# State of CA to make insulin **URL:** \ **Category:** Miscellaneous and Personal Stuff I Must Share\ **Created:** [July 7, 2022, 8:25pm UTC](https://boards.straightdope.com/t/state-of-ca-to-make-insulin/967577 "2022-07-07T20:25:16Z")\ **Posts on this page:** 20\ **Page:** 2
**Author:** ![Dr.Winston\_OBoogie](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dr.winston_oboogie/32/2945_2.png) [@Dr.Winston\_OBoogie](https://boards.straightdope.com/u/Dr.Winston_OBoogie)\ **Post date:** [July 8, 2022, 9:08pm UTC](https://boards.straightdope.com/t/state-of-ca-to-make-insulin/967577/21 "2022-07-08T21:08:15Z")
> [@puzzlegal](#): > > There has also been a shift away from cheaper human insulin to more expensive insulin analogs I wonder how much this has to do with Pharma reps visiting doctors… ---
**Author:** ![Senegoid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/senegoid/32/6606_2.png) [@Senegoid](https://boards.straightdope.com/u/Senegoid)\ **Post date:** [July 8, 2022, 9:09pm UTC](https://boards.straightdope.com/t/state-of-ca-to-make-insulin/967577/22 "2022-07-08T21:09:59Z")
> [@SmartAleq](#): > > Fun fact–there are things called “compounding pharmacies” Good fucking luck finding one when you need. AFAIK, “compounding pharmacies” are mostly small one-off independent pharmacists, most of whom are driven out of business by the major chains, none of which do compounding. Maybe there are still a few around, if you can find them. ---
**Author:** ![Senegoid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/senegoid/32/6606_2.png) [@Senegoid](https://boards.straightdope.com/u/Senegoid)\ **Post date:** [July 8, 2022, 9:14pm UTC](https://boards.straightdope.com/t/state-of-ca-to-make-insulin/967577/23 "2022-07-08T21:14:20Z")
> [@VOW](#): > > I remember having a tantrum in the pharmacy when the cost of my asthma inhaler went up. It was the same damned medication! But the Federal government required a different propellant to be used. No shit Sherlock! I had an asthma inhaler that cost me about $90 (that was just the co-pay) for a three month supply. Well, surprise, surprise! One day I called for a three-month refill, and when I got it, the co-pay was $600 (yes, that was just the co-pay)! Which they went ahead and billed to my credit card, with no advance notice. (This had nothing to do, AFAIK, with any change of propellant.) My doctor found a different inhaler that seems to work as well, which I now pay $90 a month for. ---
**Author:** ![SmartAleq](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/smartaleq/32/163_2.png) [@SmartAleq](https://boards.straightdope.com/u/SmartAleq)\ **Post date:** [July 8, 2022, 9:16pm UTC](https://boards.straightdope.com/t/state-of-ca-to-make-insulin/967577/24 "2022-07-08T21:16:46Z")
I actually know where one lives, it’s on Broadway around NE 25th in Portland OR. Thing is, yes, most are small and don’t have much scale BUT can you imagine what would happen if every compounding pharmacy in California suddenly got a huge influx of state cash to boost their efforts? Think that might make a dent in the big pharma companies bottom lines? They have the knowledge, all they need is the resources and demand to rocket them into the stratosphere–and California IS the sixth (or maybe fifth) largest economy in the WORLD. If California decides to take on a problem and is serious about it, they can make a gigantic wave of influence. ---
**Author:** ![Senegoid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/senegoid/32/6606_2.png) [@Senegoid](https://boards.straightdope.com/u/Senegoid)\ **Post date:** [July 8, 2022, 9:19pm UTC](https://boards.straightdope.com/t/state-of-ca-to-make-insulin/967577/25 "2022-07-08T21:19:36Z")
> [@SmartAleq](#): > > Thing is, yes, most are small and don’t have much scale BUT imagine what would happen if every compounding pharmacy in California suddenly got a huge influx of state cash to boost their efforts? My guess would be, if there was some real money in it, then the big chain pharmacies would get into the compounding business. The small independent pharmacy operators would still be run out of business, as all small independent business operators are when they try to compete with the Big Boys. ---
**Author:** ![SmartAleq](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/smartaleq/32/163_2.png) [@SmartAleq](https://boards.straightdope.com/u/SmartAleq)\ **Post date:** [July 8, 2022, 9:25pm UTC](https://boards.straightdope.com/t/state-of-ca-to-make-insulin/967577/26 "2022-07-08T21:25:22Z")
Depends on how the state money was dispensed and structured. There’s no actual rule that says everybody who wants it can jump onto a program–the state could make a carve out that disallows the big chains to hop on the bandwagon for a long enough period to allow the compounding pharmacies (who, after all, have been at the forefront of helping patients get the exact formulations they need at a price they can manage) to get enough of an advantage to keep them on top of that particular food chain. With SCROTUS busily dismantling federal control of just about anything it’s going to be vanishingly difficult to bring restraint of trade or monopoly suits against the state, and if California keeps all the legal shit in state courts then federal overturn of its programs will become less and less successful. ---
