Mylan and epi pen

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Pooh & Annie

Pooh & Annie

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People generally go into business to make money.

It must be an amazing feeling for these heroes when they incidentally get to save lives...

Although I wonder if it takes a certain kind of businessperson to go into pharma. Saving or improving lives doesn't really register as a positive OR negative. Except in the sense that you know people HAVE to buy your product to stay alive, which creates all kinds of opportunities for you and your investors.
http://www.nbcnews.com/business/con...elves-raises-they-hiked-epipen-prices-n636591
 
Pooh & Annie said:
People generally go into business to make money.

It must be an amazing feeling for these heroes when they incidentally get to save lives...

Although I wonder if it takes a certain kind of businessperson to go into pharma. Saving or improving lives doesn't really register as a positive OR negative. Except in the sense that you know people HAVE to buy your product to stay alive, which creates all kinds of opportunities for you and your investors.
http://www.nbcnews.com/business/con...elves-raises-they-hiked-epipen-prices-n636591
Click to expand...
I normally give drug companies a pass on most of their crap because its rarely for unique and important drugs (who cares if the third me-too diabetes drug is $800/month). This is different though.

I've started giving out vials of epinephrine with written instructions (and a demo) to patients. Best price I've been able to find is $600 for a 2 pack. I can give a 1mg 1:1000 vial (so you take 0.3ml when drawing it up) for $4.
 
I'm kinda curious what part of EpiPen is protected by patent. I mean the epinephrine is obviously not patented. Can nobody else not make an auto-injecting device to deliver subcutaneous epi?
 
Mman said:
I'm kinda curious what part of EpiPen is protected by patent. I mean the epinephrine is obviously not patented. Can nobody else not make an auto-injecting device to deliver subcutaneous epi?
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Think they say it's not the drug itself but the delivery system is much easier.

Don't like the price

But why can super lawyers charge $800-1000/hr?

I had some legal stuff to tie up (non-criminal!). Still cost me $400/hr.
 
aneftp said:
Think they say it's not the drug itself but the delivery system is much easier.
Click to expand...

I just don't really get it. I mean couldn't someone just sell a TB syringe with 0.3 ml of epi in it that has like a safety tear away you have to pull off before the plunger is active? I mean the epi pen is a spring loaded syringe with a needle on the end and a button to push. I'm not a patent lawyer, but wouldn't seem that hard to work around.
 
pgg said:
Auto injectors are not new technology.

I don't get it.
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It's gotta be the patent. Weird things like RIM's blackberry delivery system cost them 600 million in litigation settlement.

Same with Amazon one click tech they impinged one patent squatter.

Pharma companies face patent issues all the time. The cost/benefit for getting something new onto the market with the old drug may not be worth it's R and D
 
This is crony capitalism at it's worst. Mylan bought the EpiPen and increased it's spending on lobbying efforts. Now your tax dollars are paying this Heather Bresch's millions in compensation. The government is giving grants to states that require schools to stock the EpiPen. We pay more taxes and the mega-rich find ways to make money off of it.

This company or CEO didn't create anything or discover anything. There was no R&D. They bought the rights to the EpiPen then spent a lot of money on marketing and lobbying.

Heather Bresch is no different than "Pharma Bro" who was denounced by the media a few months ago. She is also the daughter of a U.S. Senator. The problem is, if you come up with a catchy name to describe her, like they did with Martin Shkreli, you will be labeled a misogynist.
 
Mman said:
I'm kinda curious what part of EpiPen is protected by patent. I mean the epinephrine is obviously not patented. Can nobody else not make an auto-injecting device to deliver subcutaneous epi?
Click to expand...
There is another off brand auto injector - a 2 pack of that is a mere $400
 
Mylan just announced a 400% increase in price for their generic Reglan:

metoclopramide-mylan-10mg-20cpr.jpg
 
aneftp said:
It's gotta be the patent. Weird things like RIM's blackberry delivery system cost them 600 million in litigation settlement.

Same with Amazon one click tech they impinged one patent squatter.

