Editorial (Nov. 9, 2025). Why Weight-Loss Drug Prices Are Falling - Competition is working, even as the FTC meddles in a takeover fight in a way . . .

[MsGizmo]

Since we've veered into a discussion of pharma development funding, I would note that several things can be true simultaneously.

"Big Pharma" has invested billions in making these drugs available. Eli Lilly in particular is building new production lines or even entire new factories to meet the anticipated demand. The trials needed to get regulatory approval are very costly.

Unfortunately, publicly traded companies are vulnerable to shareholder pressure. Activist shareholder groups often accuse the board/management of fiduciary negligence if they don't maximize profits.

Public sector investment in basic science plays a crucial role. Academic researchers are often mocked for pursuing weird or seemingly useless studies, but the open-ended quest for knowledge is key to breakthroughs in science. Search for "Gila Monster Venom GLP-1" to get a relevant example. At least in the U.S. public/academic investment seems to be under attack...

Yes, it costs approximately a billion dollars to bring a drug to the market. Novo Nordisk made an average of 20 billion sales PER YEAR since its development. In 2023, for example, sales of Ozempic/Wegovy accounted for HALF of their annual revenue.

Yes, public investment is under attack. Why should Americans invest in new drug development only to be charged more than double for the end result? As an example ... the Epipen. The drug in those is epinephrine, which was developed in 1897. The patent is long expired. The auto injector used for them was based off of one that was designed by the US military. What justification do they have to charge $300 per pen? Other than they can get away with it?

 

[keangkong]

Yes, it costs approximately a billion dollars to bring a drug to the market. Novo Nordisk made an average of 20 billion sales PER YEAR since its development. In 2023, for example, sales of Ozempic/Wegovy accounted for HALF of their annual revenue.

Yes, public investment is under attack. Why should Americans invest in new drug development only to be charged more than double for the end result? As an example ... the Epipen. The drug in those is epinephrine, which was developed in 1897. The patent is long expired. The auto injector used for them was based off of one that was designed by the US military. What justification do they have to charge $300 per pen? Other than they can get away with it?

The US military didn't design the epipen. Nor did the US military design the ComboPen, a predecessor to the epipen that permitted administration of another drug. Survival Technology Inc. (STI) invented both. Although a team invented them, the name most frequently associated with the invention of the epipen is Sheldon Kaplan.

A doctor can also prescribe epinephrine in a vial with a syringe for extremely cheap. An alternative to the epipen that costs less is the Adrenaclick, however, the Adrenaclick is still not cheap. The difficulty of producing pens causes much of the problem. The FDA had to withdraw from the market a previous pen that didn't work right. It also appears that the epipen manufacturer has engaged in some anticompetitive practices. See Michael A. Carrier & Carl J. Minniti III. (2017) The Untold Epipen Story - How Mylan Hiked Prices by Blocking Rivals. 102 Cornell L. Rev. Online 53. However, that's a problem that can be addressed through antitrust law.

 

[AndyPanda]

The US military didn't design the epipen. Nor did the US military design the ComboPen, a predecessor to the epipen that permitted administration of another drug. Survival Technology Inc. (STI) invented both. Although a team invented them, the name most frequently associated with the invention of the epipen is Sheldon Kaplan.

A doctor can also prescribe epinephrine in a vial with a syringe for extremely cheap. An alternative to the epipen that costs less is the Adrenaclick, however, the Adrenaclick is still not cheap. The difficulty of producing pens causes much of the problem. The FDA had to withdraw from the market a previous pen that didn't work right. It also appears that the epipen manufacturer has engaged in some anticompetitive practices. See Michael A. Carrier & Carl J. Minniti III. (2017) The Untold Epipen Story - How Mylan Hiked Prices by Blocking Rivals. 102 Cornell L. Rev. Online 53 . However, that's a problem that can be addressed through antitrust law.

I remember the good old days of carrying those Atropine and Valium auto injectors with my MOPP gear. The funny thing is they weren’t designed to save you, rather to keep you fighting just a little longer before you died.

 

[Zydeceltico]

I remember the good old days of carrying those Atropine and Valium auto injectors with my MOPP gear. The funny thing is they weren’t designed to save you, rather to keep you fighting just a little longer before you died.

"They" perhaps were existentially mistaken that "saving a life" and "keep you fighting a little longer before you died" are synonyms, although the majority of us would much prefer to argue the contrary.

 

[Zydeceltico]

Since we've veered into a discussion of pharma development funding, I would note that several things can be true simultaneously.

Indeed! FWIW - one of the most effective psychological tools that a former counselor ever offered me that I practice to this day because it has such a profound effect on my thinking, judgement, anxiety, dissonance, etc., is super, incredibly simple: Any and every time I find myself wanting to use the word "but, " use the word "and" instead. Don't even have to question why. Talk about rewiring the neurons! As effective for my critical thinking as tirzepatide is for my weight loss and physical health.

 

[Foggy-Hollow]

Yes, public investment is under attack. Why should Americans invest in new drug development only to be charged more than double for the end result? As an example ... the Epipen. The drug in those is epinephrine, which was developed in 1897. The patent is long expired. The auto injector used for them was based off of one that was designed by the US military. What justification do they have to charge $300 per pen? Other than they can get away with it?

It spiked up to $400 at first. I think our first fill was a bit under $100 way back. (Good insurance.) Maybe even $70. $300 was a “compromise” to keep it “more affordable.”

I’m salty because my son’s allergy isn’t too bad, but allergy doc said to carry one. I think it’s a CYA move to avoid a lawsuit, we’ve never needed it in the 13y since diagnosis. Yet who wants to be the foolish parent that was told to have one and didn’t? Never mind the sticker price is exorbitant. A lifetime of guilt isn’t worth $400. Pharma knows this.

Vial and a pin might be an option if a parent was a medical professional. I could execute it now that I’ve taken hormones for a few years, but at diagnosis, hold myself together long enough to draw accurately - while my child is having an event - and then poke my 4yo? I’m the calmer one in a situation and it would have gotten done but I don’t think it’s reasonable. To expect my 17yo non diabetic to? Not a dependable option.

More salt: there was a generic alternative auto-injector. It was credit card shaped in profile. It was bought out and killed.

More salt: During Covid manufacturer stated that the pens were good as long as the fluid was clear. Last year I figured it was time to toss the 2019 expired pens, they were clear but 5 years past… it was time. The 2017 one had started to turn. These dates aren’t too real.

I don’t need a tin foil hat to see what’s going on. In this case my hands are a bit tied. I’m not super tied to expirations and it’s not a severe allergy so we’ve been able to not be strict.

I have zero guilt about gray. The system has more of my earned wages than it deserves.