sure they won\u2019t break. Finally, Target spends tens of millions of dollars on lawyers and gets the okay to compete with IKEA, but people can only get Target chairs if they have a note signed by a professional interior designer saying that their room needs a \u201ccomfort-producing seating implement\u201d and which absolutely definitely does not mention \u201cchairs\u201d anywhere, because otherwise a child who was used to sitting on IKEA chairs might sit down on a Target chair the wrong way, get confused, fall off, and break her head.<\/p>\n<p>(You\u2019re going to say this is an unfair comparison because drugs are potentially dangerous and chairs aren\u2019t \u2013 <a href=\"http:\/\/danger.mongabay.com\/injury_death.htm\" target=\"_blank\">but 50 people die each year from falling off chairs<\/a> in Britain alone and as far as I know nobody has ever died from an EpiPen malfunction.)<\/p>\n<p>Imagine that this whole system is going on at the same time that IKEA spends millions of dollars lobbying senators about chair-related issues, and that these same senators vote down a bill preventing IKEA from paying off other companies to stay out of the chair industry. Also, suppose that a bunch of people are dying each year of exhaustion from having to stand up all the time because chairs are too expensive unless you\u2019ve got really good furniture insurance, which is totally a thing and which everybody is legally required to have.<\/p>\n<p>And now imagine that a news site responds with an article saying the government doesn\u2019t regulate chairs enough.<\/p><\/blockquote>\n","protected":false},"excerpt":{"rendered":"<p>Scott Alexander explains why &#8220;the market&#8221; has very little to do with the outrageous price hike for EpiPens: EpiPens, useful medical devices which reverse potentially fatal allergic reactions, have recently quadrupled in price, putting pressure on allergy sufferers and those who care for them. Vox writes that this \u201ctells us a lot about what\u2019s wrong [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":35193,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[8,84,66,13],"tags":[727,243,661,1022],"class_list":["post-35757","post","type-post","status-publish","format-standard","hentry","category-bureaucracy","category-government","category-health-science","category-usa","tag-cronycapitalism","tag-medicine","tag-regulation","tag-regulatorycapture"],"jetpack_featured_media_url":"https:\/\/quotulatiousness.ca\/blog\/wp-content\/uploads\/2016\/06\/favicon.png","jetpack_shortlink":"https:\/\/wp.me\/p2hpV6-9iJ","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/quotulatiousness.ca\/blog\/wp-json\/wp\/v2\/posts\/35757","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/quotulatiousness.ca\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/quotulatiousness.ca\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/quotulatiousness.ca\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/quotulatiousness.ca\/blog\/wp-json\/wp\/v2\/comments?post=35757"}],"version-history":[{"count":1,"href":"https:\/\/quotulatiousness.ca\/blog\/wp-json\/wp\/v2\/posts\/35757\/revisions"}],"predecessor-version":[{"id":35758,"href":"https:\/\/quotulatiousness.ca\/blog\/wp-json\/wp\/v2\/posts\/35757\/revisions\/35758"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/quotulatiousness.ca\/blog\/wp-json\/wp\/v2\/media\/35193"}],"wp:attachment":[{"href":"https:\/\/quotulatiousness.ca\/blog\/wp-json\/wp\/v2\/media?parent=35757"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/quotulatiousness.ca\/blog\/wp-json\/wp\/v2\/categories?post=35757"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/quotulatiousness.ca\/blog\/wp-json\/wp\/v2\/tags?post=35757"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}