Pharma companies face patent issues all the time. The cost/benefit for getting something new onto the market with the old drug may not be worth it's R and D
Click to expand...

I get that, but the thing is the drug is so old and generic that the patent has to be the injection side of it. But something like that is so simple that I find it hard to believe you could patent every effective way to do it.
 
GravelRider said:
This is crony capitalism at it's worst. Mylan bought the EpiPen and increased it's spending on lobbying efforts. Now your tax dollars are paying this Heather Bresch's millions in compensation. The government is giving grants to states that require schools to stock the EpiPen. We pay more taxes and the mega-rich find ways to make money off of it.

This company or CEO didn't create anything or discover anything. There was no R&D. They bought the rights to the EpiPen then spent a lot of money on marketing and lobbying.

Heather Bresch is no different than "Pharma Bro" who was denounced by the media a few months ago. She is also the daughter of a U.S. Senator. The problem is, if you come up with a catchy name to describe her, like they did with Martin Shkreli, you will be labeled a misogynist.
Click to expand...
Did you see the part where she got an MBA without completing her requirements right after Mylan gave her business school 20 mil?

All these raises for the execs. Was it because they're brilliant, and developed new marketing strategies or shifted development resources here or there with amazing results?

Nope. She got her 600% raise and the other suits got their millions because someone thought to-- wait for it--jack up the price every other quarter for the product that accounts for 40% of the company's profits! That's brilliance that highly educated business exec types can offer you. No wonder they got big raises.

I always complain about Hollywood dbags getting millions to remake movies that have already be done or make mindless sequels. This is a great example of the business equivalent. Except much worse. And much more profitable.
 
The problem with all of this is that the healthcare system is a giant bubble in the making. Our economy simply cannot afford these prices much longer. Healthcare is the #1 cause of bankruptcy in America. We've seen stagnant growth in our economy because of the cost of healthcare. People's wages have not kept up with inflation for the the past 20-30 years. However, the total compensation per employee has increased by a huge amount in the form of health insurance premiums. Healthcare is holding back the growth in our entire economy. It is a bubble that will cause far worse implications than the real estate bubble when it finally collapses. These healthcare costs are simply unsustainable.
 
The US is allowing drug companies to make patients of all socioeconomic classes to decide between everyday necessities and their life or the lives of their child. Epipen prices have risen from $75 apiece to $300 each since 1995, and is now only available in 2-packs, therefore $600 each at the very minimum. The epinephrine in each syringe carries with it a 9-12 month expiration date, therefore it's upwards of $600 per year for someone with a life threatening allergy. Only an 800% price increase. I am not debating delivery system or drug cost, but as an EpiPen carrying person since 1995, this is a gross misconduct by Mylan.
 
GravelRider said:
The problem with all of this is that the healthcare system is a giant bubble in the making. Our economy simply cannot afford these prices much longer. Healthcare is the #1 cause of bankruptcy in America. We've seen stagnant growth in our economy because of the cost of healthcare. People's wages have not kept up with inflation for the the past 20-30 years. However, the total compensation per employee has increased by a huge amount in the form of health insurance premiums. Healthcare is holding back the growth in our entire economy. It is a bubble that will cause far worse implications than the real estate bubble when it finally collapses. These healthcare costs are simply unsustainable.
Click to expand...

Healthcare is an ever increasing part of the "entire economy". You want a Camry or a hip? You want a new kitchen for your house or repair the foundation? Sometimes you have to spend for things that aren't glittery.
 
