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11 posts found
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Mar 12, 2025
acx
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11 min 1,644 words 489 comments 730 likes podcast (11 min)
Scott analyzes the implications of the FDA ending compounded GLP-1 weight loss drugs, which have provided a cheaper alternative to official channels for the past three years, and examines various responses from both compounding pharmacies and pharmaceutical companies. Longer summary
Scott discusses the upcoming end to compounded GLP-1 weight loss drugs in the US, as the FDA declares the shortage over. He explains how for the past three years, compounding pharmacies have provided these drugs at $200/month compared to the official $1000/month price, helping about 2 million Americans. The post explores various strategies companies are using to try to continue providing cheaper alternatives, and how pharmaceutical companies are responding with their own direct-to-consumer models. Scott concludes by noting how this experiment in semi-free-market medicine has shown that a less regulated supply chain can work effectively. Shorter summary
Aug 22, 2024
acx
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12 min 1,776 words 330 comments 210 likes podcast (11 min)
Scott Alexander examines how compounding pharmacies are producing cheaper versions of GLP-1 agonist drugs, exploring the economics, safety, and future implications of this practice. Longer summary
Scott Alexander discusses the 'compounding loophole' that allows compounding pharmacies to produce cheaper versions of GLP-1 agonist drugs like semaglutide (Ozempic). He explains how these pharmacies operate, the cost differences, safety concerns, and potential future implications. The post covers the legal basis for this practice during drug shortages, the impact on drug manufacturers like Novo Nordisk, and speculates on what might happen when the shortage ends. Scott also touches on the broader implications for drug pricing and availability. Shorter summary
Nov 30, 2022
acx
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41 min 6,260 words 123 comments 64 likes podcast (36 min)
Scott Alexander summarizes and responds to comments on his post about semaglutide, covering corrections, additional information, and user experiences with the weight loss drug. Longer summary
Scott Alexander summarizes and responds to comments on his previous post about semaglutide, a weight loss drug. The highlights include corrections to his original analysis, additional information on obtaining semaglutide cheaply, discussion of other weight loss drugs and treatments, challenges to Scott's predictions, debate over whether weight loss is maintained after stopping the drug, personal anecdotes from users, and mentions of some tangential debates in the comments. Shorter summary
Nov 24, 2022
acx
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28 min 4,293 words 736 comments 221 likes podcast (30 min)
Scott Alexander analyzes the economic and societal implications of semaglutide, a new effective weight loss drug, and its potential to reshape obesity treatment. Longer summary
Scott Alexander explores the economic and societal impact of semaglutide, a new weight loss drug. He discusses its effectiveness, current limited availability, and potential future widespread use. The post covers the drug's history, its current pricing and accessibility issues, and projections for its future market. Scott also touches on the broader implications for obesity treatment and the possibility of a 'post-obesity' future. Shorter summary
Mar 16, 2022
acx
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12 min 1,804 words 16 comments 37 likes podcast (14 min)
Scott Alexander highlights and responds to expert comments on his previous posts about Zulresso and Zuranolone, covering various aspects of these drugs and related topics. Longer summary
Scott Alexander summarizes and responds to comments on his previous posts about Zulresso and Zuranolone. The post covers various topics including drug pricing, mechanism details of GABA receptors, etymology of drug names, tolerance development, progesterone's effects, and personal experiences with progesterone. Scott expresses appreciation for the expertise of his commenters, particularly in biomedical topics, and acknowledges learning new information from them. Shorter summary
Mar 08, 2022
acx
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24 min 3,655 words 117 comments 73 likes podcast (30 min)
Scott Alexander examines Zulresso and Zuranolone, two neurosteroid drugs for postpartum depression, discussing their efficacy, challenges, and potential future applications. Longer summary
Scott Alexander discusses Zulresso (allopregnanolone) and Zuranolone, two related drugs for treating postpartum depression. He explains their mechanisms, efficacy, and the challenges in their development and usage. The post covers the history of allopregnanolone research, its connection to GABA and hormones, clinical trials, and potential future applications. Scott also discusses the high cost of Zulresso, its limited availability, and the mixed results of Zuranolone in treating regular depression and anxiety. The post ends with predictions about the future of these drugs and related research. Shorter summary
