Stick to baseball, 11/28/15.

Eric Longenhagen and I posted a too-early ranking of the top 2016 MLB draft prospects, one that highlights the lack of a clear #1 overall prospect.

I reviewed two boardgames for Paste recently, the tile-laying game Cacao and the the family adventure game Mission: Red Planet.

Around these parts, I posted my annual list of recommended cookbooks and a short post listing boardgame app sales for this weekend.

And now, the links…

  • Glenn Greenwald destroyed CNN for suspending reporter Elise Labott for two weeks for a rather innocuous (my opinion) tweet on the Syrian refugee topic. Greenwald even went on CNN to rip them apart for their fearmongering and mishandling of Labott, as covered here by Erik Wemple, whose initial complaint of Labott’s “bias” in her tweet seems to have sparked the suspension. (Wemple has said he opposes such suspensions, but I don’t see why he singled out Labott, a relatively unknown female reporter, among the various more serious breaches of ethics Greenwald listed.)
  • Alabama Congressman Mo Brooks says Syrian refugees are just looking for a “paid vacation.”
  • Is the west’s reaction to the Paris terror attacks the war that ISIS wants?
  • The young Iraqis who are presumably risking their lives promoted evolutionary theory and rational thinking.
  • A great longread on so-called “inauthentic” ethnic cuisine as practiced by Asian-American chefs like Danny Bowien, Dale Talde, and David Chang. Authenticity is great, but isn’t de facto superior to inauthentic food made well.
  • The Guardian weighs in on fad diets that are often light on science, asking what constitutes “healthy eating?”
  • Aziz Ansari appeared on NPR’s The Hidden Brain podcast to discuss findings from his book on love and dating, co-authored with a sociologist, called Modern Romance.
  • Via a reader, a story from June in Slate that describes aquafaba, the possible vegan replacement for egg whites. It’s actually just the brining liquid found in canned chickpeas, and for reasons not yet understood, its protein structure can create a stable foam just like the albumin from chicken eggs.
  • Remember that hedge fund douchebag who bought the rights to a decades-old drug and raised the price fifty-fold, then reversed that decision under public pressure? Yeah, well, they reversed that reversal. It’s a clear situation where the free market – of which I’m a rather ardent supporter – fails, because the market for the drug is so small (the NY Times says that there were only 8821 prescriptions for it in 2014) that it likely wouldn’t support the creation of a competitor due to the high regulatory costs. The only solution I see would be for the FDA to “fast track” a generic alternative, assuming a manufacturer could be found – or, unfortunately, for the federal government to mandate a price cap.

Comments

  1. Seamball Invictus

    I was hoping you would get into the Ahmed clock hoax movement. The people behind the movement like Dawkins, Molyneux, and Cult of Dusty are a bit extreme to say the least, but they do make solid points that are backed by reporting.

    That’s not to say islamaphobia didn’t play a part, but did everyone move too quickly to praise a harmless prank? I have no clue, but I’m not sure we have the whole story either.

    • I’ve had a hard time with the Ahmed truthers leaping to the conclusion that this was a prank or even a staged event. At worst it seems like a youthful folly, a kid perhaps overrating the extent of his work (reassembling but hardly inventing). The fact that many of those truthers are a bit nuts hasn’t helped.

      Besides, I think the actual issue is the Islamophobic reaction by school and city officials. The clock didn’t even have to work for this to be a story.

  2. Chang (to his credit) has rarely discussed “authenticity”/”inauthenticity” in public fora, instead emphasizing how he just wants to make food that’s tasty and often does so by thinking differently about how to put together all the culinary experiences (both professional and from his upbringing) that he’s had. The Hsu piece also reminds me of this comic, albeit from another perspective: https://bitchmedia.org/post/a-comic-about-food-and-cultural-appropriation

  3. I admit I should know this, but I can’t find a good source. The drug is off patent, so there isn’t a barrier to entry based on market control. Is the only reason no generic exists is because it’s an orphan drug? I feel like a price hike would bring in competitors, and the fda already has fast track process for generics. Any good sources for this particular drug?

