Eli Lilly CEO says insulin tweet flap “probably” signals need to bring down cost | Hacker News Reader

Eli Lilly CEO says insulin tweet flap “probably” signals need to bring down cost

arstechnica.com

59 pointsstalfosknight33 comments

> "Those are the cases that produce the outrage, and understandably," Ricks said. "We want to do our part and work with payers in the system to provide copay assistance. We’re open to feedback [on improving communications],” he said. “We’ve done tons of things, but it obviously hasn’t penetrated the clutter. We’re obviously not the only insulin company. But the tropes go on."

Cool. "We're sorry there are hoops to jump through, we'll do our best to clearly mark where we've placed the stepladders".

Okay, so like, to give this CEO a little credit, it sounds like nobody is paying these prices (at least if they know how to play the game). The issue here is that prices are completely fake, the consumers are supposed to never know the MSRP, and anyone who does is getting caught in the middle of a stupid pricing game between insurers, Medicare, and providers.

So I can see why, from their perspective, they see it as a "communications" issue.

I'm no biomedical guy and an just an ignorant schlub, but I remember hearing similar arguments from Shkreli, that he wasn't making Daraprim inaccessible to the poor due to things like copays and he was only stiffing the big insurers, and the reason there was so much anger at him was that these big players manipulated the public into doing their bidding.

I call bullshit on such arguments honestly, the costs of such schemes do get passed onto the consumers and general public. At the very least such schemes raise insurance prices. I feel this sense of getting pissed on and being told that it's raining. It reminds one of the broader issues of administrative overhead and lack of price discovery in the American healthcare system.

Yeah, you don't have to love it. But if the entire system is a stupid game, it seems pointless to get mad at any one particular player for playing by the rules.

But like, there's a reason Mark Cuban's Cost Plus Drugs company will never be able to supply people on Medicare or Medicaid. If you actually advertise a real cost and Medicare says "we're only going" to pay 70% of that" you will be getting bilked for being honest.

The entire healthcare industry is all based on inflated numbers. Doctors have to charge $100 to get $10 from the insurance company, hospitals charge $1,000 and then accept $100 and write the rest off as "losses" so they can tweak the books in other areas.

> It probably highlights that we have more work to do to bring down the cost of insulin for more people

...

> We want to do our part and work with payers in the system to provide copay assistance.

In other words: to a Pharma exec, "bring down cost" means that insurance and the government should pick up more of the bill, not that they should charge less.

No, it means that the government and insurance companies already don’t pay what they are charging. You should look into the rebate system in the US. Pharma companies charge high sticker prices only to knock them back down to very low prices via a “rebate” for insurers. Insurers aren’t paying hundreds of dollars for the insulin that it would cost a normal consumer to buy, they are paying tens of dollars that is in line with what people expect insulin to cost.

Look Musk is going to solve Twitter and Insulin pricing at the same time!

If by "solve Twitter" you mean "get the hellsite to go away".

I do agree that insulin pricing is whack and it going down would be a good thig.

you know what, if you reject the algorithm and block all politics and other topics you don't care about as well as some prominent ideologues and then follow some topics you do care about like some kind of art, twitter is actually fine, and I met some cool people on there. People who call it a hellsite are intentionally using it like one.

People who call it a hellsite are using it the way it is specifically designed and intended to be used.

Twitter was originally exactly the experience you suggest; they then spent years and billions designing a system to create, out of nowhere, all of the problems that the site has, and they spend all their time and energy pushing people into that system to drive "engagement" metrics and "time on site" metrics.

People who call it a hellsite are complaining about two things:

1. The intentional design goals of the site which they are trying to force onto people

2. The result of those goals being applied to people who don't know that they can spend a ton of time and energy to avoid the problems they don't realize aren't mandatory.

Saying that it's the user's fault that Twitter is a cesspool that promotes and spreads awful content and rewards people being horrible is just the "you're holding it wrong" of our day.

Not calling it a hellsite, i actually used it (to read, not to tweet), but there is A LOT of dark pattern on twitter and i think you can build better communities on discord or reddit.

So if you learn to become in expert in Twitter and spend a lot of time tuning it, you can get a decent experience. That’s not a ringing endorsement. It’s like saying a car is fast if you put a turbocharger in it.

I spent a grand total of about two minutes. I just block things I don't like in my feed as they come up and it got better very quickly. Sure, it's up to you to be principled enough to stash your immediate emotional reaction and desire to engage and instead evaluate and block content that's bad for you, and, sure, that's difficult at first, but it's easy once you realize it's bad for you and making you unhappy.

