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Insulin is way too expensive. California has a solution: Make its own

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Re: Insulin is way too expensive. California has a solution: Make its own

#201

Post by PragmaticPulp »

r3trohack3r wrote: post #69

> Though insulin generally costs less than $10 per dose to produce, some versions of the drug have a list price above $200. This is in part because, in the US, a warped market has allowed three companies to dominate the insulin business. > With California leading the way, a handful of states are considering trying to disrupt the market for essential medications, starting with insulin. The plan would be to manufacture…

> I feel like I'm missing something here. My understanding of why insulin is so expensive: laws are created and enforced by the government preventing people from competing in the space

The article doesn't do a good job of explaining that "insulin" isn't a single drug, or at least how they describe it.

Generic insulin is cheap. You can get it for $25/vial from your local Walmart. With production costs, regulation compliance, storage, transport, and paying pharmacists, they're not making much profit on that.

Patented insulin analogs are not cheap. They have different characteristics for duration and onset time that make them easier to dose, but the patent means that you can't produce and sell it unless you own the patent or have licensed it. Drug companies who own these patents set their prices according to what they can get insurers to pay, not according to what they expect people to pay out of pocket.

One of the weird quirks of the US medical system is that drug companies often have alternate prices for people without insurance. Remember, the high prices aren't designed for you to pay, the high prices are designed to extract as much money as possible from your insurance company.

You can see this in action on drug company websites. Lilly has a program that will cap your payments at $35 for even their expensive insulin analogs: https://www.insulinaffordability.com/ You have to renew every 12 months and hope they're still doing it, but they generally keep these programs around because it dampens the outrage about the high prices.

Re: Insulin is way too expensive. California has a solution: Make its own

#202

Post by basch »

dmitriid wrote: post #192
basch wrote: post #165

Earlier quoted context omitted.

Which is what the conversation should be, and how it should be framed. The press writing "life saving insulin" headlines takes away from the ability to discuss that: within the last decade or two, modern improvements made the process of managing diabetes significantly easier and else stressful. The drug companies gave everybody a taste of an easier life, and then jacked up the price, saying "pay us more or go back to…

> At what level should the government step in and subsidize or control this quality of life improvement? At what level should its creators be rewarded? You assume that creators are rewarded. In Sweden you get the insulin and pens for free (that is, you've paid for it with your taxes).

And it was invented there? When I say create I mean discovered not manufactured. The R&D.

And the answer/solution is somewhere in the realm of a public/private hybrid, where the government is funding short term expensive, long tail benefit research.

Re: Insulin is way too expensive. California has a solution: Make its own

#204

Post by SecurityMinded »

Don't believe in Gavin Newsom's new bullshit. Last I heard about this, a Vial of generic insulin was going to be $35. Walmart sells the same insulin (regular or suspended varieties) for $25 It is just a publicity ploy. Even at $25/vial, Walmart insulin has a very nice mark-up. Why buy it from state of CA for a more expensive price tag? To boot all of this, if you do not have health insurance, Walmart sells the insulin to you without prescription. CA? Not so much. I am sick and tired of this quasi-populist sounding stories from California nad other liberal inundated locations.

Re: Insulin is way too expensive. California has a solution: Make its own

#205

Post by olliej »

basch wrote: post #128
olliej wrote: post #76

Earlier quoted context omitted.

You know developing insulin doesn't require violating patents, right? And the price of insulin in the US is entirely an artifact of monopoly behavior by a small number of pharmaceutical companies? The ability to mass produce insulin at negligible cost has been around for decades, they guy who discovered it made it patent free even. Only in the US do companies get away with this kind of price gouging, and only because…

Insulin is cheap. Long acting insulin is not. They are different products, and the formers patent being free has nothing to do with the later innovations being locked down.

The whole point of this is that insulin is more expensive in the US than elsewhere. So maybe it isn't "cheap", the point is the price is being inflated due to many factors, including through monopoly tactics such as paying off competitors to not compete.

Re: Insulin is way too expensive. California has a solution: Make its own

#206

Post by basch »

olliej wrote: post #205
basch wrote: post #128

Earlier quoted context omitted.

