Earlier quoted context omitted.
What's the actual situation there? I have read that cheap insulin for example is available at WallMart, but for some reason the price of insulin seems to be a huge issue.
There’s different kinds. IIRC the cheap stuff and Walmart is just that, cheap. It’s fast acting, and varies in how it reacts in the body. Our real issue here is that there is absolutely no incentives to control costs. You’d think our ins companies would do it, but I’m practice, they end up negotiating sweet deals with the drug manufacturers. say med X @ $1000/mo msrp, but the ins companies negotiate it down to $400/m…
I believe they offer R (short acting / 2-5h), N (medium), and L (long acting / 24h). The problem with the older insulins isn't so much that they're faster, it's that they're less "specific" (from my experience). A newer short acting insulin (Apidpra, etc) has a spike in the 15-30 minute range and the spike is steep and the tail (while up to 5 hours) is low. Whereas R peaks in the 30m-1h range and the peak is low and the tail is much higher. As such, you need to plan ahead much better for your eating. It's frustrating, but not horrible. The N and L have similar problems (L is the reverse, where you want a tail equal to the spike, but it isn't).
The newer insulins a just much more convenient and require a lot less planning of what you eat and when... and not as close an eye on your blood.