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Biohackers take aim at big pharma’s stranglehold on insulin

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Re: Biohackers take aim at big pharma’s stranglehold on insulin

#111

Post by giles7777 »

myelin wrote: post #40
sparrish wrote: post #8

This is bogus. Wal-mart sells insulin for $24.88 a vial without prescription currently. It's only the newer 'guchi' insulin brands that are crazy expensive. Stuff from 1996 that is compared to in this article is actually cheaper than it was in 1996 (adjusted for inflation).

Type 1 diabetic here. Managing T1D even with the "Gucci" insulins (I use Novolog and have tried Fiasp) is still a huge pain in the butt; you have to give yourself a dose of insulin a fairly precise amount of time before eating, and accurately judge how much you're going to need, which is half science and half wild guesswork. My per-meal dosage requirements vary randomly from month to month -- a dose that would be fin…

Have you tried low-carb eating? I've been doing it for years and it seems to be an easier method then insulin(type2 borderline when I started, so not exactly the same).

Re: Biohackers take aim at big pharma’s stranglehold on insulin

#112

Post by nceqs3 »

lotsofpulp wrote: post #103
gruez wrote: post #87

Earlier quoted context omitted.

That doesn't seem too strange when you consider that those two types of companies have different operating models. A drug company is in the business of taking relatively cheap goods and converting them to very expensive goods, in other words adding a lot of value. A insurance company/PBM is mostly in the business of skimming a percentage off transactions.

It is not strange, but it also contradicts claims about managed care organizations earning tons of money. It is not a business you go into to get super rich.

LMFAO. Express Scripts (the biggest PBM) was bought for 67 billion! They have never saved a patient life but are bigger than most pharma companies.

Re: Biohackers take aim at big pharma’s stranglehold on insulin

#113

Post by Teknoman117 »

chiefalchemist wrote: post #51
skohan wrote: post #41

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.

The situation is that Type 2 Diabetes has raised the demand for insulin. More demand raises prices. The thing we can't talk about without risking cancellation is that nearly all Type 2 Diabetes is preventable. In other words, the choices of the many have a significant negative impact on those (i.e., Type 1'ers) who don't really have a choice.

the EU has twice as many diabetics as the United States yet they have no "shortage" or "demand" related problems.

Our situation has nothing to do with demand and everything to do with corporate greed. Many western European countries empower their governments to set upper bounds on the costs of medication to reduce the ability of pharma-bros to make disgusting amounts of personal wealth off the suffering of others.

Re: Biohackers take aim at big pharma’s stranglehold on insulin

#114

Post by hourislate »

chiefalchemist wrote: post #51
skohan wrote: post #41

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.

The situation is that Type 2 Diabetes has raised the demand for insulin. More demand raises prices. The thing we can't talk about without risking cancellation is that nearly all Type 2 Diabetes is preventable. In other words, the choices of the many have a significant negative impact on those (i.e., Type 1'ers) who don't really have a choice.

I think we all understand that Type II is preventable but I don't think that's the main focus here. There are plenty of folks who have Type I that can't afford Insulin and have to ration it causing harm and additional costs in healthcare. It's slow mass murder for Type I diabetics who can't afford their medicine. If you believe that it is a supply and demand issue why does the same Insulin cost 80% less in a country like Canada and before you say it's subsidized, it isn't. An American can buy it for substantially less if they can get a prescription from a Canadian doctor.

Re: Biohackers take aim at big pharma’s stranglehold on insulin

#115

Post by HideousKojima »

RHSeeger wrote: post #71
mgarfias wrote: post #53

Earlier quoted context omitted.

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…

> It’s fast acting, and varies in how it reacts in the body. 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.…

If that's actually the case that puts all the "You're literally killing us with expensive insulin prices" people in a very negative light. At best they're ill-informed, at worst they're being intentionally deceptive to achieve political aims.

