[HN Gopher] Fort Botox, Where a Deadly Toxin Yields $2.8B Drug (...
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Fort Botox, Where a Deadly Toxin Yields $2.8B Drug (2017)
Author : Tomte
Score : 38 points
Date : 2024-02-18 11:24 UTC (1 days ago)
(HTM) web link (www.bloomberg.com)
(TXT) w3m dump (www.bloomberg.com)
| caycep wrote:
| I would say the cost of a vial of medicine for neuromuscular
| spasms and dystonia (the initial purpose, not cosmetic) is cost
| prohibitive for a lot of people. Usually, insurance should cover
| it, but the cost is $1,000/vial for a medicine that was approved
| over 30 years ago, and the price has only gone up, not down. Some
| plans (off the top of my head, some Blue Shield plans and anyone
| who is on straight Medicare/Medicaid) won't cover the cost.
|
| There are a couple of competitors that work roughly the same and
| are slightly cheaper but it def seems like an oligopoly to keep
| the costs artificially high.
| Sparkyte wrote:
| You go to any country outside of North America and you can get
| medicines the exact same ones for a fraction of the cost on the
| dollars. US generally is up charged due the ability squeeze
| insurance and then the patient. So definitely greed, some
| regulations should be applied. Insurance companies would be
| happy to not be squeezed, if some sort of regulation was made
| to prevent squeezing it would be nice. Even a culture where
| doctors were glorified over YouTube stars would help too. Asia
| for example if you're a doctor you're making money! But the
| scary thing is that doctors in Asia don't charge 100,000 USD
| for said surgery. Just think about it.
| caycep wrote:
| I would hope so...not sure what the EU or Canada cost of a
| 100U vial but I would hope and be pleased if it were much
| less than $1k US
| Sparkyte wrote:
| I plan to retire in my wife's home country where family
| values and everything else is just that much better.
| mike10921 wrote:
| I'm the last to defend the drug companies, but at a basic
| level, they get the right to sell at high prices because of
| the cost to bring to market which is absolutely enormous.
| Once it goes to market the cost of producing the drug is
| often very low compared to the price but it's in order to
| encourage companies to invest in future drugs.
| LadyCailin wrote:
| In this case, the drug is 30 years old. I'd say any cost to
| bring to market is well paid now, and even if it isn't,
| this is why the public should fund the research via taxes,
| not locking profits up via corporate entities.
| s1artibartfast wrote:
| The product is long off patent. The only thing stopping
| someone from selling it cheaper in the US is the
| government itself and limited economic returns.
| systems_glitch wrote:
| Not patented, trade secret.
| reaperman wrote:
| Sure, but it's only the USA paying the most truly
| ridiculous prices. They're usually quite affordable in the
| rest of the world.
| mike10921 wrote:
| The reason is that labs can decipher the drug contents
| and produce the drugs at a fraction of the cost. Of
| course, these companies never paid for the research and
| cost to bring to market. So yes US citizens end up
| carrying the cost, but in practicality, a very big number
| of life-saving drugs originate in US companies. I am
| definitely not defending these companies just pointing
| out the basics.
| koolba wrote:
| > Insurance companies would be happy to not be squeezed, if
| some sort of regulation was made to prevent squeezing it
| would be nice.
|
| Insurance companies are bound by ACA profit caps where 80% of
| revenue has to go to "medical claims". This leads to a
| perverse situation where their theoretical maximum profit is
| tied to higher cost of services. If they're at that limit and
| actually negotiated lower prices, they'd be in violation of
| those (perverted) profit caps.
| fegu wrote:
| This is very interesting and completely new to me (I'm
| European). Suddenly so much of the situation in the
| American health business makes sense.
| ramblenode wrote:
| > So definitely greed, some regulations should be applied.
|
| Regulations are what prop up the high prices. Allow people to
| import drugs from overseas or Canada and you would see prices
| start plummeting overnight.
| swayvil wrote:
| Accusing businesshumans of greed is like accusing gas molecules
| of pressure. It's just part of the thing.
| lxe wrote:
| Barring the cosmetic use, do the medical benefits of botox
| outweigh the bio-terrorism risk to justify its production?
| lxe wrote:
| ChatGPT seems to think so, after a lengthy cost/benefit/risk
| analysis:
| https://chat.openai.com/share/83b9dd37-487b-4474-b8ff-5df29e...
|
| It thinks that the risk of catastrophic outcome is low, while
| benefit to individual quality of like is high. I don't know if
| I agree with this.
| heisenbit wrote:
| It is a matter of perspective, chances are ChatGPT would do
| just fine in case of a bio terror event.
| lelandfe wrote:
| > _Is it reasonable to assume that the cons of production of
| botox outweigh the pros...?_
|
| Pro-tip, hypotheticals don't really work with LLMs. The rest
| of your interaction was contaminated by the sentiment
| proposed.
| s1artibartfast wrote:
| There are no meaningful bio-terrorism risks to production and
| supply chain.
