This whole epi-pen™ thing doesn’t add up.
It is my understanding that epinephrine in a vial costs about a buck, more plus than minus ±500% or so. We routinely give away syringes to drug users but they’re about a buck or so, similarly caveatted, and with a nice 1000% markup, the trademarked combo pre-prepared and sterile packed in a twofer used to cost about $100 bucks. Now, in the middle of anaphylactic shock is not the first time you should be learning how to draw emergency medicine into a syringe, and there’s probably a lot to be said for building a better injector being nothing like a better mousetrap.
But somehow, even though a competitor product is (still) sold despite failures of others, the patent on the epi-pen™ is somehow nearing expiration. And Mylan NV, despite somehow being a generic drug company, paid good investor money to buy the “rights” to it, and doggoneit, investors are people. So the CEO, faced with the Scylla of expiration and the Charybdis of Obamacare, deftly sailed into pharmaceutical infamy.
Okay, charging $600 for something that, without formulation change, regulatory change, or noticeable inflationary pressure used to cost $100 seems Shkrelian, if such a neologism warranted creation.
But, note that this is still $1 of drug, and even it needs to be sterile packed, so YODO.
Here’s the kicker. The current alternative, which the much hallowed Consumer Reports suggests should be mansplained to your idiot of a doctor as “Generic Adrenaclick(™)”, retails for… $606 at WalMart. Because doctors, despite being trusted to tell fibrillation from indigestion, are somehow at a loss to tell that this is a much cheaper alternative. Oh, because there’s a cheat code that gets you savvy frugal minded readers a coupon that only makes it cost $140, or some such. Reminder, that’s still $1 of medicine.
Somehow, despite having watched Dr McCoy autoinject himself into the 1930’s two years before I was born, (I’m very clever…) the concept of an injection that gives itself automatically warrants a patent not owned by Harlan Ellison’s estate and not long expired. And generic competition before the patent expires. Because without the Guardian to mansplain why the future changed, I’m kinda getting a little confused about what the terms “patented”, “branded”, “generic” and even “drug” mean.
Do you know what the Boomers are known for? Believing stupid shit. Like, those hairs on your knuckles are caused by masturbation, as well as your poor eyesight. And wealth trickles down, presumably the best wealth down Lizzie’s leg. And a standing police force armed with chemical weapons and tanks is not an invading army. And guns must be allowed, and potassium nitrate forbidden, because tyranny. Don’t get me started on iodine or pseudoephedrine. And if god catches you eating shrimp in a cotton poly blend sweater, you will burn in hellfire for eternity… but he loves you, and really needs ten percent of your pretax income. And Bryce Canyon, and the Sun, and Uranium, is only 6020 years old in less than a month (awww, let’s get them a card!)
There’s one thing that really sticks in my craw, and that’s lying fucks who double down on their lies, and other lying fucks who lie about why the first liar is lying. I can mostly accept that Clinton and Bush, first of their name, and Clinton and Bush, second of their name, represent a mediocre norm that is mostly bland and not too rapey, the way American Pie and Caddyshack are mostly bland and not too rapey. I accept that beyond one billion dollars is so hard to count, that even with half a trillion dollars in funding and computers that can WOPR down the four horsemen any time, is somehow uncountable.
But I happen to know a little something about drugs, particularly injectable drugs, having spent a good part of my life doing my best to prevent middling management on up and down from poisoning you (you know, “accidentally”). And this shit doesn’t add up.
There’s not a single media outlet that is telling you the truth. Because while I think there is universal consensus that an epi-pen™ shouldn’t be priced at either $1 or $600; a reasonable price is somewhere in the middle. But we have shackled ourselves to a system that makes reasonable pricing impossible, probably the only honest thing Mylan NV’s CEO is actually telling you. And we let Boomers write themselves increasingly larger checks in the form of tax cuts, and medicare expansion, and CEO and Congress’ pay, all the while pretending that growth is something that is Moore’s law, rather than sigmoidally, shaped.
The sigmoid function is a lot like the motion of a pendulum, and unlike the aquarian age heralds of my childhood, that pendulum is slowing down really fucking quickly of late. Before the shofar blows its final note this year, make it a mitzvah to take a good hard look at yourselves and your terrible fucking assumptions.
Here’s some suggestions.
- Your cheese will get moved. And eaten. Don’t think you can trade one inch of that movement for anyone else’s at any price. You’re either fooling yourself, or conning them.
- You are going to die. Have some fucking dignity and don’t cling. If you want to live forever or collect all the toys, genetically engineer becoming a fucking tree, because they’re the only things that have ever outlived a millennium. You’re not going to dump your consciousness into silicon that has an average life expectancy of 3–5 years, less if you use it, and liquid nitrogen is fucking cold.
- Money is meaningless. Power is meaningless. Own your shit, and apologize when it lands on someone else’s home.
- Intelligence is not infinite, and Nick Bostrom is a fucking ass. So is Elon Musk, for that matter. Computers, like “hebrews” and “slaves” and “employees” and “robots” before them, are tools. Don’t be a fucking tool.
- Reduce suffering. Acquire experience, and compassion. Go fucking well quietly into that good night, some of us are trying to sleep.
- Justice is a comic book league and a clothing store for girls. Behave better, and you’d need a lot less of it.
- Fair is a county thing in september. Eat a frito pie, and a deep fried twinkie. Henry VIII would have given his left nut for a frito pie and a fried twinkie. Appreciate that it’s going to end, and actually taste it.
- Get a buddy. Learn how to use a syringe if you can die from peanut butter, and teach your buddy how2 if they might see you blueing up. Or just accept that people’s tickets do eventually get punched- no need to rush to the exit, don’t panic.
- Cleanliness, like watering your lawn or putting an addition on your home, can be overdone. Give your immune system some practice.
10. Learn the difference between accidental confabulators and lying fucks. Again, too much is overdoing it.