  4. Justin – not enough prescriptions to substantiate competitors investing in manufacturing process, prove bioequivalency and file for approval, only to turn around and compete on price. When this guy acquired rights to the drug the supply chain was already established. I agree with Keith – this douchebag found a niche to exploit the free market and douchebagged it all up. But this would be a good PR move for a large member of PhRMA to suck it up, eat the investment and send this douchebag packing.

  5. Issue with generics is result of loopholes in regulations, IIRC, not necessarily a market failure. Basically, to prove bioequivalence they need adequate samples of drugs, of which Turing controls the distribution. In addition, the testing process isn’t super cheap and only makes a lot sense if you can make monopoly profits (like Turing). So it is unlikely to happen. There are a few market-ish solutions that I’ve heard of:

    1) The compound itself is cheap and widely used in combination with other medications. One can take such medications, but that isn’t ideal.

    2) Alternatively, the compound itself can be mixed with other innocuous drugs by a “compounding pharmacy” and sold. So a company called imprimis did just that – it charges $1/pill. Basically, all they have to do is show that they are creating a small batch for a special need. In this case, I think that strategy seems to be on solid legal ground. Not sure what this will do to Turing’s pricing strategy. I thought it would have demolished it so I’m not sure what’s going on.
    http://gawker.com/surprise-surprise-turing-pharmaceuticals-is-reneging-1744722454

    3) In addition, allowing generic drugs approved by European agencies would end Turing’s monopoly immediately. http://marginalrevolution.com/marginalrevolution/2015/09/generic-drug-regulation.html .

    #3 seems like a good solution to me. European agencies seem to have reasonable standards, and for decades-old drugs it is hard to see the harm in it. The current regulations favor Turing-style gouging of providers and insurers of patients with “orphan” diseases.

    • By “market failure,” I was referring to the fact that the optimal number of producers of such orphan drugs is often one, because the market itself can’t support two at a profit level that would allow both to remain in this particular line of business, and as such we end up with monopoly pricing.

    • Mark Geoffriau

      I don’t see how that can make sense — if we “end up” with monopoly pricing, then that would encourage a competitor to undercut the price. It’s a bit of a circular argument to say that the market can’t support more than one producer, so we end up with monopoly pricing. The problem is the cost of entry for the second producer, not a “market failure”.

    • Agree with Mark that cost of entry is the problem. Toxoplasmosis is an uncommon disease in the US, but the drug isn’t really an “orphan drug” in that it is widely and cheaply available in all developed and most developing countries. It is really that the barrier to entry is too high. Turing’s CEO has implied that they can block other companies from obtaining the drug to establish bioequivalence, which is a first step toward FDA approval. There is no reason for this regulation from a patient safety perspective as far as I can tell, but it does create a big barrier to entry that Martin Shrekeli and others have exploited. Given that compounding pharmacies can and will make the drug available, and the fact that there are some European manufacturers as well as many (possibly dodgy) Indian manufacturers, it’s hard to say that the optimal number of producers is 1. So I don’t agree that “market failure” is the best way to describe this case in particular.

    • Mark Geoffriau

      And in a matter of days, another company (Express Scripts) has stepped in to help streamline access to the compounded version of the drug from Imprimis.

      http://arstechnica.com/science/2015/12/1-pill-alternative-to-turings-750-pill-gets-boost-from-drug-manager/

  6. Keith, thanks for re-linking your holiday gift guide for cooks. I’ve added several things to my wish list as I hope to get more into cooking and especially baking next year.

  7. Enjoyed the links post as always, Keith.

    I know I’m late to the party, but I seem to remember that the FDA granted Turing marketing exclusivity for Daraprim in exchange for Turing running some clinical trials, etc. (The FDA does this sometimes with older drugs that were grandfathered in and never went thru their approval process.) As a result, you get the unintended consequence we have here: price spike thanks to what is, in effect, a government-granted monopoly.