|
| The bacteria that make botulinum toxin are found naturally in
| many places, but it's rare for them to make people sick. A
| hypothetical bio-terrorist does not need to break in to a
| medical factory to procure it
| yellow_lead wrote:
| While it's true the toxin is found naturally, is it really so
| easy to make such a large quantity? Making one gram, for
| instance, might require a very large factory.
| s1artibartfast wrote:
| That I don't know. I brew beer and can grow 100g of
| cultured yeast in a few days in my kitchen. Botulism isn't
| a hobby I'm looking to get into.
|
| Something must be tricky, because several companies have
| spent billions to try to make a product and failed.
| However, I suspect that is mostly due to purification and
| process control.
|
| I assume that the reason we haven't seen a botox attack is
| simply because there are many easier ways to kill people
| for those inclined.
| trhway wrote:
| For bio-terrorism you can just use dirty homemade version. For
| injection (for cosmetics and valid medical reasons like spasms)
| you'd want to use clean lab-produced. So I think that is the
| reason justifying its production. The security theater around,
| beyond the basic security, is I think mainly just a part of the
| moat and the politicians having to look tough on anything
| resembling a possibility for terrorism. I think it is similar
| to say marijuana research - in half the states one can do at
| home all the research one likes, yet the the official academia
| would have to jump through impossible hoops to do any marijuana
| research.
| kjkjadksj wrote:
| Clearly yes since there hasn't been any cases of weaponized
| botox attacks. This probably goes to show old fashioned ways of
| terrorism are significantly easier or more effective for
| whatever reasons. If botox was an attractive weapon it would
| have been used already but clearly there is some Great Filter
| in place preventing that today.
| krunck wrote:
| This has only been posted fourteen times before. Eight of those
| were by the current OP, "tomte". Whats up with that, Tomte?
| pqdbr wrote:
| I visit HN daily more times I'd like to admit and I hadn't seen
| it before.
|
| If OP gets some karma every time he posts it, like he did from
| me this time, what's wrong with that?
| mschuster91 wrote:
| They are quite the prolific poster - enough to not have the
| value shown in the HN leaderboard [1] O.o
|
| [1] https://news.ycombinator.com/leaders
| klyrs wrote:
| I dunno anything about the user but they sumbit lots of stories
| every day. Just a wild-ass guess: there's a script underlying
| the submissions, which works from a finite pool of Tomte-
| curated links.
| re wrote:
| It got no traction any of the previous times, though, and has
| been posted approximately twice yearly, which isn't that
| excessive. https://hn.algolia.com/?query=inside-fort-
| botox&type=story
|
| Interestingly it looks like it this made it to the front page
| via the second-chance pool: https://news.ycombinator.com/pool
| rKarpinski wrote:
| > Interestingly it looks like it this made it to the front
| page via the second-chance pool:
| https://news.ycombinator.com/pool
|
| Why are almost all the submissions on /pool by the same
| accounts (I see ~4 Tomte)? Are they the ones curating the
| pool?
| leakybit wrote:
| The article is also old with outdated information
| nostromo wrote:
| It is curious. They seem to repeatedly submit old stories over
| and over. Some other examples:
|
| 20 CDs curated by Steve Jobs & the iPod team - submitted 20
| times over 7 years:
|
| https://hn.algolia.com/?dateRange=all&page=0&prefix=true&que...
|
| Prefix for SQLite Tmpfiles - submitted 10 times over 7 years
|
| https://hn.algolia.com/?dateRange=all&page=0&prefix=true&que...
|
| The submissions do seem to be good though. Perhaps they just
| re-read old articles occasionally and re-submit them.
| Teever wrote:
| I've got a few links that I resubmit periodically to HN.
|
| I do that because they've never gained traction and I would
| like to see discussion about them.
| AtlasBarfed wrote:
| "Allergan says Botox has more than 90 percent of the market for
| medical uses of neurotoxins and 75 percent of the market for
| cosmetic uses. "I used to say, 'How often do you see that
| distribution of market share in any category--not just drugs,
| just in anything?' "
|
| Yeah, uh, buddy, EVERYWHERE.
| kjkjadksj wrote:
| People forget that many products they find today especially at
| the grocery store are either the product of a monopoly or
| simply a cartel.
| mschuster91 wrote:
| > But a study published in 2001 in the Journal of the American
| Medical Association said that a single gram in crystallized form,
| "evenly dispersed and inhaled, would kill more than 1 million
| people."
|
| Given the potency, how does the manufacturer make sure that
| dosages are dispersed equally during manufacture?
|
| That one is a serious problem with the
| heroin/fentanyl/carfentanyl opiate family - more than a few
| people have died because their dealer didn't mix the fent with
| the heroin properly.
| kjkjadksj wrote:
| Well, they use trained chemists and not drug dealers. Its easy
| to correctly dilute a compound if you know what you are doing.
| They already do it for the fentanyl used in hospital settings
| without much risk, for example.
| cactusfrog wrote:
| They are not likely to be mixing powders and instead perform
| serial dilutions of the suspensions.
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