By chance I just talked to someone with deeper knowledge on this and they said the current constraint is actually ramping up supply of the delivery mechanism, not the drug.
I have zero expertise on this, but would be curious if anyone knows what's special about Ozempic delivery that can't be served by a commodity syringe.
> but would be curious if anyone knows what's special about Ozempic delivery that can't be served by a commodity syringe.
They can't charge as much. That's basically it. Generic semaglutide from compounding pharmacies (which have their own issues for sure) is under $150 a month cash-pay these days.
The real issue with syringes and self administration is that the vast majority of the population are not comfortable with it and don't have the diligence to do it correctly every time, so you get under/over dosage or noncompliance.
That being said, the autoinjector format doesn't really solve that problem, it just slightly ameliorates it, in exchange for approximately 8x the cost.
So basically, 99.8% margin the maximum they can charge (at ~15-30cents/mo) or 99.5% margin at $1000/mo for a $2.5 injector? Semaglutide has been in production since 2012 and approved by the FDA since 2017. There's a real chance that specifically as a weight loss drug it's not patentable since it was in off label use before the patent was filed. That's being argued in the PTO now.
>Generic semaglutide from compounding pharmacies (which have their own issues for sure) is under $150 a month cash-pay these days.
...Is that supposed to be impressive? I assume you mean USD, so that works out to more than I pay for my food. Toronto isn't a cheap place to buy food, either.
> By chance I just talked to someone with deeper knowledge on this and they said the current constraint is actually ramping up supply of the delivery mechanism, not the drug.
The article says this:
> Surprisingly, the study found that the biggest cost in producing Ozempic is not the active medicine, called semaglutide, but the disposable pens used to inject it. They can be made for no more than $2.83 per month’s supply, the authors concluded, based on interviews with former employees and consultants to injection device manufacturers. One Ozempic pen is used weekly and lasts a month.
So while the injection pens are significantly more expensive than manufacturing the drug itself, they are still relatively cheap. So it seems to be not a major problem to strongly ramp up production here as well.
Which suggests any supply shortage will be resolved relatively quickly. Perhaps in less than a year? Then the limiting factor will not be the supply but the market price.
There are also doctors that are prescribing vials of semaglutide and commodity needles, and training patients to properly dose up and administer the drug via a standard needle. There's more to it than the auto-injector pens, but not that much more to it. And it does bring costs down, which is important to some. Alternatively, you can just go to the doctor's office weekly and have a nurse there do a traditional injection for you (doesn't help as much with costs, but does bypass the auto-injector shortage).
I agree needles can alleviate the Ozempic shortage, though only if Novo Nordisk decides to sell Ozempic without pens. But not including pens will hardly reduce the price of Ozempic anyway, because pens cost basically nothing (estimated USD 2.83 for a month) compared to the full price of the drug.
The marginal cost to produce the few milligrams of the drug that goes into the pens is much much less than $2.83; it's on the order of cents. Plus, scaling up manufacturing of the drug is easier than scaling up manufacturing of the auto-injectors (which have a decent number of parts in them). The auto-injectors really are the bottleneck, and manufacturing of them so far has not been able to be ramped up quickly enough.
"hims" is selling Compound Pharmacy drugs, which will be made illegal soon. Soon your options will be $1000-1500/month from the two big drug companies.
They're meant to have a vial-needle version, but it is $600/month and you can only do it for up to 5-months and a low max dose. So it isn't a real program, but rather a way to avoid critique from legislators.
It’s “legal” because of the lack of supply in critical medications so the FDA gives a variance to allow compound pharmacies to produce/sell critical medications until supply issues are resolved.
I wonder if a more workable arrangement would stipulate that indigenous people are exempt from these regulations only when the work and management of a project is also designed and implemented by Indigenous people.
That would seemingly circumvent this loophole where a large, private corporation run by white canadians effectively uses the indigenous people as a loophole, cutting them in to circumvent regulations.
Wouldn't really help e.g. overfishing issues but seems directionally better.
Would be pretty easy for a motivated corporation to set up a branch composed entirely of those indigenous people for the purpose, or to form a partnership with a company of those indigenous people.
Appreciate you fighting the good fight here, but this one is actually a valid point. If real GDP growth is at 4.9% while the government deficit is at 5.3% of GDP, (in most cases) GDP isn't actually growing organically.
That's not really how it works. US deficit spending isn't producing goods or services. It can motive the production thereof, but it doesn't change the fact that actual things were produced and then purchased using that money.
If people took 100% of the government deficit spending and left it in a savings account, it wouldn't count towards GDP. But clearly that's not happening.
No, it is really how it works, (as I caveated) most of the time.
I don't understand what you're arguing here. Is your claim that most of that government deficit was not spent in the domestic economy (therefore stimulating GDP growth)?
The 8% deficit listed above _is_ a percentage of total GDP of the whole country (although the Fed has it at only 5.3%). The numbers are directly comparable.
One is a rate of growth and the other is a rate of spending. It would be like comparing that you spend 8% of your income on food and that you got a 4% raise this year. The two numbers have nothing to do with each other other than using the same unit.
No, that's a bad analogy. It's more like I borrowed 8% of my annual income this year, and then bought 4% more than last year. If I hadn't borrowed all that money, I wouldn't have been able to buy that much. It's both intuitively obvious and empirically demonstrable that government deficits stimulates economic growth in the immediate term, since most government expenditure happens in the domestic economy.
Because Germany has "make-work" policies; if you want a job, you can get one repaving roads, cleaning up trash, or otherwise maintaining public infrastructure. My American uncle sneered at this "work for the boys" attitude, but as a lifelong US resident, I can't help but envy that solution.
I'd be curious to know how much the ~25pt asian-white SAT score gap is explained by ALDC students. In other words-- how much harder is it for a non-ALDC asian student to get into Harvard than a non-ALDC white student?
The savings from turning household heat down during the day aren't trivial, but they aren't very large either. You can keep your heat ~10-20°F lower during the day when you're not home and save energy, but then additional energy is needed later in the day to get the temperature back up. Typical estimates are that this lowers gas or oil consumption by 10-15%, and only in the colder months. Certainly dwarfed by energy spent commuting, on average.
Your comment on the second+ order effects is much more interesting, but also much more uncertain.
I have zero expertise on this, but would be curious if anyone knows what's special about Ozempic delivery that can't be served by a commodity syringe.