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Insulin Wars: How insurance companies farm out dirty work to doctors patients

nytimes.com

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Re: Insulin Wars: How insurance companies farm out dirty work to doctors patients

#41

Post by lozenge »

Zimahl wrote: post #6

I 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…

Try incognito mode. The article is about patients having to switch insulins every few months due to their insurance changing their minds on what's covered and what isn't.

Re: Insulin Wars: How insurance companies farm out dirty work to doctors patients

#42

Post by refurb »

tracker1 wrote: post #39
refurb wrote: post #35

Earlier quoted context omitted.

I’d argue you’d get far fewer advances in drugs with a system like that.

I'd argue most new drugs aren't "advances"

Tell that to cancer patients who are living longer than ever.

Re: Insulin Wars: How insurance companies farm out dirty work to doctors patients

#43

Post by syn0byte »

rbobby wrote: post #38

Why is insulin not an over the counter medicine? Would having it OTC cause problems on the scale of alcohol? What's the "value add" of having a doctor renew an insulin prescription?

The number of unexplained but apparently natural heart attacks in middle aged people with disgruntled partners would sky rocket.

Weight trainers can and probably already do (ab)use insulin to maximize their gains by manipulating blood sugar levels during workouts.

self-diagnosed and self-medicated diabetics showing up at hospitals that have no indication of this and pump them full of glucose.

Re: Insulin Wars: How insurance companies farm out dirty work to doctors patients

#44

Post by SketchySeaBeast »

refurb wrote: post #31
Gibbon1 wrote: post #15

Earlier quoted context omitted.

Kenneth Arrow showed in 1963 that markets can't work for Healthcare.

Yet they seem to work fine for elective surgery like vision correction and cosmetic surgery.

Possibly because there's an opt in gap between "I need larger breasts" and "If I don't find a way to pay for my chemo, I'll die"?

Re: Insulin Wars: How insurance companies farm out dirty work to doctors patients

#45

Post by myrryr »

tracker1 wrote: post #33

While not for everyone, there's religious-like contention on all sides... but a ketogenic diet and fasting focus can help most people get off of insulin. It isn't easy and takes more effort for some than others. I've been mostly off of insulin for well over a year, though I do keep a vial in the fridge for emergencies, I tend to have a spike once in a while. Personally, I think it's about time for medical patents to…

For type I diabetics, that option is off the table.

It isn't that they are resistant, it is they don't produce any at all.

It is insulin or death for them.

Re: Insulin Wars: How insurance companies farm out dirty work to doctors patients

#46

Post by amriksohata »

ninjin wrote: post #37
amriksohata wrote: post #22

I always say this, but reading that makes me think thank God for the NHS in the UK. Health and education should never be a business. The pharmaceutical companies are so strong and greedy in the US they want people on their drugs, rather than look for preventing the problems. They often lambast and send confusing scientific studies out to ensure no alternative therapies succeed over their drugs.

As a Type 1 diabetic in the UK I feel inclined to agree and disagree. Yes, the drug price negotiation is great and keeps my insulin affordable. However, the NHS comes with its own ailments that we should admit. For Type 1 diabetics in particular, technological support in the form of insulin pumps, continuous glucose metres, and closed-loop systems are only handed out readily to children, while in the US they are far…

Agreed lots of flaws, what I like is because it's state based it's in their interest to cut costs of medicine rather than try give as much medicine as they can to increase profits

Re: Insulin Wars: How insurance companies farm out dirty work to doctors patients

#47

Post by ceejayoz »

refurb wrote: post #34
ceejayoz wrote: post #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.

That’s list price. Interestingly, net prices have barely budged in the last decade. Up only single digit percentage.[1] As the list price rose and rebates grew, Novo ended up paying more and more rebate money into the health insurance system. Employers used these extra payments to offset costs in any area, including hospital and physician payments. Health plans used them to reduce premiums and also offset other healt…

https://www.nytimes.com/2018/07/27/health/rebates-high-drug-...

> Even as insurers’ drug spending has grown slowly, critics say the rebate game has served to inflate the list price of drugs, which consumers are increasingly responsible for paying. This is especially true for expensive specialty drugs, which treat serious conditions like cancer and multiple sclerosis — and whose prices have been skyrocketing.

> As the cost of these products has gone up, insurers have raised deductibles and out-of-pocket contributions so that many of the sickest Americans must now pay thousands of dollars a year to cover their drug costs. These out-of-pocket costs are calculated using something close to the list price of a product, not the net price.

Re: Insulin Wars: How insurance companies farm out dirty work to doctors patients

#48

Post by [deleted] »

conanbatt wrote: post #27
LorenPechtel wrote: post #7

I 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 Medi…

> 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. Then you only sell the drugs that do profit, and stop making the ones that cost money. You cant make people do what they don't want to do, pharma is no exception. The source of this problem is patent law, importation rest…

[deleted]

Re: Insulin Wars: How insurance companies farm out dirty work to doctors patients

#49

Post by test6554 »

LorenPechtel wrote: post #7

I 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 Medi…

Perhaps they should just prohibit price and coverage changes mid-year. It's fine if prices change from year to year, but what's not fine is if the drugs that are covered are suddenly not covered after you enroll in a medical plan for that year. Prices should be locked in for the following year by summer of the previous year and in the fall of the previous year when people start shopping for insurance plans, insurers should be able to provide a list of medications that they will guarantee to be covered.

Re: Insulin Wars: How insurance companies farm out dirty work to doctors patients

#50

Post by HarryHirsch »

hirundo wrote: post #23

> This pricing is, of course, hidden from most patients, except those without insurance, who have to pay full freight. The rest of the story flows from this. The ordinary price mechanism is broken because the patient isn't the customer, and the customer is paramount to any business. As long as most patients don't care what it costs most of the time, it will stay broken.

* As long as most patients don't care what it costs most of the time, it will stay broken*

Say what? With insulin it's "your money or your life".

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