this post was submitted on 26 Nov 2025
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[–] Zacryon@feddit.org 42 points 21 hours ago (5 children)

Naive question from a european: Aren't there companies on the market who can offer a cheaper price and therefore beat greedy competitors?

[–] fullsquare@awful.systems 102 points 20 hours ago* (last edited 19 hours ago) (3 children)

the problem is that there is natural (as in, unmodified) cheap generic insulin available, it's just that it sucks compared to everything else. you see, insulin is a peptide that is supposed to appear, do some signalling, then disappear and unmodified insulin copies this thing exactly. the problem is, most of the time when peptide is supposed to work as a pharmaceutical, you don't want to do that, you'd like insulin to last longer than usual, which means changes to it that make breakdown slower, or adding something that makes it stick to albumin, which has similar effect because it hides insulin somewhere enzymes can't reach it and also it makes it start acting slower. this means less frequent dosing and less changes in insulin activity over time. there are also other insulins that start acting faster than natural, and this is also due to a couple of modifications in its structure

for another example, ozempic was not the first drug in its class, it's also a modified peptide, and it can be injected s.c. once a week, compared to previous iteration (liraglutide) that requires daily injections. if natural peptide is injected i.m. instead, its halflife is half an hour, and in serum it's only two minutes (it gets released a bit slower than it is metabolized)

manufacturing costs are about the same for any variant, most of it is in purification. patents for a couple of these have expired anyway by now, but if manufacturing is limited then price can be set arbitrarily high (see daraprim)

[–] Sir_Premiumhengst@lemmy.world 43 points 19 hours ago (1 children)

Oh wow, an actual nuanced response and genuine answer!

Also today I learned!

[–] buttnugget@lemmy.world 2 points 12 hours ago (1 children)

Responses don’t need to be nuanced to be useful.

[–] princessnorah@lemmy.blahaj.zone 2 points 10 hours ago (1 children)
[–] buttnugget@lemmy.world 1 points 10 hours ago (1 children)
[–] princessnorah@lemmy.blahaj.zone 1 points 10 hours ago (2 children)
[–] buttnugget@lemmy.world 1 points 3 hours ago

Since your comment was entirely superfluous, I just replied in that same spirit.

[–] ryedaft@sh.itjust.works 5 points 16 hours ago (1 children)

Costs aren't just research and purification, it's also good manufacturing practice and quality control.

[–] fullsquare@awful.systems 4 points 12 hours ago* (last edited 12 hours ago)

i mean i don't think about it as a separate budget line because if you don't have that you get police raids and investigation instead of normal business, but yea. insulin is purified using HPLC, so at all times you get some of analytical data about fractions you just made, so some of QC, not all, but already something, already happens at this point

my point is that actual manufacturing costs will be low because biotech scalability logic is that you need to make yeast or something that makes peptide you like and then all you need to do is keep bioreactor alive and happy. lots of what is left is in purification

also it's an injectable so it's gonna be kept to some standards that non-injected drugs aren't. whoever comes up with insulin pill will be printing money

[–] Tollana1234567@lemmy.today 1 points 15 hours ago (1 children)

thats why the big 3 companies make different version insulin so they are effective at certain times of the day, or when you eat/

[–] fullsquare@awful.systems 2 points 12 hours ago* (last edited 12 hours ago)

there are multiple short-acting and long-acting insulins because you can't patent other people's things, but now it's all off-patent. just take your stainless steel bioreactor and preparative HPLC, cook up a batch, wait ten years for biosimilar approval and you're good to go

because unlike with small molecule drugs, when cooking up generic biopharmaceutical there’s extra approval process that amounts to a tiny clinical trial https://en.wikipedia.org/wiki/Biosimilar this and type of economics of scale that there is with biologicals makes manufacture at large scale way more preferable. these requirements were loosened a bit over time

[–] Soulg@ani.social 20 points 20 hours ago

Correct, but when it's already been established that people will pay those prices, they keep them high. So instead of going from $800 to $5 out of the goodness of their hearts, they go from $800 to $650 (number made up) to get more business but still make massive profits.

[–] Lumidaub@feddit.org 19 points 21 hours ago (3 children)

You'd THINK capitalism would cause that to happen, wouldn't you?

[–] Banana@sh.itjust.works 16 points 20 hours ago (1 children)

Doesn't work when people don't get to choose not to take it when it gets too expensive! That thing that capitalists always forget about: necessities.