GravelRider said:
The problem with all of this is that the healthcare system is a giant bubble in the making. Our economy simply cannot afford these prices much longer. Healthcare is the #1 cause of bankruptcy in America. We've seen stagnant growth in our economy because of the cost of healthcare. People's wages have not kept up with inflation for the the past 20-30 years. However, the total compensation per employee has increased by a huge amount in the form of health insurance premiums. Healthcare is holding back the growth in our entire economy. It is a bubble that will cause far worse implications than the real estate bubble when it finally collapses. These healthcare costs are simply unsustainable.
Click to expand...
You could have written that in 2009 or earlier (and many did). Healthcare is a bubble but not all bubbles are the same. If this bubble "popped", it wouldn't have the same effect as the 2008 collapse. The amount of leverage in the housing market when it burst created an insurmountable amount of unpaid debt. There's still a large enough part of the population paying into healthcare so it wouldn't burst like 08.
But I'm sure we'll figure it all out. We are a nation of problem solvers. Our gov't is smart. We think outside the box. Like "Mexico will pay for the wall".
 
nimbus said:
Healthcare is an ever increasing part of the "entire economy". You want a Camry or a hip? You want a new kitchen for your house or repair the foundation? Sometimes you have to spend for things that aren't glittery.
Click to expand...
Yes you do have to pay for things that don't glitter, but that doesn't mean you should be held hostage by companies that behave like the mafia and buy politicians and laws.
 
New and expanding regulations for pharmaceutical manufacturers, new and expanding costs of employing individuals manufacturing the products, and ever expanding legal costs for any producer of any product that actually saves lives. Why are people posting on this subject so incredibly comfortable achieving an annual salary in excess of $250K (low end for anesthesiologists), but complain about a manufacturer of product, enabling anesthesiologists to actually safely practice their profession, charging enough money to actually pay decent salaries to their employees? These companies have armies of engineers, Phd scientists, manufacturing specialists, an ever expanding clinical regulatory staff, along with the numerous other employees necessary to make any company function. Plus, they are required to spend millions, millions of dollars on legal costs completely unrelated to normal manufacturing and distribution costs. And of course, how many of you, deriding the profit making of these companies, will intentionally put your retirement savings into a company that is intentionally not for profit? I get the emotional appeal of your arguments, but I hope that your clinical practice is not so emotionally based and instead relies on practical evidence and reality.
 
gtb said:
New and expanding regulations for pharmaceutical manufacturers, new and expanding costs of employing individuals manufacturing the products, and ever expanding legal costs for any producer of any product that actually saves lives. Why are people posting on this subject so incredibly comfortable achieving an annual salary in excess of $250K (low end for anesthesiologists), but complain about a manufacturer of product, enabling anesthesiologists to actually safely practice their profession, charging enough money to actually pay decent salaries to their employees? These companies have armies of engineers, Phd scientists, manufacturing specialists, an ever expanding clinical regulatory staff, along with the numerous other employees necessary to make any company function. Plus, they are required to spend millions, millions of dollars on legal costs completely unrelated to normal manufacturing and distribution costs. And of course, how many of you, deriding the profit making of these companies, will intentionally put your retirement savings into a company that is intentionally not for profit? I get the emotional appeal of your arguments, but I hope that your clinical practice is not so emotionally based and instead relies on practical evidence and reality.
Click to expand...

That money is not going to the engineers, scientists, etc... That money is going to executives. This company didn't do research and development. They didn't risk anything by researching a novel new drug for decades. They bought the rights and then basically bought a couple of politicians to gain favorable laws and grants that allowed these executives to get huge profits. This did not benefit society in anyway. If anything, it hurts society. Healthcare costs continue to increase and those costs are bankrupting people and adding to national debt. Companies like this are parasites. Comparing a 250k salary of an anesthesiologist does not even come close to being a legitimate comparison to the executive compensation at these companies.
 
gtb said:
New and expanding regulations for pharmaceutical manufacturers, new and expanding costs of employing individuals manufacturing the products, and ever expanding legal costs for any producer of any product that actually saves lives. Why are people posting on this subject so incredibly comfortable achieving an annual salary in excess of $250K (low end for anesthesiologists), but complain about a manufacturer of product, enabling anesthesiologists to actually safely practice their profession, charging enough money to actually pay decent salaries to their employees? These companies have armies of engineers, Phd scientists, manufacturing specialists, an ever expanding clinical regulatory staff, along with the numerous other employees necessary to make any company function. Plus, they are required to spend millions, millions of dollars on legal costs completely unrelated to normal manufacturing and distribution costs. And of course, how many of you, deriding the profit making of these companies, will intentionally put your retirement savings into a company that is intentionally not for profit? I get the emotional appeal of your arguments, but I hope that your clinical practice is not so emotionally based and instead relies on practical evidence and reality.
Click to expand...