Jan 27, 2022
acx
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59 min 9,034 words 205 comments 52 likes podcast (60 min)
Scott Alexander compiles reader comments on healthcare systems in various countries, discussing economics, drug pricing, and personal experiences. Longer summary
This post is a collection of reader comments on healthcare systems in various countries, focusing on the US, Germany, Netherlands, UK, Australia, Switzerland, and several others. It covers topics like drug pricing, healthcare economics, and personal experiences with different systems. The post is structured into four main sections: comments on US healthcare, discussions on drug pricing and subsidies, explanations of why healthcare economics are unique, and detailed accounts of healthcare systems in specific countries. Shorter summary
Jan 19, 2022
acx
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22 min 3,356 words 698 comments 172 likes podcast (26 min)
Scott Alexander reviews a book comparing international healthcare systems, finding it informative but lacking in explaining why some systems succeed while others fail. Longer summary
Scott Alexander reviews 'Which Country Has The World's Best Health Care?' by Dr. Ezekiel Emanuel, a book comparing healthcare systems across 11 countries. The book categorizes systems into five types, from fully socialized to mostly privatized. Emanuel reluctantly concludes that Germany, the Netherlands, Norway, and Taiwan have the best systems. Scott finds the book informative but criticizes its organization and limited scope. He expresses confusion about why some systems work better than others, particularly regarding drug pricing and budget setting. The review highlights the complexity of healthcare economics and the difficulty in understanding why the US system performs poorly compared to seemingly similar systems in other countries. Shorter summary
Mar 11, 2019
ssc
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14 min 2,023 words 164 comments podcast (15 min)
Scott Alexander critiques the FDA approval of esketamine for depression, discussing issues with drug development, efficacy, cost, and administration requirements. Longer summary
This post discusses the FDA's approval of esketamine for treatment-resistant depression, highlighting the issues with the pharmaceutical industry's approach to drug development and approval. Scott Alexander explains how companies often make minor changes to existing chemicals to patent them, as in the case of esketamine (a left-handed version of ketamine). He critiques the high cost of esketamine compared to regular ketamine and the FDA's stringent requirements for its administration. The post also questions the efficacy of esketamine based on clinical trials and discusses the inconvenience of the approved delivery method. Scott expresses disappointment that this approval may set a precedent for future psychedelic medicines, making them equally inconvenient and bureaucratic to access. Shorter summary
Sep 07, 2016
ssc
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31 min 4,731 words 467 comments
Scott argues against Vox's proposal for drug price controls, citing studies that such policies would significantly reduce pharmaceutical innovation and potentially cost millions of life-years long-term. Longer summary
Scott Alexander responds to Sarah Kliff's Vox article about drug pricing, arguing that her proposal for price controls on brand-name drugs would significantly decrease pharmaceutical innovation. He cites multiple economic studies suggesting price controls reduce R&D and new drug development. Scott argues that while price controls might lower costs in the short-term, they could cost millions of life-years long-term by reducing new drug creation. He suggests focusing on increasing generic drug competition and reducing unnecessary prescriptions of expensive brand-name drugs with cheap generic alternatives as better solutions to high drug prices. Shorter summary
Sep 24, 2015
ssc
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16 min 2,383 words 532 comments
The post examines three major issues with generic medications: barriers to market entry, problematic FDA initiatives, and inconsistent pricing across pharmacies. Longer summary
This post discusses the problems with generic medications in the United States, focusing on three main issues. First, it explores why competitors don't easily emerge to challenge price gouging, using the example of Daraprim's price increase. The author suggests that FDA approval processes, including bioequivalence studies, create significant barriers to entry. Second, it critiques the FDA's Unapproved Drugs Initiative of 2006, which allowed companies to gain exclusive rights to public domain drugs by conducting studies, leading to price increases. Finally, it highlights the wide price disparities for generic drugs at different pharmacies, suggesting that comparison shopping can lead to significant savings. Shorter summary
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