[–] Natanox@discuss.tchncs.de 19 points 19 hours ago (1 children)

Every time someone talks about you being supposedly free to choose where to work they should get instant diarrhea. Let alone medicine of course, that's a hard dependence.

Nobody is truly free without proper UBI and free healthcare and good public transport. Only then true freedom can exist.

[–] Iceblade02@lemmy.world 9 points 17 hours ago (2 children)

A lot of the benefits people associate with capitalism require a free market. The US problem is that the megacorps have gotten sufficiently powerful to abolish that free market through regularory (and legal) capture, enabling entrenched monopolies.

[–] Aceticon@lemmy.dbzer0.com 3 points 11 hours ago* (last edited 11 hours ago)

Look, mate, Intellectual Property Laws are literally the government creating and giving somebody an artificial monopoly on something which would not naturally exist if it wasn't for artificial limitations on "doing the same thing" being forced on everybody thanks to legislation and the coercive powers of the Legal system, and this was purposefully written in Law to do exactly that, so it's not an unexpected legislative side effect.

So anywhere were Intellectual Property legislation can apply the market is not free, on purpose and by policy.

Now, a good argument can be done about how IP law incentivises the creation of things with a high utility value which would otherwise not be created, but that doesn't alter the fact that the whole thing is a giant legislative sledgehammer with massive destructive capability for both the Economy and people's lives, which needs to be handled very carefully in order not to do more harm than good.

As it so happens IP has gone completelly out of control in the US because Corruption there is incredibly high, more some when it comes to the property of ideas since holding a piece of such property can yield billions of dollars in profits - the profits from owning ideas can be far vaster than of merelly owning land - and this shit has been copied around the world by almost as corrupt politicians (for example, the thoroughly corrupt crooks in the EU commission pretty much copy every single "this will make me personally lots of money from thankful corporations" pieces of legislation from the US).

So Copyrights now last an insanelly long period - about 1.5 times the average human lifetime - before things covered by it go into the Public Domain, whilst lots of Patent Offices (most notably the ones in the US and Japan) will just accept patents on everything no matter how obvious without even a proper search for prior art, hence things like the "round corner button" patent that Apple has as well as countless business patents for "solutions" which are obvious to any domain specialist (many such patents literaly the product of paying a domain expert for an hour of their time by a patent troll to just "think up a solution for this" as no actual implementation is needed to get a patent, just the idea of how it could be done).

All this to say that this fucked up situation of insane government-given monopolies all over the place for shit that's obvious to domain experts or derivative (a common trick in patents for medicine is to just do a small tweak in the formulation to get another 25 years of patent protection on pretty much the same thing) was created ON PURPOSE by the very politicians who claim to want a Free Market.

The entire thing should be reviewed and ajusted in exactly the opposite direction it is going (so we should have shorter protection periods, no "ideas only" patents, proper prior art searches rather than relying on expensive court cases to nullify patents on things somebody else already did or which are common practice in that industry, no business patents, properly funded Patent Offices, no transnational recognition of patents - so that countries *cough* Japan *cough* can't just use their Patent Office as some sort of commercial weapon to benefit their local companies in other markets - and so on) but given that Intellectual Property is an area worth trillions (and, remember, it's entirelly artificial, so without that legislation such property would be worth nothing at all) and politicians are incredibly corrupt nowadays, this shit is getting worse rather than better (and, IMHO, severely slowing down the speed of progress in the current Era versus a Free Ideas system)

[–] emergencyfood@sh.itjust.works 1 points 8 hours ago

Sectors like pharma require enormous R&D budgets. If you have a free market with many companies, each company will have only a tiny marketshare, and therefore only a tiny budget. So you can't do without the megacorps. The solution is for the megacorps to be run by the government / non-profits / trusts, or, if that is not possible, for prices to be fixed by an independent regulatory body.

[–] Kaput@lemmy.world 7 points 19 hours ago (1 children)

What USA is experiencing is feral Capitalism.

[–] Bronzebeard@lemmy.zip 8 points 19 hours ago

Crony capitalism

[–] Ensign_Crab@lemmy.world 13 points 16 hours ago

That's certainly how capitalism is marketed, isn't it?

[–] hakase@lemmy.zip 0 points 21 hours ago

Yup, but their products don't work as well, don't work for everyone, or have other downsides. Banting's original insulin would be dirt cheap today, but it's shit compared to what we have now, so the best products on the market today charge a premium for either efficacy or convenience.