Many parents have been struggling to afford Epi pens for their children who may need it not to die, now the cost is more than doubled. It's an abomination and has nothing to do with my salary or investment choices.
 
gtb said:
New and expanding regulations for pharmaceutical manufacturers, new and expanding costs of employing individuals manufacturing the products, and ever expanding legal costs for any producer of any product that actually saves lives. Why are people posting on this subject so incredibly comfortable achieving an annual salary in excess of $250K (low end for anesthesiologists), but complain about a manufacturer of product, enabling anesthesiologists to actually safely practice their profession, charging enough money to actually pay decent salaries to their employees? These companies have armies of engineers, Phd scientists, manufacturing specialists, an ever expanding clinical regulatory staff, along with the numerous other employees necessary to make any company function. Plus, they are required to spend millions, millions of dollars on legal costs completely unrelated to normal manufacturing and distribution costs. And of course, how many of you, deriding the profit making of these companies, will intentionally put your retirement savings into a company that is intentionally not for profit? I get the emotional appeal of your arguments, but I hope that your clinical practice is not so emotionally based and instead relies on practical evidence and reality.
Click to expand...
You clearly have no understanding of the problem - or you work for Mylan.
 
jwk said:
You clearly have no understanding of the problem - or you work for Mylan.
Click to expand...

No, I am a fellowship-trained physician working as a clinical anesthesiologist. And reading these posts and replies to mine, makes it increasingly clear why the public and our surgical colleagues, so very often, treat us like nurses. No offense intended to JWK.
 
Planktonmd said:
Yes you do have to pay for things that don't glitter, but that doesn't mean you should be held hostage by companies that behave like the mafia and buy politicians and laws.
Click to expand...


I'm just playing devil's (literally) advocate. We all know the actual manufacturing costs for epi pens are not high. But they are lifesaving drugs and have value. Similarly my own professional services are usually pretty low effort and low stress on my part. Am I worth the cost to my patients? Who decides? And who else advocates for political influence? Asapac?
 
I was just informed that our ephedrine (Akorn pharma) now costs $500 for a 10-pack. :boom:
 
gtb said:
No, I am a fellowship-trained physician working as a clinical anesthesiologist. And reading these posts and replies to mine, makes it increasingly clear why the public and our surgical colleagues, so very often, treat us like nurses. No offense intended to JWK.
Click to expand...

Explain please. How is outrage over what amounts to bribery to crooked politicians in order to give a CEO a $10 million raise while the majority of Americans struggle have anything to do with being treated like nurses? I'm all for making money and rewarding hard work, but it has to be done within the confines of being a good citizen.
 
gtb said:
No, I am a fellowship-trained physician working as a clinical anesthesiologist. And reading these posts and replies to mine, makes it increasingly clear why the public and our surgical colleagues, so very often, treat us like nurses. No offense intended to JWK.
Click to expand...
:thinking:

So... Doctor, You think it's OK for these companies to sell an old drug that they just acquired for 10 to 20 times the previous price simply because people will die if they can't get it?
And at the same time sell that drug much cheaper in other parts of the world simply because these other countries have real regulations and politicians who are less corrupt than ours???
And... Doctor, in your opinion to be seen as doctors not nurses we need to be able to ignore the injustice of the current healthcare system and help those criminal entities known as the pharmaceutical companies f*ck the patients?
 
Last edited:
Planktonmd said:
:thinking:

So... Doctor, You think it's OK for these companies to sell an old drug that they just acquired for 10 to 20 times the previous price simply because people will die if they can't get it?
And at the same time sell that drug much cheaper in other parts of the world simply because these other countries have real regulations and politicians who are less corrupt than ours???
And... Doctor, in your opinion to be seen as doctors not nurses we need to be able to ignore the injustice of the current healthcare system and help those criminal entities known as the pharmaceutical companies f*ck the patients?
Click to expand...
 
