In 2001, Acthar sold for about $40 a vial. Today: more than $40,000. An increase of 100,000 percent.
"Medicare is not allowed to negotiate the price of drugs because of a law passed by Congress." [1]
26-year-old recently removed from his parent’s insurance plan, was found dead in his home because he couldn't afford $1,300 per month for insulin. [2]
This is basically white-collar looting. It is sad that this allowed to happen in USA.
The problem is not that one company attempts to raise its prices, the problem is that it is very difficult for competitors to undercut them. The FDA has made it very expensive to introduce and support products in the US pharmaceutical market; it has imposed huge compliance costs, and helped drug companies sustain those costs through exclusivity arrangements.
Moralizing about health issues feels good, but these issues are created by simple economics (market and regulatory issues), not ethical deficiencies.
I live in CA and have type 2 diabetes, and I need to inject insulin once per day; on average, I use 1 insulin pen per month. The cost of 5 pens box at local pharmacy is about $33. The price used to be $40+ per box two years ago and recently dropped. So the insulin cost for me is about $7 per month.
I usually only care about the “real” price, which is the price I actually paid, rather than the prices from an article.
Maybe there’s difference between a type 1 patient, but this is my personal experience.
Is there any discussion as to why he didn't just switch to a cheaper (older) insulin? Last time I checked, it was still possible to get the older (R/N/L) insulins at around $25/bottle, over the counter.
I don't know why this propaganda is so highly upvoted. Monthly insulin doesn't cost $1,300. Nowhere near that. Maybe if you select the highest priced option on the market. But what stops you from buying a reasonably priced option?
Supported by both parties for decades. The US healthcare is between social and full private in a deep hole of despair and the funniest to me is that people trying to blame it on the other party they support. There are good examples for successful healthcare models in Asia or in Europe, they just need to pick one and go with it.
This shouldn't be allowed to happen. These people need this to live and your extorting as much as inhumanely possible from them. As a Canadian this disgusts me, I hope that there is change to allow people to get medication they need.
I thought the current administration was going to fix this problem once and for all. 3.9 years in and we’re no better than that other guy. I encourage you to vote and make sure your voice is heard!
> The final, net prices paid for insulins are likely to be significantly lower than manufacturer prices in the U.S. because rebates and other discounts often drive down the price paid by individuals in the U.S.
I suspect this gives a hint to one contributing factor. Suppliers probably list much higher prices so that they can negotiate lower prices with insurance companies without losing profit. But then the consumer needs to use an "in-network" supplier to get those reduced prices, which removes competition and drives prices up even further.
The only thing almost as obscene as medical sticker prices in the US is the amount that just disappears after insurance settles. I have actually had a bill with a 94% "insurance discount" applied.
bingo, the kick backs work in a similar feedback loop. My insurance only covers long term rx from CVS. If I go somewhere else, they stop covering it after about 3 fills.
CVS is more expensive then my warehouse club price.
To put this in perspective: I am from Slovakia (Europe). I am type 1 diabetic. NovoRapid (10 x 3ml) costs 73€. My insurance (which is required in Slovakia and costs me about 70€/month) covers 64€. That means I pay only 9€. I usually get one package every three months. That means insulin costs me 3€ per month. Average salary in Slovakia is currently 13100€/year.
OK good data point. Is NovoRapid about the same as Novolog 70/30? 73 euro is about $86 which is about the same price as Wallgreens/RiteAid. CVS is more expensive.
As someone who is type 1 diabetic, and someone who has had insurance that required me to pay up front, and then get reimbursed after the fact - insulin was charged at ~200 dollars a vial, I can't speak for everyone, as everyone is different - but i would hazard to guess that most use 2-3+ vials a month (of rapid acting, on a pump).
I had a 40 day insurance lapse when I started my new job and it was $350 for a vial for me :( luckily I only needed to buy one, and it was enough to last me until the end of the period.
For a full year and a half before that, I had to go to the pharmacy every 20 days to pick up more insulin because my insurance didn't want to risk paying for medicine that I could still use after leaving my job / insurance.
I wonder how long it will take the "favored nations" policy to get through the courts. And if it gets nixed by the courts, will Congress pick up the ball.
The only medications on the market that can prevent the transmission of HIV in people who don't have HIV costs about $2000 a month in the US. In the UK, they cost $40 a month. That's a 50x markup.
HIV transmission could be virtually eradicated within the US if at-risk populations had access to the medications at the same price as people in the UK do.