I think it's just like food. You need to develop the mental response when you look at something so that you consider whether it's good for you first.

I did all that, for years. I dont actually see the algo - but everyone I follow does. And they retweet the shit out of the algo feed crap.

yeah, I've got one friend I follow who is hopelessly enmeshed in politics, so I hit "Not interested in this tweet" and then "Show fewer posts from X" and that solved it.

> false tweet from a fake-but-blue-checkmarked account

> as staff tried to contact Twitter employees but didn't get a response for hours

I'd be happy to see Eli Lilly send lawyers after Twitter for negligence in recent decisions there.

Maybe also subpoena identifying info of the poster, and start discouraging people who plant false news stories (for market manipulation, amusement, or whatever).

This is a random social media site that businesses choose to use rather than have their own customer service, PR, or media teams handle.

This is not a public infra funded by the government.

Also how is Twitter worse than the greedy life-destroying PharmaCo in any context?

It's crazy to me that the patent for insulin was sold for $1 so it would be accessible, and now it's one of the most expensive liquids on the planet. A month's supply is around $500 for two little bottles, required for someone with Type I (juvenile) diabetes to stay alive.

The patent has expired anyone can make insulin cheaper if they want to. The new drugs on patent (many set to expire in the short term future) are all improvements that greatly improve quality of life for patients which is why they are preferred to just using human insulin.

Why is it so much cheaper in countries other than the USA?

Higher cost of labor and customers have more money to spend

Than in Europe, Australia, and the UK? Laughable.

Why is that laughable, US has a higher median and mean income than nearly all of Europe, Austrialia, and the UK.

This means workers cost more and have more.

According to the first google results this is not true for the US and Australian comparison, even after converting AUD to USD the Australian worker makes about $2000 more than the US worker.

You also fail to recognize that US workers spend more to achieve similar healthcare outcomes, something highly relevant to this conversation.

Both wrong. Labor costs are high in Europe too, and people have as much money to spend. Also, if that was the reason, American patients would just buy the European products since they where cheaper. Also the drugs sold on the two sides of the Canadian border are produced the same places but sell at much lower prices outside the US.

The reason the North American market is so expensive is because of convoluted and honestly just shady practices of middlemen who negotiate on behalf of insurances companies and pharmacies but have a vested interest in pushing the list price as high as possible, but then demanding an insane rebate against those high list prices. During the congressional hearings it was stated that Eli Lilly paid something like 68% in rebates in order to get onto the insurance coverage plans. Also, even though their prices where rising year after year, they took back less and less after rebates where figured in. That means that whenever Eli Lilly sells 100$ worth of insulin, 22$ goes towards research and development, clinical trials, branding, marketing, production and distribution, and then 68$ goes to the pharmacy benefits managers who kick it back to the insurance companies, who then go to their customers and demand a copay as a percentage of the 100$ potentially not even needing to cover anything and just making bank on the drug sales, while charging their customers for the privilege of taking their money.

I don't necessarily disagree, but was answering from the perspective of generic insulin purchased without insurance.

Why is Insulin aspart $70 for 1,000 units at walmart, but much cheaper in India.

Isn't Mark Cuban's cost-plus pharmacy company thing working on this too?

Not the same insulin. A months supply of that insulin is 25$ at walmart.

Interesting, thanks for the correction. So the human insulin is $25, and the newer analog types of insulin are the super expensive ones.

The insulin the patent was sold for costs about $20 at Walmart. The modern insulin costing $500 is a completely different product. It’s an insulin analogue. It’s not even human insulin, it’s a synthetic compound that provides the same function of insulin, but with a much more efficacy, convenience, and safety. They were developed by the pharma companies in the last few decades, and continue to be iterated and improved on.

There are reasons to be concerned about insulin pricing, but this remains a completely wrong and uninformed one. It is the equivalent of expressing shock that a smartphone costs hundreds of dollars when walkie talkies have been around for decades and only cost $20.

Another win for the EMH , I guess. It shows that the initial price action is not so irrational after all.

So people dying avoidable deaths because of insulin prices is less important than brand reputation? Deaths should be a much stronger signal than a day of bad stock prices.

He deserves credit for potentially taking action now but also blame for the deaths caused by the status quo.

As much as the verified chaos shouldn't have happened, whoever sent that tweet is a hero.

Also free aspirin and T.P. and other basic, simple items TBD, thank you very much.

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