Insulin Wars: How insurance companies farm out dirty work to doctors patients
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Re: Insulin Wars: How insurance companies farm out dirty work to doctors patients
#2The reason seems pretty clear from contrasting these two passages:
> The pricing is all the more infuriating when one considers that the discoverers of insulin sold the patent for $1 each to ensure that the medication would be affordable.
> The bigger issue, however, is that companies tweak their formulations so they can get new patents, instead of working to create cheaper generic versions.
Re: Insulin Wars: How insurance companies farm out dirty work to doctors patients
#3> There are several reasons that insulin is so expensive. It is a biologic drug, meaning that it’s produced in living cells, which is a difficult manufacturing process.
Seems like this is a fairly minimal component. Per the chart at https://twitter.com/odavis_/status/930094350478045184, the price has gone up 10x in the last twenty years or so. It has presumably not gotten more difficult to manufacture.
Re: Insulin Wars: How insurance companies farm out dirty work to doctors patients
#4Interestingly, Walmart sells generic insulin. The same stuff used decades ago, for only $25 a vial.
However, the advances in insulin since then mean it’s a much more burdensome therapy.
https://insulinnation.com/treatment/why-walmart-insulins-are...
Re: Insulin Wars: How insurance companies farm out dirty work to doctors patients
#5This is exactly what you get when there is no transparency, and everything is driven by non-market forces. Why not create an actual market where all medications, medical services, tests, etc, have a known price and people can make decisions based on cost, quality, and other factors?
Re: Insulin Wars: How insurance companies farm out dirty work to doctors patients
#6I can't read the article, it's behind a paywall. But from the comments I get that people don't truly understand that there isn't just one thing called 'insulin' that is universally the same. As the husband of a type-1 diabetic who has been on $25 Walmart generic insulin and $1000 name-brand insulin (we have insurance, obviously we don't pay that amount), I can tell you they are not the same. For my wife, she never has unexpected highs/lows on the more expensive insulin.
So, sure, non-generic insulin is probably more expensive than it should be. But there was serious research and development done to make these better insulins, and thankfully someone did because they can make life just that easier to manage for a type-1 diabetic.
Re: Insulin Wars: How insurance companies farm out dirty work to doctors patients
#7I still think the approach I proposed years ago would be a big help: Turn the usual arguments on their head, prohibit all negotiation. Drug companies would be required to sell to all customers at the same price. This would end all cost-shifting, it's fair for all and forces the drug companies to actually compete on the end price.
This would end this sort of preferred drug shifting, it would end the game of state Medicaid often mandating the name brand rather than the generic because most of the money is federal and the state receives a big enough rebate that it's cheaper for them. Applied internationally (we don't have direct authority over foreign drug companies but we could make it a condition of importing them to the US that they follow our pricing rules) and the big subsidy to the UHC countries goes away.
Re: Insulin Wars: How insurance companies farm out dirty work to doctors patients
#8I can't read the article, it's behind a paywall. But from the comments I get that people don't truly understand that there isn't just one thing called 'insulin' that is universally the same. As the husband of a type-1 diabetic who has been on $25 Walmart generic insulin and $1000 name-brand insulin (we have insurance, obviously we don't pay that amount), I can tell you they are not the same. For my wife, she never ha…
This is a great point. They might all be insulin’s, but the “tweaking” the author refers to means real benefits to patients.
Re: Insulin Wars: How insurance companies farm out dirty work to doctors patients
#9> There are several reasons that insulin is so expensive. It is a biologic drug, meaning that it’s produced in living cells, which is a difficult manufacturing process. Seems like this is a fairly minimal component. Per the chart at https://twitter.com/odavis_/status/930094350478045184 , the price has gone up 10x in the last twenty years or so. It has presumably not gotten more difficult to manufacture.
Insulin demand is apparently increasing at quite a rate[0]
It's plausible that that could contribute significantly to price increases. Not, to be clear, that I'm defending that or the actions described in the NYT article.
[0] https://uk.reuters.com/article/us-health-diabetes-insulin/mi...
Re: Insulin Wars: How insurance companies farm out dirty work to doctors patients
#10> There are several reasons that insulin is so expensive. It is a biologic drug, meaning that it’s produced in living cells, which is a difficult manufacturing process. Seems like this is a fairly minimal component. Per the chart at https://twitter.com/odavis_/status/930094350478045184 , the price has gone up 10x in the last twenty years or so. It has presumably not gotten more difficult to manufacture.
Insulin demand is apparently increasing at quite a rate[0] It's plausible that that could contribute significantly to price increases. Not, to be clear, that I'm defending that or the actions described in the NYT article. [0] https://uk.reuters.com/article/us-health-diabetes-insulin/mi...
That article is talking about needing to increase production 20% over twelve years, which doesn't seem like a major obstacle. It also highlights pricing as the issue more than production capacity.