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Re:Illinois governor signs law capping insulin costs at $100... by nate_meurer on Wednesday January 29, 2020 @01:18PM (#22183941)
No, trickle-down refers very specifically to tax breaks tailored narrowly to the wealthy, in hopes that they will in turn distribute their wealth via increased employment of capital and, ultimately, labor. Since its origins in Gilded Age populist political writing and depression era popular media, it has never meant anything else, and it has nothing to do with the subject at hand.

> Give companies, who are additionally acting unethically, a guaranteed and direct profit increase...

No, lowering barriers to competition doesn't give anyone guaranteed profit. It reliably does the opposite, depriving incumbent companies of their monopolies.

> Furthermore, private corps aren't the only way drugs can be invented.

Nobody -- literally nobody -- would dispute that. The question is whether the government is able to do the various parts of drug development as efficiently as the private sector. This is not a simple analysis, but I think the answer is more often than not, No.

[dead]
Re:Illinois governor signs law capping insulin costs at $100... by tptacek on Wednesday January 29, 2020 @01:46PM (#22184324)
Because in most markets, one of the more straightforward ways to make money is to deliver products more efficiently, split the reduced cost basis with the customer, and outcompete incumbents.

You're not doing your argument any favors with this "typical HN response" stuff. Have a discussion with people on the thread or don't; it is fine for you to simply disagree and walk away.

Re:Illinois governor signs law capping insulin costs at $100... by jahaja on Wednesday January 29, 2020 @01:56PM (#22184436)
And in many markets it's not. Well-run state companies, that exists, and have existed for a long long time, efficiency is not a problem and they can focus their efforts and money on what's important, not profits and marketing.

Don't tone police me please. I find it rude to assume ignorance and go on explaining. Did you miss the whole mansplaining wave?

Re:Illinois governor signs law capping insulin costs at $100... by dang on Thursday January 30, 2020 @09:07PM (#22198332)
Would you please stop posting in the flamewar style to HN? It's not what this site is for, and we ban accounts that keep doing it.

https://news.ycombinator.com/newsguidelines.html

Re:Illinois governor signs law capping insulin costs at $100... by jahaja on Friday January 31, 2020 @04:46AM (#22200355)
Sure. However, given the rudeness in the replies I feel that I restrained myself decently with a few slips.

"You can't coherently and simultaneously believe"

"You might as well call it "fascist" or "colonialist". It's jibberish."

"it is fine for you to simply disagree and walk away"

"Right, so it was a bullshit distraction that can safely be ignored."

"You're still not understanding."

"Now read this slowly and carefully"

"You are completely misunderstanding the argument."

"I think you're trying to construct a straw man"

"which discussion you opened with a snarky, dismissive one-liner."

"[if] you're able to use google for five minutes. At this point, though, I'm confident that you're interested only in polemics, rather than actually learning anything about the issue."

Re:Illinois governor signs law capping insulin costs at $100... by nate_meurer on Wednesday January 29, 2020 @03:13PM (#22185277)
Ah I see. So as long as we append the word "type", we're free to throw phrases into completely non-sensical contexts? How convenient.

Kidding aside, your use of the phrase here indicates a fundamental misunderstanding. This isn't "similar" to trickle-down. This has nothing to do with it whatsoever. You might as well call it "fascist" or "colonialist". It's jibberish.

Try this: You can find the Hopkins paper that Rayiner cited at https://sci-hub.tw/10.1056/nejmms1411398. It's a consice description of the causes of the ongoing dearth of generic biologic (non-small-molecule) medicines.

Read that. It's only five pages. Then tell me how the various possible ways to limit the monopoly position of incumbent insulin makers -- patent reform, lowered regulatory barriers for new competitors, whatever -- would constitute a "trickle down type" giveaway to said incumbents. Tell me how that makes any sense at all.

> Profit-driven drug companies will obviously focus on things that make money, e.g. superficial/vanity related things, not what's necessarily aligned with public interests.

Just for fun, give me some examples of drugs that are merely "superficial/vanity related". I think you're trying to construct a straw man.

It's certainly true that the free-market does not guarantee alignment with the public interest. It's also true that over-regulation is one of things that causes such misalignments.

In this case, a strong regulatory framework around biosimilars may be unavoidable due to their extreme complexity (again, read the paper). But if there are regulatory hurdles that can safely be removed, and thus allow generic drug makers to enter the market with cheaper alternatives, how exactly would that be unfair or unjust for anybody?

Re:Illinois governor signs law capping insulin costs at $100... by jahaja on Wednesday January 29, 2020 @04:12PM (#22185879)
The template of trickle down economics I'm referring to is the method where the already wealthy/profiting and so on, is given immediate benefits under the premise of vague and long-term benefits for the many. This method of upwards redistribution has been applied repeatedly time and time again, and tax cuts in the style of trickle down economics are just one instance of it.