**Author:** ![Joey\_P](https://avatars.discourse-cdn.com/v4/letter/j/919ad9/32.png) [@Joey\_P](https://boards.straightdope.com/u/Joey_P)\ **Post date:** [July 8, 2022, 9:29pm UTC](https://boards.straightdope.com/t/state-of-ca-to-make-insulin/967577/27 "2022-07-08T21:29:56Z")
> [@Senegoid](#): > > Good fucking luck finding one when you need. AFAIK, “compounding pharmacies” are mostly small one-off independent pharmacists, most of whom are driven out of business by the major chains, none of which do compounding. > **[Pharmacy Compounding Services](https://www.walgreens.com/topic/pharmacy/compounding.jsp)** > > Walgreens. Trusted Since 1901. > We offer basic medication compounding at all neighborhood Walgreens pharmacies. We also offer more complex compounding services at some of our pharmacies ---
**Author:** ![panache45](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/panache45/32/64_2.png) [@panache45](https://boards.straightdope.com/u/panache45)\ **Post date:** [July 9, 2022, 6:22am UTC](https://boards.straightdope.com/t/state-of-ca-to-make-insulin/967577/28 "2022-07-09T06:22:32Z")
> [@puzzlegal](#): > > No one wants to take more than they need Except people intent on committing suicide. > [@SmartAleq](#): > > WebMD says a range of 80-130 units per day is a good starting point. I have to take 300 units of two different types of insulin per day. This would be unbearably expensive without my insurance. ---
**Author:** ![Smapti](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/smapti/32/17938_2.png) [@Smapti](https://boards.straightdope.com/u/Smapti)\ **Post date:** [July 9, 2022, 6:46am UTC](https://boards.straightdope.com/t/state-of-ca-to-make-insulin/967577/29 "2022-07-09T06:46:19Z")
> [@VOW](#): > > I remember having a tantrum in the pharmacy when the cost of my asthma inhaler went up. It was the same damned medication! But the Federal government required a different propellant to be used. The drug manufacturer decided “different stuff in the inhaler = new formulation = higher price.” Is that what happened? I’m still salty that my Flovent went from being fully covered by insurance years ago to costing me $80 for a 2-month supply. ---
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [July 9, 2022, 7:21am UTC](https://boards.straightdope.com/t/state-of-ca-to-make-insulin/967577/30 "2022-07-09T07:21:26Z")
Yep. The propellants changed to protect the ozone layer. All the manufacturers used it as an excuse to increase prices. And if you think that’s bad, check out what happened to the price of epi-pens. Without insurance people are really screwed because the costs involved get to be prohibitive very quickly. ---
**Author:** ![puzzlegal](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/puzzlegal/32/3827_2.png) [@puzzlegal](https://boards.straightdope.com/u/puzzlegal)\ **Post date:** [July 9, 2022, 11:41am UTC](https://boards.straightdope.com/t/state-of-ca-to-make-insulin/967577/31 "2022-07-09T11:41:42Z")
The price of epipens went up because the manufacturer decided they could make more money at a higher price point. They might have misjudged, because some competition did spring up as a result. Or maybe it was worth it to them, and their profits are up. ---
**Author:** ![Northern\_Piper](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/northern_piper/32/5304_2.png) [@Northern\_Piper](https://boards.straightdope.com/u/Northern_Piper)\ **Post date:** [July 9, 2022, 4:46pm UTC](https://boards.straightdope.com/t/state-of-ca-to-make-insulin/967577/32 "2022-07-09T16:46:23Z")
> [@gnoitall](#): > > I’d speculate that the accusation would be something analogous to “dumping”, saturating a market with a commodity at a price point that makes all other seller’s offerings uncompetitive at the “required” profitable price. Do US competition laws apply to states when they provide a public service? ---
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [July 9, 2022, 7:36pm UTC](https://boards.straightdope.com/t/state-of-ca-to-make-insulin/967577/33 "2022-07-09T19:36:24Z")
> [@puzzlegal](#): > > The price of epipens went up because the manufacturer decided they could make more money at a higher price point. They might have misjudged, because some competition did spring up as a result. Or maybe it was worth it to them, and their profits are up. I’m sure all of that is of great comfort to those people _ **who might actually DIE** _ if they can’t afford to purchase one, but then go into allergic shock. But let’s keep worshiping at the altar of The Free Market regardless of the human carnage that might result. ---
**Author:** ![puzzlegal](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/puzzlegal/32/3827_2.png) [@puzzlegal](https://boards.straightdope.com/u/puzzlegal)\ **Post date:** [July 9, 2022, 8:50pm UTC](https://boards.straightdope.com/t/state-of-ca-to-make-insulin/967577/34 "2022-07-09T20:50:01Z")
That’s true of lots of drugs, not just epi pens. It’s among the reasons our entire health care system is broken. ---
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [July 9, 2022, 9:23pm UTC](https://boards.straightdope.com/t/state-of-ca-to-make-insulin/967577/35 "2022-07-09T21:23:12Z")
True, that. So far we’ve had a couple examples, I’m sure we can all go on and on about this. ---
