Friday, October 14, 2016

Over A Barrel

When it comes to medicine the pharmaceutical have us at their mercy. How much will you pay to live for another year? How much would you pay to save your life? How much would you pay for your hormones?

That is the question that big pharma is asking.

A drug that has been around since the early forties is seeing a shortage and price increases.
The US Has Run Out Of Injectable Estrogen For Trans Women — Again
Doctors blame a profit-driven pharmaceutical industry and idle regulators.
By Azeen Ghorayshi
Posted on Oct. 8, 2016

The 2014 national shortage of injectable estrogen was not the first, nor the last. It happened again this summer, leaving thousands of trans women without their preferred — and often, they say, life-saving — option for feminizing their bodies: redistributing fat to produce smaller waists and bigger hips, enhancing breasts, rounding out their faces, and boosting mood.
Although patients like Bigham can turn to estrogen pills or patches, many trans women strongly prefer the injectable form. Some claim that it provides stronger effects, while others point out that taking a daily hormone pill is not only an inconvenience, but a danger if someone is trying to be discreet about their transition. The pill also comes with more possibilities of side effects: Because, if swallowed, it passes through the digestive system, there is the potential for liver damage. There’s also an increased risk of blood clots. Patches can irritate the skin or fall off, and because they are visible, also run the risk of inadvertently outing people.

The simultaneous shortage of the two injectable forms of estrogen — Delestrogen, the brand-name version, and estradiol valerate, its generic formula — has left clinics and patients scrambling for alternatives. Although the generic was supposed to be made available in October, this week the FDA announced that it was pushing its availability back yet another month, but even that date is no guarantee.
FDA blames big pharma while big pharma blames the FDA in not certifying a new supplier of one of the ingredients for the injectable estrogen.
What’s not being talked about enough, Smith said, is the root cause of these recurring shortages. Although doctors have prescribed injectable estrogen to trans women since the 1950s, they do so at their own discretion, or “off label.” The FDA has only approved the drug for women going through menopause.
I use the pill form because my health insurance company does not pay for the patch but even with insurance the pills cost $90 for a three month supply, but with the patch it was $190 for a three month supply, so where do trans people turn to get their hormones?
Sketchy Pharmacies Are Selling Hormones to Transgender People
Burdened by cost and medical discrimination, many people are taking a do-it-yourself approach to transitioning.
​The Atlantic
By Gillian Branstetter
August 31, 2016

After meeting a few transgender women at the famed music and arts festival, Andrea decided to pursue her own transition. But when she sought out feminizing hormones through clinics around her home in Philadelphia, she ran into lengthy waiting lists and high costs. So she decided to experiment on her own. She ordered Estradiol, a commonly prescribed form of estrogen, and Spironolactone, a testosterone blocker traditionally prescribed to transgender women, from an online pharmacy without a prescription.

Andrea’s decision to manage her own transition outside of a doctor’s care is common. With a lack of transgender-related services across the country, as well as discrimination from medical professionals and insurance companies, many transgender patients are conducting their own hormone replacement therapy, a regiment of medications meant to help them develop some of the secondary sexual characteristics of their gender identity.

Online forums and blogs devoted to DIY HRT—do-it-yourself hormone replacement therapy—help transgender people access drugs that are typically meant to be guarded by a doctor’s prescription and certified pharmacies. The websites’ members recommend online pharmacies of dubious legality and help each other navigate shipping and possessing such drugs. They monitor their own blood results and manage each other’s side-effects—all without the oversight of a doctor. (Because of the legal questions around these practices, we agreed not to identify the full names of some individuals we spoke to for this story.)
We probably all know someone who is getting their hormones from online sources because they can’t pay the price for domestic hormones.

My guess is that the storage will mysteriously disappear once the price increases.

Our hormones are not the only drug that the price is skyrocketing. We all remember the AIDS meds that when from $13.50 to $750 overnight and just recently the EpiPen, but also insulin. According to Time,
Over 29 million Americans suffer from diabetes and need insulin, according to the American Diabetes Association, and there’s no generic option for any insulin brand. JAMA’s study looked at the prices of insulin from 2002 to 2013. It found that “the mean price of insulin increased from $4.34/mL in 2002 to $12.92/mL in 2013—a 200% increase.” Spending per patient sky-rocketed from about $231 to $736, the study found. A survey of hundreds of people from 40 countries by T1International, a diabetes advocacy group, found that patients in the U.S. pay astronomically more for insulin than people in other countries.
Where will all these price increases stop? Only when Big Pharma think they squeezed us until they think they can't get anymore blood from the us. 

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