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The Hollow Men of Hims

(www.alexkesin.com)
199 points quadrin | 3 comments | | HN request time: 0.569s | source
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mlsu ◴[] No.44383056[source]
The explosive growth of Hims and other side-channel healthcare businesses (using this model -- telehealth combined with compounded meds) is entirely due to the "legitimate" healthcare system's complete and total failure to serve patients' needs.

You can maybe talk about the hollow men of Novo and Lilly, who colluded with PBMs and insurers for most of a decade to push the cost of insulin analogues into the stratosphere, taking billions in profit while people died in agony rationing insulin. (in horrible agony -- blood turning into acid until brain death)

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turnsout[dead post] ◴[] No.44383070[source]
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kragen ◴[] No.44383371[source]
An oligopoly colluding to push the price of easily produced products into the stratosphere isn't a product of deregulation. In a deregulated or under-regulated market, thousands of cottage-industry insulin producers would be competing to shave pennies off the prices of their insulin. You might have a hard time finding safely produced insulin, but you wouldn't have a hard time finding cheap insulin.

Oligopolies colluding to elevate prices of necessities to fatal levels is a product of regulation. In cases like these, incumbent businesses support regulation because it raises barriers to entry for new entrants; this results in oligopoly or monopoly, permitting the extraction of monopoly rents, even when people are literally dying in the streets because they can't afford products like insulin which are extremely cheap to produce.

(Insulin wasn't always cheap to produce, but for 43 years now it's produced by genetically engineered microorganisms, which makes it very cheap. It's a tiny protein, only 51 amino acids, produced from a 110-amino-acid precursor protein.)

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1. turnsout ◴[] No.44383500[source]
This is a complex picture, so there's much more going on here than Big Pharma trying to squeeze out white-knight compounding pharmacies and supplement makers. What we have in the US is an industry that is constantly at the brink of system collapse, because that's the point of maximum efficiency/optimization. Pharma charges whatever payers (insurance companies) will support, and payers pass on whatever consumers can bear before literally becoming insolvent.

Consumers are so alienated that they'll pay out of pocket for a disruptor like Hims, which is doing its best to circumvent the entire system. Sadly, just as there's little government oversight to prevent pharma from becoming monopolistic, there's virtually no regulation on supplements. So you end up with the worst of both worlds; you can either take the $1000 monopoly pill or the $2 gas station pill filled with sawdust and raccoon repellant.

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2. kragen ◴[] No.44383564[source]
Your comment seems very far from relevant; possibly you posted it in the wrong thread? Either that, or you're stringing words together with no regard for what they mean.

Those complexities may be relevant to other drugs, but not specifically to insulin, which is the case we're discussing here. Nobody needs to recoup their research investment for figuring out how to make insulin cheaply, and insulin prices are extremely far from "the point of maximum efficiency/optimization", which would be where drug companies were charging barely enough to cover the cost of production. Insulin is not regulated as a supplement, it cannot be administered as a pill, it is not sold in gas stations, and no cases of sawdust or raccoon repellent contamination have been reported in insulin.

All that's happening with insulin is that there's an oligopoly that's colluding to extract monopoly profits, which they can do precisely because regulation prevents biology students from hacking together insulin-producing yeasts over the weekend and selling the insulin to whoever is willing to risk it. That same regulation is what prevents Harbor Freight from importing insulin by the case from any of the dozens of other countries where it costs a tenth of what it costs in the US.

https://old.reddit.com/r/AskChina/comments/1j9zf2u/chinese_i... says of China, "I checked and found that rapid-acting insulin is $4 per bottle, long-acting insulin is $10 per bottle, and other brands of insulin cost between $5 and $8." So why does it cost US$100 per bottle in the US? You'd think you could make a big profit importing Chinese insulin, no? But regulations make it difficult to import that insulin from China, so difficult that incumbents can extract US$100 per bottle in monopoly rents.

3. ◴[] No.44383668[source]