What I believe is irrelevant to the reality of pharmaceutical and device pricing. I do believe that research, development, manufacturing, distribution, and day-to-day operations are expensive. I do believe that the complexities of operating a pharmaceutical company are far beyond my education, experience, and talent. I do believe that individuals, who have the acumen to keep a company solvent are rare, and that their contribution to providing hundreds and thousands of jobs is at least as relevant to society as anything, any single anesthesiologist contributes. I do believe that without the pharmaceuticals and devices we use in day-to-day clinical practice, modern, safe anesthesiology is not possible. I do believe that medicines like Harvoni for hepatitis C, and devices like pacemakers and ICDs would never have been developed without the motive of significant profit. I do believe many physicians incorrectly believe that they are personally responsible for the miracles of modern drugs and devices they use on a daily basis. I do believe that snarky, arrogant, uninformed responses like yours, are the single reason that 99.85% of board-certified anesthesiologists around the world, never bother to visit this particular website. And finally, I believe that many of those posting on this particular topic, give credence to the opinion of so many people that, "doctors are stupid."
 
gtb said:
What I believe is irrelevant to the reality of pharmaceutical and device pricing. I do believe that research, development, manufacturing, distribution, and day-to-day operations are expensive. I do believe that the complexities of operating a pharmaceutical company are far beyond my education, experience, and talent. I do believe that individuals, who have the acumen to keep a company solvent are rare, and that their contribution to providing hundreds and thousands of jobs is at least as relevant to society as anything, any single anesthesiologist contributes. I do believe that without the pharmaceuticals and devices we use in day-to-day clinical practice, modern, safe anesthesiology is not possible. I do believe that medicines like Harvoni for hepatitis C, and devices like pacemakers and ICDs would never have been developed without the motive of significant profit. I do believe many physicians incorrectly believe that they are personally responsible for the miracles of modern drugs and devices they use on a daily basis. I do believe that snarky, arrogant, uninformed responses like yours, are the single reason that 99.85% of board-certified anesthesiologists around the world, never bother to visit this particular website. And finally, I believe that many of those posting on this particular topic, give credence to the opinion of so many people that, "doctors are stupid."
Click to expand...
Do you honestly not see the difference between Harvoni, the first ICDs, and an epi pen? No one objects to making money on a new product. Epi pens aren't new though, they are probably older than I am. Buying the patent for an old drug and then raising the price by an order of magnitude doesn't seem a problem to you? Mylan didn't do anything other than market this drug, and not even to doctors or patients (we know its a good drug) but to politicians to convince them that every school in American needs one.
 
gtb said:
What I believe is irrelevant to the reality of pharmaceutical and device pricing. I do believe that research, development, manufacturing, distribution, and day-to-day operations are expensive. I do believe that the complexities of operating a pharmaceutical company are far beyond my education, experience, and talent. I do believe that individuals, who have the acumen to keep a company solvent are rare, and that their contribution to providing hundreds and thousands of jobs is at least as relevant to society as anything, any single anesthesiologist contributes. I do believe that without the pharmaceuticals and devices we use in day-to-day clinical practice, modern, safe anesthesiology is not possible. I do believe that medicines like Harvoni for hepatitis C, and devices like pacemakers and ICDs would never have been developed without the motive of significant profit. I do believe many physicians incorrectly believe that they are personally responsible for the miracles of modern drugs and devices they use on a daily basis. I do believe that snarky, arrogant, uninformed responses like yours, are the single reason that 99.85% of board-certified anesthesiologists around the world, never bother to visit this particular website. And finally, I believe that many of those posting on this particular topic, give credence to the opinion of so many people that, "doctors are stupid."
Click to expand...
And I believe that you should not have stopped taking your pills!
 