Insulin is cheap. Long acting insulin is not. They are different products, and the formers patent being free has nothing to do with the later innovations being locked down.

The whole point of this is that insulin is more expensive in the US than elsewhere. So maybe it isn't "cheap", the point is the price is being inflated due to many factors, including through monopoly tactics such as paying off competitors to not compete.

Traditional insulin is cheap in the US. The price has not changed in a decade. Nobody wants it, it is a product of last resort.

Modern insulin is protected by moats, two of which are intellectual property and regulatory approval. Modern insulin being cheaper in other countries is because they are not following the same trade and approval laws. The way to match abroad prices would be to change protections and approvals, the latter of which is and has been happening over the last five years.

Re: Insulin is way too expensive. California has a solution: Make its own

#207

Post by philjohn »

thesausageking wrote: post #46

Walmart now sells Novo Nordisk produced insulin for $17 per pen[0]. I have a hard time believing California will do it cheaper than that. [0] https://www.walmart.com/cp/relion-diabetic-care/3769564

It says from $73 per vial or pen on the site for me?

Re: Insulin is way too expensive. California has a solution: Make its own

#208

Post by Spooky23 »

WalterBright wrote: post #169
Spooky23 wrote: post #124

Earlier quoted context omitted.

Not really. The internet is an example of what happens when you suck margin out of high margin businesses like content creators. India is an example for pharmaceuticals. If the state takes a commodity and sells it on a cost plus or cost basis, it’s going to kill investment in the spaces and collapse the margin. At this point, we’re killing people and bankrupting states and employees with out of control costs. Making…

> Making an example out of insulin would fix that No it won't. It will just shift the cost to the taxpayers.

Who do you think is paying now? States are spending billions on it through Medicaid cost share.

A state like California with a contract manufacturer would probably break even on the insulin and save billions for reduced complications. Poor people with diabetes are frequent fliers for ER admissions. The cost of one ER visit is probably close to annual insulin cost.

Re: Insulin is way too expensive. California has a solution: Make its own

#209

Post by ksaun »

basch wrote: post #115
rayiner wrote: post #73

Earlier quoted context omitted.

> I don't understand. My understanding of why insulin is so expensive: intellectual property laws are enforced by the government preventing businesses without that intellectual property to compete in the space. That’s not an accurate understanding of intellectual property specifically. Insulin isn’t like a pill, where once you have a chemical formula you can make millions of them very cheaply. It’s a biologic, an art…

People dont want insulin (traditional insulin.) They want fancy insulin (modern insulin), because it is convenient. They want modern rapid and long acting insulin. They want pens. Maybe people want the inhalable powder. Those innovations exist outside the original insulin patent. They are also mixing other drugs with the insulin. >Average retail prices of Novolin and Humulin (traditional short- and intermediate-actin…

I do agree with the statement that some of the language around the lack of insulin availability is misleading, but it's not just that it's more convenient. "Fancy" insulin allows one to better manage blood glucose levels. Poorly managed blood glucose strains various organs/systems in the body and over years and decades leads to various health complications, some resulting in death. (It's still a lot of work and stress -- modern insulin isn't an automatic improvement; but it does allow greater success in managing diabetes.)

(My comments here are in the context of type 1 diabetes. The (potential) positive health impact of modern insulin may be less pronounced for other diabetics.)

Re: Insulin is way too expensive. California has a solution: Make its own

#210

Post by swayvil »

anonuser123456 wrote: post #187
genderwhy wrote: post #60

This is great news. Honestly, I hope to see more nationalization of widely used services (or whatever the equivalent word for nationalization is at state or municipal levels.) Municipal broadband, power, roads, schools, post, housing, and healthcare? It's long overdue, and with an appropriate amount of funding has been shown to be effective at controlling costs and delivering moderately good quality in most cases. A…

If you study the insulin pricing issue carefully, you will find that largely the problem is government, not the market. The profit motive coupled with competition works very well to keep prices low. You need only realize the following; European firms stand at the ready to supply insulin at well below US prices today, but are prevented from doing so by the FDA. And they can do so and still turn a profit.

Can I, in the usa, order my insulin to be delivered from Europe? If not then it's a fabulous opportunity for an enterprising smuggler.
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