**Author:** ![ASL\_v2.0](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/asl_v2.0/32/3525_2.png) [@ASL\_v2.0](https://boards.straightdope.com/u/ASL_v2.0)\ **Post date:** [July 9, 2022, 9:40pm UTC](https://boards.straightdope.com/t/state-of-ca-to-make-insulin/967577/36 "2022-07-09T21:40:37Z")
> [@Northern\_Piper](#): > > Do US competition laws apply to states when they provide a public service? Well, there is: > **[Reeves, Inc. v. Stake](https://en.wikipedia.org/wiki/Reeves,_Inc._v._Stake)** > > Reeves, Inc. v. Stake, 447 U.S. 429 (1980), was a United States Supreme Court case in which the Court held that individual states, when acting as producers or suppliers rather than as market regulators, may discriminate preferentially against out-of-state residents. This "market participant" doctrine is an exception to the so-called negative commerce clause, which ordinarily deems state regulations invalid where they discriminate against interstate commerce in favor of intrastate commerce f In ... Which might be taken to stand for the proposition that states can discriminate against out of state residents when acting in a non-regulatory producer/supplier role (and so, might fairly make their product available to state residents at a discount, to avoid the risk that all the product meant to improve the lives of residents might be scooped up by interstate buyers and sold elsewhere for a huge profit). But of course that was a 5-4 SCOTUS decision forty years ago. Who knows what that’s worth now, seeing as precedent doesn’t matter and this might hurt profits for some billionaires. ---
**Author:** ![SmartAleq](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/smartaleq/32/163_2.png) [@SmartAleq](https://boards.straightdope.com/u/SmartAleq)\ **Post date:** [July 9, 2022, 11:25pm UTC](https://boards.straightdope.com/t/state-of-ca-to-make-insulin/967577/37 "2022-07-09T23:25:24Z")
There’s a meme floating around that basically states that the three things that should NEVER be privatized are healthcare, prisons and schools because those institutions translate exactly to life, liberty and the pursuit of happiness and are therefore expected to be under the exclusive purview of government. I think that’s a pretty reasonable take on our current situation where we can see that the fetish of privatization of public goods for the sake of private profits has proven to be an absolute, utter, abysmal failure. I think it’s way past time to rake all this back into the umbrella of government and put some smart people to work fixing this shit like right fucking now. ---
**Author:** ![Hari\_Seldon](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/hari_seldon/32/5173_2.png) [@Hari\_Seldon](https://boards.straightdope.com/u/Hari_Seldon)\ **Post date:** [July 9, 2022, 11:51pm UTC](https://boards.straightdope.com/t/state-of-ca-to-make-insulin/967577/38 "2022-07-09T23:51:55Z")
Good luck with that. Recall how Obama got creamed in the 2010 election because he actually tried, in a limited way, to do something about it. ---
**Author:** ![thorny\_locust](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/thorny_locust/32/431_2.png) [@thorny\_locust](https://boards.straightdope.com/u/thorny_locust)\ **Post date:** [July 10, 2022, 12:01am UTC](https://boards.straightdope.com/t/state-of-ca-to-make-insulin/967577/39 "2022-07-10T00:01:46Z")
> [@Northern\_Piper](#): > > > [@gnoitall](#): > > > > I’d speculate that the accusation would be something analogous to “dumping”, saturating a market with a commodity at a price point that makes all other seller’s offerings uncompetitive at the “required” profitable price. > > Do US competition laws apply to states when they provide a public service? Don’t those only apply, if they apply at all, to selling below the cost of production? And I’m not sure that in general even that’s illegal in the USA. Stores routinely carry “loss leaders”, after all. ---
**Author:** ![SmartAleq](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/smartaleq/32/163_2.png) [@SmartAleq](https://boards.straightdope.com/u/SmartAleq)\ **Post date:** [July 10, 2022, 12:53am UTC](https://boards.straightdope.com/t/state-of-ca-to-make-insulin/967577/40 "2022-07-10T00:53:37Z")
Y’know what? Either people wake the fuck up and force change or we’re all gonna die screaming. We’re at that tipping point and quite frankly I’m tired of endlessly putting my energy into learned helplessness and faux cynicism. Sure, that might score some cool points with people I personally have zero respect for but it’s obvious that quite a lot of people would rather make doom pronouncements than to go out on a limb and declare they want more positive outcomes and tangible change. That’s the choice we all have and I know which way I’m leaning. I’m a Wiccan, and a firm and basic tenet of my belief system is “as below, so above.” Creating small pockets of positive change impetus and encouraging them in others does much more to help the world than to continually tear people down for their optimism. But tearing down, making fun and mocking people for their hope is definitely more fashionable. [Previous page](https://boards.straightdope.com/t/state-of-ca-to-make-insulin/967577.md?page=1) [Next page](https://boards.straightdope.com/t/state-of-ca-to-make-insulin/967577.md?page=3)