VA Hopeful Dr said:
Do you honestly not see the difference between Harvoni, the first ICDs, and an epi pen? No one objects to making money on a new product. Epi pens aren't new though, they are probably older than I am. Buying the patent for an old drug and then raising the price by an order of magnitude doesn't seem a problem to you? Mylan didn't do anything other than market this drug, and not even to doctors or patients (we know its a good drug) but to politicians to convince them that every school in American needs one.
Click to expand...

I have no idea what the costs of an company acquisition is, but from my limited reading, much of the cost involves getting the federal government to approve the merger or acquisition. I suspect that tens or hundreds of millions of dollars were spent on the marketing you referred to. Consider the hundreds or thousands of jobs involved with the merger and acquisition, and the marketing process alone. That does not even consider the hundreds of government employees involved with the M&A and the review and approval of the marketing strategy. Unless you have personal knowledge of what Mylan actually did with the epinephrine injector, it seems that you, and many other posters are simply guessing about the increased cost of the product. Maybe even just repeating what you've heard or read in a hopefully reputable source. If you are simply guessing, I truly hope your clinical judgement is less speculative and more grounded in fundamental knowledge.
 
Planktonmd said:
And I believe that you should not have stopped taking your pills!
Click to expand...
Your comment is a beautiful illustration of the "ad hominem" logical fallacy. That is, an insult of character rather than any meaningful argument. This is remarkably common in children, but less frequently seen in adults, particularly someone who should be adequately versed in the concept of professionalism. I refer you to this exhaustive list of logical fallacies so you might better improve your rebuttal skills.
http://www.don-lindsay-archive.org/skeptic/arguments.html
 
gtb said:
What I believe is irrelevant to the reality of pharmaceutical and device pricing. I do believe that research, development, manufacturing, distribution, and day-to-day operations are expensive. I do believe that the complexities of operating a pharmaceutical company are far beyond my education, experience, and talent. I do believe that individuals, who have the acumen to keep a company solvent are rare, and that their contribution to providing hundreds and thousands of jobs is at least as relevant to society as anything, any single anesthesiologist contributes. I do believe that without the pharmaceuticals and devices we use in day-to-day clinical practice, modern, safe anesthesiology is not possible. I do believe that medicines like Harvoni for hepatitis C, and devices like pacemakers and ICDs would never have been developed without the motive of significant profit. I do believe many physicians incorrectly believe that they are personally responsible for the miracles of modern drugs and devices they use on a daily basis. I do believe that snarky, arrogant, uninformed responses like yours, are the single reason that 99.85% of board-certified anesthesiologists around the world, never bother to visit this particular website. And finally, I believe that many of those posting on this particular topic, give credence to the opinion of so many people that, "doctors are stupid."
Click to expand...

I think you are missing the reason that people are angry over this. This same anger has given birth to the Donald Trump and Bernie Sanders "movements." That money that you are talking about is not creating jobs or increasing working Americans' wages. The CEO and executives are getting increases in compensation. They are buying bigger yachts. All because they lobbied some politicians after buying a patent (again, this particular company did not create anything). There is an increasing feeling that the cards are stacked against working Americans and raising a price on an old medication does nothing to alleviate that feeling.
 
gtb said:
And finally, I believe that many of those posting on this particular topic, give credence to the opinion of so many people that, "doctors are stupid."
Click to expand...

So I think this would be a passive aggressive "ad hominem" logical fallacy. It could also be cliche thinking in the sense that "doctors just don't understand business."

As an aside, do you have any conflicts of interest to claim?
 
gtb said:
Your comment is a beautiful illustration of the "ad hominem" logical fallacy. That is, an insult of character rather than any meaningful argument. This is remarkably common in children, but less frequently seen in adults, particularly someone who should be adequately versed in the concept of professionalism. I refer you to this exhaustive list of logical fallacies so you might better improve your rebuttal skills.
http://www.don-lindsay-archive.org/skeptic/arguments.html
Click to expand...
Actually no, this was not ad ad hominem - it was a pure insult. And ad hominem is when your argument is based on a personal attack. Plankton's was an insult with no attempt made at rebutting your point with it.

