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Why treating diabetes keeps getting more expensive

washingtonpost.com

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Re: Why treating diabetes keeps getting more expensive

#21

Post by bruxis »

Kayou wrote: post #20
kylell wrote: post #11

Earlier quoted context omitted.

Yes, sorry, I was thinking at type-2 diabetes, I have a relative with type-2 and doctor told her to cut alcohol, sugar, carbs, etc, type-1 is entirely different, the immune system attacks the pancreas.

Thanks for the apology, but you got me quite irritated with your first comment. It was like saying to a paraplegic in a wheelchair to man up and hit the gym because there is only so much you can do with a wheelchair... Dreadful.

Just to add a bit of a positive spin on this: even type-1 diabetics could take measures to both improve their health and reduce the amount of insulin they require.

I consider myself moderately overweight at this point (maybe 10-15kg). If I lost weight, I could reduce the baseline amount of insulin I need every day, thus reducing the amount of insulin overall that I need to pay for.

I also fully acknowledge that, upon getting an insulin pump (16 years ago), I instantly became aware that I had much more freedom to eat what I want, when I wanted and thus, put little effort to cutting back on sugar outside of switching to diet drinks. If I were to switch to a low-carb diet, or no carb (which is admittedly very hard, I've tried), I could further reduce my insulin costs.

Personally (keep in mind these numbers depend highly on each individual), if I got my weight down 10kg, and ate < 100g of carbohydrates per day, I could theoretically only require ~35-40 units of insulin per day. At 40 units, I would only need ~1.35 vials of insulin per month. Ballparking, I'd say my current rate is likely around 2 vials per month.

Re: Why treating diabetes keeps getting more expensive

#22

Post by Kayou »

bruxis wrote: post #21
Kayou wrote: post #20

Earlier quoted context omitted.

Thanks for the apology, but you got me quite irritated with your first comment. It was like saying to a paraplegic in a wheelchair to man up and hit the gym because there is only so much you can do with a wheelchair... Dreadful.

Just to add a bit of a positive spin on this: even type-1 diabetics could take measures to both improve their health and reduce the amount of insulin they require. I consider myself moderately overweight at this point (maybe 10-15kg). If I lost weight, I could reduce the baseline amount of insulin I need every day, thus reducing the amount of insulin overall that I need to pay for. I also fully acknowledge that, upon…

You still need to have carbs in your diet, it wouldn't be healthy otherwise. Especially if you practice a sport.

I eat whatever I want (mostly pasta usually) and I need 20 units a day at most. (100 units/ml dosage).

Re: Why treating diabetes keeps getting more expensive

#25

Post by nunb »

Dr Fung's article [1] is a good complement to this one and explains how the market for insulin has been deliberately increased. As other commentators mentioned, once you can have carbs with insulin, why bother changing and looking for an alternative? Dr Fung treats patients with fasting protocols, where compliance is harder, but costs lower. FTA I just learned that Dr Banting is famous for both insulin and the original (proto) Atkins diet.

[1] https://medium.com/@drjasonfung/the-diabetes-payroll-291649d...

Re: Why treating diabetes keeps getting more expensive

#26

Post by nunb »

Kayou wrote: post #22
bruxis wrote: post #21

Earlier quoted context omitted.

Just to add a bit of a positive spin on this: even type-1 diabetics could take measures to both improve their health and reduce the amount of insulin they require. I consider myself moderately overweight at this point (maybe 10-15kg). If I lost weight, I could reduce the baseline amount of insulin I need every day, thus reducing the amount of insulin overall that I need to pay for. I also fully acknowledge that, upon…

You still need to have carbs in your diet, it wouldn't be healthy otherwise. Especially if you practice a sport. I eat whatever I want (mostly pasta usually) and I need 20 units a day at most. (100 units/ml dosage).

Doctors Phinney and Volek would disagree on the carbs/sport connection.

Re: Why treating diabetes keeps getting more expensive

#27

Post by radicalbyte »

kgwgk wrote: post #18
kakoni wrote: post #16

Whats up with those US prices, Humalog more than $250 per vial? In Europe (Finland) non-subsidized price is $34.

Drug pricing in the US is complicated. Humalog list price has doubled in the last few years, but the rebates have increased faster and the average net price is actually going down. The average discount is 75%! https://www.bloomberg.com/news/articles/2017-06-29/the-crazy...

So it's $75 a vial, only three times as much as the NHS.

Re: Why treating diabetes keeps getting more expensive

#28

Post by tonetheman »

kgwgk wrote: post #18
kakoni wrote: post #16

Whats up with those US prices, Humalog more than $250 per vial? In Europe (Finland) non-subsidized price is $34.

Drug pricing in the US is complicated. Humalog list price has doubled in the last few years, but the rebates have increased faster and the average net price is actually going down. The average discount is 75%! https://www.bloomberg.com/news/articles/2017-06-29/the-crazy...

I am not sure that it is complicated so much as, they gouge anyone they can in the US.

Not complicated at all, insulin keeps people alive and our shareholders need a return on their investment.

Re: Why treating diabetes keeps getting more expensive

#29

Post by kgwgk »

tonetheman wrote: post #28
kgwgk wrote: post #18

Earlier quoted context omitted.

Drug pricing in the US is complicated. Humalog list price has doubled in the last few years, but the rebates have increased faster and the average net price is actually going down. The average discount is 75%! https://www.bloomberg.com/news/articles/2017-06-29/the-crazy...

I am not sure that it is complicated so much as, they gouge anyone they can in the US. Not complicated at all, insulin keeps people alive and our shareholders need a return on their investment.

They gouge anyone they can, but the fact is that they cannot do it as well as before with the “old” products because their sales are going down (in dollars, despite an increase in volumes). And the “new” products are often not good enough to justify higher prices.

Edit: By the way, we’re not talking about insulin (which has been keeping people alive since the 20’s) but about insulin analogues developed in the 90’s.

Re: Why treating diabetes keeps getting more expensive

#30

Post by Kayou »

nunb wrote: post #26
Kayou wrote: post #22

Earlier quoted context omitted.

You still need to have carbs in your diet, it wouldn't be healthy otherwise. Especially if you practice a sport. I eat whatever I want (mostly pasta usually) and I need 20 units a day at most. (100 units/ml dosage).

Doctors Phinney and Volek would disagree on the carbs/sport connection.

Then they should come with an explanation as to why I want to throw up and can't do anything when doing sport with no insulin to use my carbs.
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