Re: Biohackers take aim at big pharma’s stranglehold on insulin

#116

Post by jcims »

gentleman11 wrote: post #36
f6v wrote: post #17

As someone who had to create transgenic E.coli in a lab, I admire the effort. It’s hard to get it right, especially when trying to make bacteria produce stuff for you. However, it feels like a huge step backward. Imagine you couldn’t afford to buy a piece of bread. Instead, you need to grow your own grains and build a windmill first. Sounds ridiculous in 2021.

My wife bakes bread almost every day and grows her own yeast. She loves it and the bread is fantastic. What is so ridiculous?

It’s a little more complicated than that. Bread is ingested through a system optimized to absorb nutrients from outside the body.

Insulin must make it into the bloodstream intact, typically through injection. It’s also incredibly potent, a unit of insulin dried to crystalline form weighs less than 40 micrograms, so it much be administered in a sterile carrier fluid.

Lastly the penalty for overdosing is generally called insulin shock or diabetic hypoglycemia, and ‘it is rare but possible for diabetic hypoglycemia to result in brain damage or death. Indeed, an estimated 2–4% of deaths of people with type 1 diabetes mellitus have been attributed to hypoglycemia.‘ [1]

That’s with pharmaceutical insulin, not DIY.

1 - https://en.wikipedia.org/wiki/Diabetic_hypoglycemia

Re: Biohackers take aim at big pharma’s stranglehold on insulin

#117

Post by nceqs3 »

lotsofpulp wrote: post #107
nceqs3 wrote: post #81

Earlier quoted context omitted.

That is a nonsense talking point from the industry. They use passthrough revenue to distort their profit margin. Express scripts is closer to 15% and CVS is closer to 10%. See https://www.fiercehealthcare.com/payer/facing-criticism-pbms... .

CVS net profit margin is in the 2% to 3% range: https://www.macrotrends.net/stocks/charts/CVS/cvs-health/pro... Cigna purchased Express Scripts in Mar 2018, and has profit margins of 3% to 5% over the last couple years. https://www.macrotrends.net/stocks/charts/CI/cigna/profit-ma... If these PBMs are making lots of profits, then they are simply subsidizing losses elsewhere in the MCO. The total costs paid for insuran…

You are not addressing my main point which is that these MCO's distort their "net margin" stat using accounting tricks. And yes PBM's are INCREDIBLY profitable. Express scripts made 4.5 billion in net income in 2017. They have never produced a drug that has saved a life.

PBMs are important but they should not be able to put a gun to these pharma companies heads because they control the formulary.

CVS net margin includes their retail business. You can't compare AWS's margin to Walmart's e-commerce margin.

Re: Biohackers take aim at big pharma’s stranglehold on insulin

#118

Post by lotsofpulp »

sithlord wrote: post #94
nceqs3 wrote: post #58

Earlier quoted context omitted.

The net price on Humalog has gone down since 2014. The PBMs are the ones who distort list prices.

This is probably true - and I am not here to point fingers - but I will say that the insulin manufacturers are at some fault too, they do just enough to keep renewing their rights to their insulins every time they come around.

You cannot renew a patent in the US. They get a new product patented, but anyone is still free to come along and make the older one. However, I bet there is a ton of expertise and cost required with doing that, and that is what is stopping others.

Re: Biohackers take aim at big pharma’s stranglehold on insulin

#119

Post by HPsquared »

mgarfias wrote: post #53
skohan wrote: post #41

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 guess the question is, do countries with socialized healthcare provide the cheap version or the expensive one?

Re: Biohackers take aim at big pharma’s stranglehold on insulin

#120

Post by UnpossibleJim »

RHSeeger wrote: post #71
mgarfias wrote: post #53

Earlier quoted context omitted.

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…

> It’s fast acting, and varies in how it reacts in the body. 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.…

They also tend to have a more reliable absorption curve. I take both Novolog (short acting) and Lantus (long acting), which are the newer insulins. Lantus has a more predictable long acting curve than the older L did, even though I take it in a 12 hour cycle. It rises not so much like a bell, but more like a plateau, I guess it a better analogy. At least for me. The L really was a pain for planning, especially when physical activity was involved, as it would shorten the bell curve.
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