You, on the other hand, by attempting to buttress your argument with phrases like "I do believe that snarky, arrogant, uninformed responses like yours" on the other hand ARE ad hominems.
 
gtb said:
Your comment is a beautiful illustration of the "ad hominem" logical fallacy. That is, an insult of character rather than any meaningful argument. This is remarkably common in children, but less frequently seen in adults, particularly someone who should be adequately versed in the concept of professionalism. I refer you to this exhaustive list of logical fallacies so you might better improve your rebuttal skills.
http://www.don-lindsay-archive.org/skeptic/arguments.html
Click to expand...
7f86bb76c00dff4f8fd51c5f82736e23.jpg


This one is still cheap!
 
gtb said:
What I believe is irrelevant to the reality of pharmaceutical and device pricing. I do believe that research, development, manufacturing, distribution, and day-to-day operations are expensive. I do believe that the complexities of operating a pharmaceutical company are far beyond my education, experience, and talent. I do believe that individuals, who have the acumen to keep a company solvent are rare, and that their contribution to providing hundreds and thousands of jobs is at least as relevant to society as anything, any single anesthesiologist contributes. I do believe that without the pharmaceuticals and devices we use in day-to-day clinical practice, modern, safe anesthesiology is not possible. I do believe that medicines like Harvoni for hepatitis C, and devices like pacemakers and ICDs would never have been developed without the motive of significant profit. I do believe many physicians incorrectly believe that they are personally responsible for the miracles of modern drugs and devices they use on a daily basis. I do believe that snarky, arrogant, uninformed responses like yours, are the single reason that 99.85% of board-certified anesthesiologists around the world, never bother to visit this particular website. And finally, I believe that many of those posting on this particular topic, give credence to the opinion of so many people that, "doctors are stupid."
Click to expand...


So you agree with me then that the problem is the patent system which allows such an absurd patent to be abused for so much money? Epi is generic. Needles are generic.

I fully support the business in charging whatever they can get paid for. I also support the right of people to complain about a system that lets them make an obscene profit that escalates at ungodly rates over time on a generic med.

Unlike you, I know what money they spent on the acquisition and the advertising and what not. It's a public company and it's all available info.
 
I am again reminded why so very, very, very few anesthesiologists have ever heard of this forum. Fortunately, I know that most anesthesiologists have a more robust grasp of economics and the reality of this world. Hopefully your residents will learn much from your styles of discussion on this forum. Hopefully they will learn the world does not respond to battery as an argument mechanism vs. a meaningful discussion.

For any resident who wonders whether your attendings have any awareness of their flawed skills and thinking, I refer you to this seminal manuscript that is titled, "Unskilled and unaware of it: how difficulties in recognizing one's own incompetence lead to inflated self-assessments." Your initial impressions of your attendings is very likely correct.
http://www.ncbi.nlm.nih.gov/pubmed/10626367
 
gtb said:
I am again reminded why so very, very, very few anesthesiologists have ever heard of this forum. Fortunately, I know that most anesthesiologists have a more robust grasp of economics and the reality of this world. Hopefully your residents will learn much from your styles of discussion on this forum. Hopefully they will learn the world does not respond to battery as an argument mechanism vs. a meaningful discussion.

For any resident who wonders whether your attendings have any awareness of their flawed skills and thinking, I refer you to this seminal manuscript that is titled, "Unskilled and unaware of it: how difficulties in recognizing one's own incompetence lead to inflated self-assessments." Your initial impressions of your attendings is very likely correct.
http://www.ncbi.nlm.nih.gov/pubmed/10626367
Click to expand...

What did you contribute to the discussion other than saying anesthesiologists are nurses and doctors are stupid? Honestly, looking back at your contributions made me realize you had nothing to contribute. Your argument can be summed up as: we don't know what it takes to keep a company afloat and doctors are stupid. Really not much substance there.
 
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