> Just for fun, give me some examples of drugs that are merely "superficial/vanity related". I think you're trying to construct a straw man.

Once again, it was one example, I was mainly thinking about hair loss or other male things caused by men, historically and still, earning more.

My main point was that the profit motive causes this kind of skew:

"Scientific publications brought the evidence that there was a lack of news drugs for diseases that cause high mortality and morbidity among people living in poor areas. One showed that only 1.1% of new drugs were approved specifically for neglected diseases over a period of 25 years (1975 to 1999) despite the fact that these diseases represented 11.4% of the global burden"

> It's certainly true that the free-market does not guarantee alignment with the public interest. It's also true that over-regulation is one of things that causes such misalignments.

I would argue that "free-markets" is the exact reason for anti-competitive regulations, among others, in the form of regulatory capture, which is inherent with capitalism.

Re:Illinois governor signs law capping insulin costs at $100... by nate_meurer on Wednesday January 29, 2020 @04:52PM (#22186251)
Regardless of how you want to redefine the phrase trickle down, your use of it here betrays a fundamental misunderstanding of the subject. If it's possible to reduce the regulatory burden of the approval process for biosimilar insulin so as to allow generic makers to compete more easily, this will REDUCE the monopoly power of the large incumbent drug companies. I don't know if you're being deliberately obtuse, but I can't say this any more clearly.

> Once again, it was one example, I was mainly thinking about hair loss or other male things caused by men, historically and still, earning more.

Right, so it was a bullshit distraction that can safely be ignored.

> My main point was that the profit motive causes this kind of skew...

Which has exactly nothing to do with insulin, or the larger problem of building a manufacturing base for complex biosimilar medicines that's big, efficient, and safe enough to not bankrupt us. Regulations are necessary and powerful tools that, if wielded clumsily, can easily kill that manufacturing base. Making sure those regulations are suited to the task is not "trickle down" in any way whatsoever.

Re:Illinois governor signs law capping insulin costs at $100... by jahaja on Wednesday January 29, 2020 @05:28PM (#22186645)
> Regardless of how you want to redefine the phrase trickle down, your use of it here betrays a fundamental misunderstanding of the subject

Care to explain how it doesn't fit the template I described?

> this will REDUCE the monopoly power of the large incumbent drug companies

This is at best naive. The approval process isn't the problem. Government granted monopolies are.

> Which has exactly nothing to do with insulin

Uhm, yes, and that was in response to the free-market nonsense, not insulin.

Re:Illinois governor signs law capping insulin costs at $100... by nate_meurer on Wednesday January 29, 2020 @08:39PM (#22188145)
> The approval process isn't the problem. Government granted monopolies are.

You're still not understanding. Overly burdensome approval processes are part of what creates government granted monopolies. In other words, those two things go together.

For example, if you're familiar with the approval pipeline for generics in the U.S., you'll remember that the main component of an ANDA filing is proving equivalence. Regulations require the evaluation to be based not just on the chemical description of the brand name medicine, but on actual physical samples. A separate regulation subjects any medicine with serious side effects to the REMS program, which restricts its distribution to narrow channels of the drug maker's choosing. Furthermore, the regulation allows companies to voluntarily subject a drug to REMS-type treatment even in the absence of serious side effects.

The result of these twisted regulations is that a large incumbent drug maker can easily deprive smaller generic makers from getting the samples they need to pursue approval.

This is just one example. REMS and other regulations allow incumbent drug makers other ways to block prospective generic makers. These abuses are common, and according to one study cited by the FTC, if we removed or reformed some these regulations, it would save Americans billions of dollars a year. [1]

Now read this slowly and carefully: these government regulations help to preserve big pharma monopolies. Read the citation below. Read the paper cited earlier. Read anything.

If you have any evidence of your own to support your positions -- studies, papers, anything -- I'd be interested to hear it. Otherwise I'm done with this.

1 - https://accessiblemeds.org/sites/default/files/2018-09/REMS_...

Re:Illinois governor signs law capping insulin costs at $100... by jahaja on Thursday January 30, 2020 @04:53AM (#22190185)
You couldn't make this up. The very group that ordered the report you are referring to, The Association for Accessible Medicines (AAM), is also appealing the introduction of a law in California that makes pay-for-delay deals with drug companies illegal. Do you understand why I'm calling it naive now? They clearly don't have the public interests in mind at all, just raking in profits, even if it's through mob-like protection fees with incumbents.

"The Association for Accessible Medicines (AAM), which represents generic drugmakers, is appealing a December 31 decision by a federal judge that allows California’s new law barring pay-for-delay arrangements between brand-name and generic pharma firms to go forward."

"AAM had argued that the law violated the federal government’s right to regulate interstate commerce and the scope of US patents"

https://www.centerforbiosimilars.com/news/lobbying-group-app...