Several people in this thread are saying regulatory issues are a major cause. Can anyone elaborate on what those regulations look like?
I've been led to believe that a large fraction of pharmaceuticals consumed in the US are produced either entirely overseas, or else active ingredients are (and this causes challenges for the FDA to actively regulate those overseas producers).
Is it the case that in some Sanofi site in Frankfurt, the same insulin meeting the same standards is put into vials, some intended for the US market, some intended for other markets around the world ... and regulations prevent someone from buying vials in the EU and selling them in the US? Like, the regulation is not only about the production methods or quality control?
There's been a steady, and huge, increase of the prices of most pharmacy products. Not just prescription drugs. Look at vitamins. Some vitamins used to be extremely cheap. The manufacturing cost of Vitamin C is very low.
It's useful to compare prices between CVS in the US and Boots in the UK. They're the same company.
Abuterol/Ventolin rescue inhalers are $70 here, but like $5 everywhere else. They managed to get them repatented by claiming that the old versions were a major contributor to global warming. I guarantee you that thousands have died because of this price change.
I can't begin to imagine the burden of asthmatic Americans when the inhalers cost so much. Yes, they're about $5 in Australia, and I've even gotten them for free on occasion when I was unemployed.
Some quick stats about the medication from wikipedia [0] - The medication was generally available in the UK 1969 (1982 for USA), and in 2017 was the tenth most prescribed medication in the USA.
When I saw news popping up over the last year or so about how exciting it was for a generic inhaler to be approved and available I was surprised and appalled by the whole ordeal, to be honest. It's an essential medicine. Generics have been available for ages here.
How on earth can companies and the government be allowed to do this to people? I mean, the literal answer is probably the oligarchy. I would have thought that people who can manage their chronic health conditions and avoid becoming disabled (or dead) would be infinitely more exploitable than those who can't, but I guess the numbers have been crunched and that mustn't be the case. It's unspeakably awful.
For those who may find themselves unable to afford their prescription insulin, you should know that Walmart Pharmacies (in most states IIRC) offers both long-acting and short acting formulas (even have a 70/30 formula) under the Novalin brand name over the counter(no prescription needed) for $25/per 10ml vial of u-100.
Product Names:
Novalin N - XR for basal
Novalin R - fast acting for bolus
Novalin 70/30 - just a premix of the two shown 70% N 30% R.
It may not be the best formulation out there but so long as you pay close attention to how your body responds to it (ie. Typical bolus duration, Blood Glucose mg/dl lowered per unit of insulin etc) when you first start using it, it can be just as effective as the name brand anologues.
Sure, it has a longer duration and takes a bit longer before it takes effect, but those shortcomings can be addressed by simply making adjustments to when you are dosing.
I typically need to bolus about 1unit/12g of carbs 20-25 minutes prior to eating with Novalin vs 1unit/15g 10-15 minutes before using an analogue.
I've actually used Novalin R in lieu of analogues in my insulin pump now for about a year with no issues. I realize getting these devices may be financially out of reach for many since they are expensive, even with insurance. If you're interested in using one but are not able to afford the cost of initial cost, Medtronic used to offer a payment plan that did not require good credit at all (mine was a complete dumpster fire) back when I got mine 6 years ago so people who are interested and could possibly afford to make monthly payments it's worth taking to your doctor and the manufacturers reps about the options they have available.
Sorry in advance for any grammatical/spelling errors, on mobile topping in a text box ~6 lines tall and 32 characters wide.
I've heard this before and dont understand the reasons - is it really just an oligopoly ripping us off? I rarely trust newpaper articles because it is so politicized, but this looks like it really is.
Also I understand there are newer Insulins which may have a patent, but the original is 100 years old and patent was not an issue. Why aren't there more manufacturers?
Off-patent insulin is $25/vial at Walmart. I’ll yield to any diabetics for additional nuance, but AIUI, this form of insulin is harder to correctly administer.
The newer, patent protected versions are safer and more effective. Again, AIUI, patent protection for at least one form is expiring or expired recently.
Low profits and a giant moat. The civilized world keeps prices down because their governments do the buying, and meanwhile any new entrant needs to prove bioequivalence.
It's not that the market was totally innovation-free. Human insulin was a gigantic breakthough when Genentech brought it to market back in 1978.
Does anyone know what is necessary for someone to manufacture their own fast-acting insulin? I’m a T1 diabetic and would really like to buy the necessary infra to create my own insulin in preparation for the end times.
