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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

#221

Post by thesausageking »

ProjectInsulin wrote: post #106
ender341341 wrote: post #61

Earlier quoted context omitted.

As someone with little actual knowledge of different insulin, I've been told that the cheaper one that Walmart sells is significantly harder to manager and you tend to end up going through lots of spikes & dips with it, which while enough to still live for some is pretty debilitating. Hopefully California is planning on doing a different style of insulin that better manages that?

Unfortunately, this is true, and a lot of people struggle to manage their diabetes after switching to the Walmart brand. The stories I have heard generally occur to young adults who have to transition out of their parents' insurance plans. https://theconversation.com/why-telling-people-with-diabetes...

This article is from 2019 and is out of date. It's saying that Walmart only sells human insulin which isn't true any more. ReliOn NovoLog is a modern, analog insulin and is exactly the same as "regular" NovoLog:

https://www.walmart.com/cp/relion-diabetic-care/3769564

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

#222

Post by Rebelgecko »

olliej wrote: post #76
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…

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…

Will California's insulin be any different than the kind you can get for $25 at Walmart?

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

#223

Post by advisedwang »

frgtpsswrdlame wrote: post #48
advisedwang wrote: post #20

Earlier quoted context omitted.

The reason private insurance was excluded from the bill was because of the "Byrd Rule". The senate parliamentarian gets to rule on and decides it unilaterally. The only reason to do it in reconciliation in the first place is because of the filibuster. I would say that whole combination is pretty arcane.

To be clear, the parliamentarian is only an advisory role, they don't get to rule or decide anything, only offer guidance which senators then choose to listen to. But they could ignore it (and have done so in the past) or can fire the parliamentarian and pick a new one which is more likely to advise in the way that they want (and have done so in the past.)

It's not the senate generally that is taking the parlimentarian's advice in this case, but the presiding officer, who does get to unilaterally decide (although the have some options).

See 2 USC 641(d) for it being out of order and Senate rule XX for how those are decided (which is surprisingly flexible, as you hit). Or for a more readable source: https://www.cbpp.org/research/federal-budget/introduction-to...

But the fact that we're even discussing this shows that the article is pretty reasonable in calling this arcane.

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

#224

Post by olliej »

basch wrote: post #206
olliej wrote: post #205

Earlier quoted context omitted.

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 approval…

You are missing the point. Every kind of insulin is more expensive in the US than _every_ other country. It's not just old stuff is "cheap", new stuff is expensive. It's old stuff is more expensive in the US, new stuff is more expensive in the US.

Average prices per "standard unit"

  * Rapid acting: $120 (US) vs $13.50 (JP)

  * Rapid-int (?) acting: $107(US) vs. $13 (JP)

  * Short-acting: $87 (US) vs $19 (FR)

  * Short-int acting: $95 (US) vs $13 (JP)

  * Intermediate acting: $73 (US) vs $13 (JP)

  * Long acting: $88 (US) vs $15 (JP)
Based on https://www.rand.org/pubs/research_reports/RRA788-1.html

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

#225

Post by refurb »

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…

Its ridiculous initiative is why.

California will make insulins already off patent. Ones where lower cost versions are already available. It would be far smarter to just subsidize existing versions.

But it doesnt solve the problem that the latest cutting edge patented insulins cant be copied by the government.

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

#226

Post by 6nf »

ProjectInsulin wrote: post #219
6nf wrote: post #186

Earlier quoted context omitted.

Why is insulin not expensive in other countries?

While I don't know the answer to this in-depth I can share some bullet points and of course it depends on what country you are talking about. On top of that it is important to note that there are insulin shortages in various countries. - one payer healthcare systems - non-convoluted distribution systems - depending where cheaper workforce/cheaper to make the insulin - less stringent regulatory processes - stronger lo…

There are no shortages in Australia, only the Eli Lily brand is low in stock but all other brands are available.

I've never heard of anyone unable to find insulin in Australia.

https://apps.tga.gov.au/Prod/msi/Search/Tradename//53488

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

#227

Post by basch »

olliej wrote: post #224
basch wrote: post #206

Earlier quoted context omitted.

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 approval…

You are missing the point. Every kind of insulin is more expensive in the US than _every_ other country. It's not just old stuff is "cheap", new stuff is expensive. It's old stuff is more expensive in the US, new stuff is more expensive in the US. Average prices per "standard unit" * Rapid acting: $120 (US) vs $13.50 (JP) * Rapid-int (?) acting: $107(US) vs. $13 (JP) * Short-acting: $87 (US) vs $19 (FR) * Short-int a…

Novolin/ReliOn is nowhere near that expensive. I skimmed it, but report you are citing appears to be averaging the price of insulin types. So if there is a cheap rapid and an expensive rapid, it ignores that somebody can buy the cheap one. That averaging distorts the price of available traditional insulin dramatically.

https://www.goodrx.com/healthcare-access/research/how-much-d...

It is more expensive in the United States because the US is subsidizing the earnings requirements the companies who make the drug require to develop new variants. At a high level, everybody pays insurance, it gets funneled into high drug prices, high drug prices pay shareholders and fund R&D. It's capitalisms version of socialized drug creation, and the rest of the world benefits from the US overpaying.

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

#228

Post by anonuser123456 »

swayvil wrote: post #210
anonuser123456 wrote: post #187

Earlier quoted context omitted.

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.

Insulin has a cold chain requirement, so smuggling is not recommended.

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

#229

Post by acdha »

tptacek wrote: post #185
kmeisthax wrote: post #180

Earlier quoted context omitted.

American schooling sucks because it's beholden to political objectives contrary to the interests of educating children. Look at the manufactured controversy over "intelligent design" a few decades back, or the current controversies over transgender bathroom access, or Florida's censorship of material in school libraries[0]. Municipal broadband and the post works well because the US is good at building infrastructure.…

None of this has anything to do with why school sucks. Schooling sucks because it's erratically funded. Wealthy families arrange to live in suburbs designed explicitly to cordon their children off from there less wealthy peers, each time setting up a vicious cycle where homes in those school districts derive much of their value from school funding, creating an incentive for an ever-increasing levy for de-facto privat…

I agree with what you wrote and would add that a lot of times we’re only talking about schools because that’s how we fund a lot of social services in the United States.

My wife is a public school teacher here in DC. You can always find examples of the popular culture war hobby-horses, but most of the time when a student isn’t doing well it comes down to money. It hurts hearing about a kid who’s trying but falling behind since they haven’t slept more than two consecutive nights in the same place since a parent lost a job, or the top kid in the class cancels their SAT test because they need to watch a younger sibling because their mother can’t afford to miss work. When it comes to stats, that shows up for the school even if the student can’t.

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

#230

Post by refurb »

ZeroGravitas wrote: post #16

Seems to be a weirdly US specific problem: https://worldpopulationreview.com/country-rankings/cost-of-i...

The net price of insulin has been dropping for years. The list price (public price) is what everyone gets worked up about, but very few people py it.

https://1.bp.blogspot.com/-ZfBANMMU5dQ/XzFtNw93ZCI/AAAAAAAAq...

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