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by complex_pi 206 days ago
The EU also has regulations, but somehow it does not make insulin as expensive as in the US. Maybe the existence of a regulation is not the issue here.
4 comments

Existence of specific bad US regulation and overregulation caused this.

Bad EU regulations and overregulation caused other problems. For example it is illegal for me to throw old socks full of holes into trash, I am supposed to take it to recycling centre on other side of the city.

Oh yeah, because in the absence of regulation, the insulin producer would sell it at negligible margins, sure!

As for the socks - my city has like ~5 locations where old textiles can be recycled, the closest one in slightly less than 1km from where I live. I see no problem with going there twice a year :)

With lack of regulations, the theory is, there will be many competing manufacturers of insulin, dropping the cost down. Probably not as simple as that, but that's the idea at least
> there will be many competing manufacturers of insulin

So... You are assuming market regulations still exist? Because without those, no, bio-chemical industry is absolutely one that consolidates quickly.

Absolutely. With no regulations I could produce/sell it for super cheap. Because I would be cutting it with tap water, and using forced labor
Preventing forced labor is a feature of normal contract law and property rights, and has little to do with regulations.
Now, that's all just regulations. What are regulations but laws that restrict/govern the way to do commerce? Anti-slavery is part of that, just like every other concession we've had to pry from the hands of capitalists over the last 100 years, like no child labor, no locking workers into factories, PPE, etc...
Yes, insulin producers would! It is illegal to compete, and insulin producers enjoy a legally backed monopoly. Yes, removing the regulations which support that monopoly will reduce prices. Any other option merely exists to support and uphold the special privileges that the current regulatory regjme grants to insulin producers.
I am not going to collect old clothes (used as rags and ready to be thrown out) for months. For start, my flat is not large enough for that.

I just throw them away with rubbish and get less supportive of people and institutions that created this law.

Please just stop being antisocial.
If that were the case, there would be no HackerNews.
Why don't the regulators stop being antisocial?
Can you please link the law that states that?

I see too much bad faith shit thrown around.

I don’t know where they live, but I’m 100% that it’s not an EU regulation, because I could throw socks into landfill/generic bins legally in the EU countries where I lived. Even the new EPR schemes about this is not about what’s mandatory by users, but what’s mandatory by textile manufacturers.
I'm not against the existence of regulation, nor is the OP. I'm against bad regulation. The US healthcare system is a gigantic regulatory morass.
Explain how the "gigantic regulatory morass" led to higher insulin costs?
I don't think there is a simple explanation, that's why I used the word "morass".

"From when insulin is produced by the drug manufacturer to when it goes to a pharmacy, profit is extracted at every step of the way. The insulin market is dominated by three large drug manufacturers—Eli Lilly, Sanofi, and Novo Nordisk—that, with little competition, have raised their list prices in lockstep. But there are other players besides the Big Three that are contributing to the problem. Pharmacy benefit managers, or PBMs, contract with insurance carriers and act on behalf of the insurer to negotiate the price of insulin with the drug manufacturers. In negotiating the price, PBMs place a drug higher or lower on their tier of preferred drugs and receive rebates based on a percentage of the list price. This kind of system incentivizes high list prices, which determine the amount of co-insurance patients pay. And if patients have a high deductible or are uninsured, they might pay the entire list price."

https://medicine.yale.edu/news-article/the-price-of-insulin-...

My position is simply that it is better to solve problems by taking regulations away than piling them on.

lol did you actually read the quoted text? Because 0% of it backs up your argument
Low regulation means almost anyone can make it, almost anyone can sell it, almost anyone can buy it.
Government capture by big players who promote heavy regulation in order to eliminate smaller competition?
> Government capture by big players who promote heavy regulation in order to eliminate smaller competition?

This is a meaningless statement without specifics. It has absolutely nothing concrete in it that would actually inform someone about what drives insulin production. It's a wrong and overly simplifies.

Are you really saying the regulations regarding the actual production of insulin is what drives up costs? We've been manufacturing insulin for > 100 years now.

And can you find a single resource that agrees with your assessment?

When you say "big players", you mean the top 3 right? Would regulating monopolies in the pharmaceutical industry maybe be a good thing?

Why do other counties pay less if it costs so much to make? Why does regulation in the US make US consumers pay more but not Europe, for example?

Do you think PBM's have any part to play in this? What about over-zealous patents by the monopoly at the top?

Do you have any actual experience in this field or are you just parroting talking points?

I worked for a large company that did devices used in surgery. They regarded FDA regulation as a moat that kept out all but large, established competitors.

Note that I am not saying that they tried to push (or worse, capture) regulators to achieve that end. I'm just saying that they didn't mind.

Website here has the cost of a vial of insulin as $99 USA, $3 Turkey. They could just let people buy it from any regulated country? https://www.visualcapitalist.com/cost-of-insulin-by-country/

Not sure how the US consumer benefits from being banned from having such choices?

Yeah but EU regulation makes other things expensive and inefficient (like the labour market, housing, building new companies because incumbents protect their interests trhough regulation).

The fact is that with insulin the regulation issues comes from the patchwork system of healthcare the US developped through political concesssionns and lobbying from private firms, which makes the developpment and the subsequent commercialization expensive relative to Europe where centralized national bodies negotiate with the pharma companies.

Regulation can be good or bad, in our era it is ineffective because politicians are boomers disconnected from the issues or in the EU a pseudo-technocratic (not really listening to technocrats recommendations) body far from reality

This series of posts is a nice forray into managerialism (the source of many regulation issues) https://baazaa.github.io/2024/10/16/managers_p1.html

> EU regulation makes other things expensive and inefficient (like the labour market, housing,

Unlike the US, where federal minimal wage remained flat since 2009 or where Black Rock is buying all available housing to keep the prices as high as possible.

The real minimum wage is also stuck in many parts of Europe relative to 2008. For example in Spain the average salary didnt increase adusted to inflation.

The blackrock thing seems like a myth, but private entities are also buying housing en masse in Spain for exammple

"remained flat" and "remained flat when adjusted for inflation" are two very different things.
The minimum wage doesnt mean much in general, many European countries either dont have it or recently instated it (Germany). What matters is the Median and quintile salaries in which, the US fares much better anyways

Many other countries have official minimum wages and a big % of people working black, unreported because the minimum wage is to high relative to the average (Spain, Greece, Italy)

US median wages are higher than most of Europe, especially when adjusted for cost of living: https://ourworldindata.org/grapher/median-income-after-tax-l...

Regarding BlackRock, I'm disappointed to see what appears to be populist misinformation on HN: https://www.investopedia.com/no-blackrock-isnt-buying-all-th...