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Comment by otterley | Hacker News Reader

For example, an EpiPen costs $79 US ($99 AUD) in Australia.

That's about what it cost in the US until recently. It's a decades-old generic med, the patent on the delivery device is long expired (https://www.google.com/patents/US4031893), and the original research was even done by the US military.

so how is this insurance company getting away with what they're doing? you'd think someone else would produce it, sell it for <$100, and people would just buy them out of pocket. what stops that?

Other companies don't sell them. They bailed for various reasons, and the expense of getting in just isn't worth it.

If you develop an EpiPen and it costs you a bunch of money then in theory you can make it up by selling more volume. Except your competitor can just cut the price because they are already selling for an absurd amount of money, so how do you win now?

Maybe we should have a non-profit that does generic versions, and we can subsidize it by preferring them to companies like this (e.g. all medicare provided drugs now go through this company which sells generics). Unless the companies are willing to match prices.

> so how is this insurance company getting away with what they're doing?

It's not the insurance company, it's the drug company. The insurance companies are probably livid about the extra costs they're having to cover.

The answer to "how" is a variety of different techniques, including changing the formulation slightly (http://www.nytimes.com/2014/09/16/business/new-york-files-an...) and outright bribery of competitors (https://www.washingtonpost.com/opinions/pay-to-delay-pharmac...).

yup, and in this case and many others, it is only the insurance companies that will save the populous at large. Only they have the negotiating power to encourage competition and affect the laws regarding these devices

As others have said it's the drug company itself, not an insurance company. The patent they had on the injector has expired so others have tried and failed to bring alternatives to market. Unlike drugs, each medical device has to be vetted by the FDA. Generic drugs can get quicker to market just by showing that they're equivalent to the already approved drug. Devices can't do that.

One of the alternatives was potentially better as they had additional features, but there were problems with the injector itself and it was recalled. That's what other companies have to contend with. It's bad if the injector fails to deliver the dosage and a person dies.

So, people making a 3D printed alternative can't really ensure that the injector works reliably without a lot of work.

> Unlike drugs, each medical device has to be vetted by the FDA. Generic drugs can get quicker to market just by showing that they're equivalent to the already approved drug. Devices can't do that.

That is incorrect -- devices can do that. Devices shown to be equivalent to an existing device can be put on the market with minimal regulatory overhead. The form to submit to the FDA for an equivalent device is a 510k Premarket Notification. Details are here:

http://www.fda.gov/MedicalDevices/DeviceRegulationandGuidanc...

This is what an acceptance letter from the FDA looks like for a substantially equivalent device:

http://www.texasbiogene.com/upload/content/file/TBGFDAapprov...

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