> The final, net prices paid for insulins are likely to be significantly lower than manufacturer prices in the U.S. because rebates and other discounts often drive down the price paid by individuals in the U.S.
Here in Russia price can only go up from manufacturer’s price. Simpler world.
Given the varying level of regulations in different countries "up to" means nothing where medical care is concerned.
What matters most is what are the prices in countries with equally strict quality controls, which would be, unless I'm mistaken, the EU, the British Commonwealth, Japan, and a few other places.
And the answer to that question seems to be >6x which is bad enough.
One of the things I've learned about persuasion is that I'm never, ever, going to persuade some people. What I can do is persuade people who can do it for me. In many cases, then, my time and effort is best spent on recruiting the folks who are good at explaining to others. In my experience most of these people can smell bullshit coming a mile away, and so if the first 'fact' out of my mouth is reproachable, I've already put them on the defensive.
I often hear, "we should be doing better than second and third world countries, so I'll list them too", that's a dangerous gambit. You're effectively appealing to nationalism and/or racism - we can't let 'those people' beat us. It's ugly, and if you have to stoop to that, is it really worth winning? It's no good living forever if you can't live with yourself.
> I often hear, "we should be doing better than second and third world countries, so I'll list them too", that's a dangerous gambit. You're effectively appealing to nationalism and/or racism - we can't let 'those people' beat us. It's ugly, and if you have to stoop to that, is it really worth winning? It's no good living forever if you can't live with yourself.
I don’t think anyone’s complaining about the price due to nationalism or racism... they just want to be able to afford insulin to keep themselves alive like they’d be able to in other countries.
Your comment is a mess. You essentially "throw a rock and then hide your hands" by stating that the rest of the world has wildly different quality controls, and then you state that you aren't going to argue about it but leave that point to other readers.
>..."we should be doing better than second and third world countries, so I'll list them too", that's a dangerous gambit. You're effectively appealing to nationalism and/or racism
Not really, what we're really saying is that with our tech resources, talent, governance and supplier pipelines we should be able to do better.
It's gatekeeping regulation under the guise of "quality control". Drug companies don't want competition from the bottom, they're happy with a regulatory framework that keeps small companies from entering the market.
Insulin itself would be simple and cheap to produce, but getting through the approval process is so expensive, it wouldn't make economical sense to then sell the product near cost. Insulin isn't the mass-market product it once was, because it has fallen out of favor for Type II diabetes and Type I diabetes is relatively rare.
The way other countries get around this is price controls. They just tell the companies what drugs are allowed to cost, so profits are limited not by competition, but by fiat.
I was always told we pay high prices to support research, which has been proven to be BS time and time again. The drug companies spend way more on marketing.
The capitalist market driven research only creates expensive drugs that treat wealthy people. India is coming up with a cheap paper based covid test, using governemnt backed research. Other countries are leaving us in the dust on results and research.
The argument I heard is that it is the US-based companies that are incurring all the R&D and subsequent safety approval costs. Once the drug is researched and determined to be safe, you'll have generic providers then make their own copies of it, for a fraction of the cost.
[+] [-] flowerlad|5 years ago|reply
26-year-old recently removed from his parent’s insurance plan, was found dead in his home because he couldn't afford $1,300 per month for insulin. [2]
This is basically white-collar looting. It is sad that this allowed to happen in USA.
[1] https://www.cbsnews.com/news/the-problem-with-prescription-d...
[2] https://www.nytimes.com/2018/06/22/well/diabetes-patients-at...
[+] [-] nickff|5 years ago|reply
Moralizing about health issues feels good, but these issues are created by simple economics (market and regulatory issues), not ethical deficiencies.
[+] [-] sushicat|5 years ago|reply
I usually only care about the “real” price, which is the price I actually paid, rather than the prices from an article.
Maybe there’s difference between a type 1 patient, but this is my personal experience.
[+] [-] offtop5|5 years ago|reply
I know if I wasn't upper middle class I'd likely be skipping medicine right now.
NHS style healthcare should be a human right
[+] [-] maxerickson|5 years ago|reply
The law says that the private insurance negotiates the prices rather than the government.
So the implication, that drug prices are not negotiated, is incorrect.
Here's an article about children and babies paying lots for Acthar too:
https://www.cnn.com/2018/06/29/health/acthar-mallinckrodt-qu...
They aren't on Medicare!
Of course, the conclusion that the entire insurance system is broken is just as bad or worse.
