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Comment by estearum | Hacker News Reader

> The thing about second order effects is that they are almost never larger than the first order effect.

Sounds clever but this is just a labeling trick. When a second order effect is larger than the first order one, we just rename them to first order and intermediate effects.

For example, the first order effects of growing GLP-1 prevalence are actually consumption of prescription pads, new demand on pill bottles, and gas consumption of pharma sales reps.

The second order effect is weight loss in patients who take the drugs.

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Cute and thus worthy of an upvote, but whenever I see scientists or economists refer to first or second order effects it pertains to things that are subsequent to each other in time, or at least intended vs. ancillary. I don't think anyone except for a Stafford "the purpose of a system is what it does" Beer acolyte would designate new demand of pill bottles as the first order effect of a new medication.

It's just something that statisticians have observed across many fields: you theorize about how potentially huge a particular interaction effect or knock-on effect could be relative to the main effect, you read about the Jevons Paradox and intuitively feel that it can explain so much of the world today... and then you get the data and it just almost never does. No reason why it couldn't, just empirically it rarely happens.

The demand for pill bottles literally does grow before anyone takes the medication, no?

And correct I agree they wouldn't designate the demand for pill bottles as the first order effect. That's because despite happening first, it's not the most important object of analysis. That's why it's a disproof of your earlier claim that second order effects aren't more significant than first order ones: because if they were, they'd be considered the first order effect.

> The demand for pill bottles literally does grow before anyone takes the medication, no?

Only really in the US. In most other countries they use blister packs instead. Global consumption of blister packs is so huge (not just for prescription medications, also OTC, vitamins, supplements, and complementary medicines), even a blockbuster medication likely only makes a modest difference to manufacturer demand in percentage terms.

> For example, the first order effects of growing GLP-1 prevalence are actually consumption of prescription pads, new demand on pill bottles, and gas consumption of pharma sales reps.

I take injectable tirzepatide prescribed by an electronic prescription… so impact on pill bottle demand and prescription pad demand in my case is literally zero.

And I doubt pharma sales reps have a lot of work to do selling GLP-1 agonists-who needs to convince doctors to prescribe a drug when there’s dozens of patients inquiring about it?

Yes the article is about pills, but most people are on injectables still (that may change over time). It likely has increased demand for needles and sharps containers. But in dollar terms, that’s a small percentage of the demand for the medication itself.

...

You are missing the point.

s/pill bottle/blister pack/

s/prescription pad/e-prescriber submissions/

All irrelevant to the convo :)

They are all irrelevant to everything, because in dollar and percentage terms they are a drop in the ocean

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