[+] [-] RHSeeger|5 years ago|reply
[+] [-] bufferoverflow|5 years ago|reply
[+] [-] StreamBright|5 years ago|reply
[+] [-] thisisnico|5 years ago|reply
[+] [-] notyourwork|5 years ago|reply
[+] [-] thayne|5 years ago|reply
I suspect this gives a hint to one contributing factor. Suppliers probably list much higher prices so that they can negotiate lower prices with insurance companies without losing profit. But then the consumer needs to use an "in-network" supplier to get those reduced prices, which removes competition and drives prices up even further.
[+] [-] vonmoltke|5 years ago|reply
[+] [-] pnutjam|5 years ago|reply
CVS is more expensive then my warehouse club price.
[+] [-] sxp|5 years ago|reply
The price charts are on page 10.
[+] [-] 54794836|5 years ago|reply
[+] [-] x87678r|5 years ago|reply
https://www.goodrx.com/novolog-70-30
[+] [-] sithlord|5 years ago|reply
[+] [-] grep_name|5 years ago|reply
For a full year and a half before that, I had to go to the pharmacy every 20 days to pick up more insulin because my insurance didn't want to risk paying for medicine that I could still use after leaving my job / insurance.
[+] [-] Consultant32452|5 years ago|reply
https://www.forbes.com/sites/avikroy/2020/07/24/trumps-most-...
[+] [-] throwaway13337|5 years ago|reply
All other countries price the drug at around 1 to 1.5k per month.
I'd been getting it from other countries over the years but, due to covid, it's not an option really.
The medical industry and its regulatory support by the government are doing a lot to destroy this country.
[+] [-] heavyset_go|5 years ago|reply
HIV transmission could be virtually eradicated within the US if at-risk populations had access to the medications at the same price as people in the UK do.
[+] [-] abeppu|5 years ago|reply
I've been led to believe that a large fraction of pharmaceuticals consumed in the US are produced either entirely overseas, or else active ingredients are (and this causes challenges for the FDA to actively regulate those overseas producers).
Is it the case that in some Sanofi site in Frankfurt, the same insulin meeting the same standards is put into vials, some intended for the US market, some intended for other markets around the world ... and regulations prevent someone from buying vials in the EU and selling them in the US? Like, the regulation is not only about the production methods or quality control?
[+] [-] pas|5 years ago|reply
In case of insulin the problem is that currently it's a mess, supply is low, demand is high, so price is high too.
https://care.diabetesjournals.org/content/41/6/1299
[+] [-] Animats|5 years ago|reply
It's useful to compare prices between CVS in the US and Boots in the UK. They're the same company.
[+] [-] bilekas|5 years ago|reply
https://www.indexmundi.com/facts/indicators/SH.STA.DIAB.ZS/r...
[+] [-] notRobot|5 years ago|reply
[+] [-] pessimizer|5 years ago|reply
[+] [-] magnetowasright|5 years ago|reply
Some quick stats about the medication from wikipedia [0] - The medication was generally available in the UK 1969 (1982 for USA), and in 2017 was the tenth most prescribed medication in the USA.
When I saw news popping up over the last year or so about how exciting it was for a generic inhaler to be approved and available I was surprised and appalled by the whole ordeal, to be honest. It's an essential medicine. Generics have been available for ages here.
How on earth can companies and the government be allowed to do this to people? I mean, the literal answer is probably the oligarchy. I would have thought that people who can manage their chronic health conditions and avoid becoming disabled (or dead) would be infinitely more exploitable than those who can't, but I guess the numbers have been crunched and that mustn't be the case. It's unspeakably awful.
[0] https://en.wikipedia.org/wiki/Salbutamol
[+] [-] anoraca|5 years ago|reply
[+] [-] rigrassm|5 years ago|reply
Product Names:
Novalin N - XR for basal
Novalin R - fast acting for bolus
Novalin 70/30 - just a premix of the two shown 70% N 30% R.
It may not be the best formulation out there but so long as you pay close attention to how your body responds to it (ie. Typical bolus duration, Blood Glucose mg/dl lowered per unit of insulin etc) when you first start using it, it can be just as effective as the name brand anologues.
Sure, it has a longer duration and takes a bit longer before it takes effect, but those shortcomings can be addressed by simply making adjustments to when you are dosing.
I typically need to bolus about 1unit/12g of carbs 20-25 minutes prior to eating with Novalin vs 1unit/15g 10-15 minutes before using an analogue.
I've actually used Novalin R in lieu of analogues in my insulin pump now for about a year with no issues. I realize getting these devices may be financially out of reach for many since they are expensive, even with insurance. If you're interested in using one but are not able to afford the cost of initial cost, Medtronic used to offer a payment plan that did not require good credit at all (mine was a complete dumpster fire) back when I got mine 6 years ago so people who are interested and could possibly afford to make monthly payments it's worth taking to your doctor and the manufacturers reps about the options they have available.
Sorry in advance for any grammatical/spelling errors, on mobile topping in a text box ~6 lines tall and 32 characters wide.
[+] [-] x87678r|5 years ago|reply
Also I understand there are newer Insulins which may have a patent, but the original is 100 years old and patent was not an issue. Why aren't there more manufacturers?
[+] [-] coredog64|5 years ago|reply
The newer, patent protected versions are safer and more effective. Again, AIUI, patent protection for at least one form is expiring or expired recently.
[+] [-] HarryHirsch|5 years ago|reply
Low profits and a giant moat. The civilized world keeps prices down because their governments do the buying, and meanwhile any new entrant needs to prove bioequivalence.
It's not that the market was totally innovation-free. Human insulin was a gigantic breakthough when Genentech brought it to market back in 1978.
[+] [-] criddell|5 years ago|reply
[+] [-] helsinki|5 years ago|reply
[+] [-] lolc|5 years ago|reply
[+] [-] mkevac|5 years ago|reply
> The final, net prices paid for insulins are likely to be significantly lower than manufacturer prices in the U.S. because rebates and other discounts often drive down the price paid by individuals in the U.S.
Here in Russia price can only go up from manufacturer’s price. Simpler world.
[1] https://redapteka.ru/catalog/lekarstva/endokrinologiya/sakha...
[+] [-] hinkley|5 years ago|reply
What matters most is what are the prices in countries with equally strict quality controls, which would be, unless I'm mistaken, the EU, the British Commonwealth, Japan, and a few other places.
And the answer to that question seems to be >6x which is bad enough.
One of the things I've learned about persuasion is that I'm never, ever, going to persuade some people. What I can do is persuade people who can do it for me. In many cases, then, my time and effort is best spent on recruiting the folks who are good at explaining to others. In my experience most of these people can smell bullshit coming a mile away, and so if the first 'fact' out of my mouth is reproachable, I've already put them on the defensive.
I often hear, "we should be doing better than second and third world countries, so I'll list them too", that's a dangerous gambit. You're effectively appealing to nationalism and/or racism - we can't let 'those people' beat us. It's ugly, and if you have to stoop to that, is it really worth winning? It's no good living forever if you can't live with yourself.
[+] [-] chrisseaton|5 years ago|reply
I don’t think anyone’s complaining about the price due to nationalism or racism... they just want to be able to afford insulin to keep themselves alive like they’d be able to in other countries.
[+] [-] x86_64Ubuntu|5 years ago|reply
>..."we should be doing better than second and third world countries, so I'll list them too", that's a dangerous gambit. You're effectively appealing to nationalism and/or racism
Not really, what we're really saying is that with our tech resources, talent, governance and supplier pipelines we should be able to do better.
[+] [-] gridlockd|5 years ago|reply
Insulin itself would be simple and cheap to produce, but getting through the approval process is so expensive, it wouldn't make economical sense to then sell the product near cost. Insulin isn't the mass-market product it once was, because it has fallen out of favor for Type II diabetes and Type I diabetes is relatively rare.
The way other countries get around this is price controls. They just tell the companies what drugs are allowed to cost, so profits are limited not by competition, but by fiat.
[+] [-] Guest42|5 years ago|reply
[+] [-] pnutjam|5 years ago|reply
The capitalist market driven research only creates expensive drugs that treat wealthy people. India is coming up with a cheap paper based covid test, using governemnt backed research. Other countries are leaving us in the dust on results and research.
[+] [-] mindfulplay|5 years ago|reply
But because this is a multiheaded beast with no clear villain to blame, nothing really happens. Congress are to blame.
[+] [-] IanDrake|5 years ago|reply
I wish someone would do something about it. Like an executive order or something.
[+] [-] addflip|5 years ago|reply
1.) https://www.whitehouse.gov/presidential-actions/executive-or...
[+] [-] ghostbrainalpha|5 years ago|reply
As a diabetic I was excited to hear when Trump said that he had made Insulin as cheap as water.
However it still looks like it costs around $300 per vial at my pharmacy.
[+] [-] apta|5 years ago|reply
Is there any merit in this argument?
[+] [-] unknown|5 years ago|reply
[deleted]