cost of pen: I am Indian american. I was in India and picked up a years supply of lantus. There the 3ML pen retails for $14. Not only that they (Novortis, lilly and the gang) has separated insulin cartridge from pen. So if you have pen (6) then you can buy the insulin cartridge for 9-10. This drop the effective price even more.
pen needle: Here in USA, the doctors (on recommedation of big pharma) tell you to use pen needles only once. I wanted to buy about 500 pen needles because I paid $58 for 100 needles here after insurance paid their share. There was a intern sitting there, she asked me why you want to buy that many? Then she added," you can use these needles at least 3 times if not more", She further elaborated (freely) that only time you need to throw away the needle is when you hit a blood vessel. In India people use reuse needles all the time.
Syringes: I have personally used syringes for insulin al least 10 times for last 11-12 years. I never had insulin vial contaminated. I threw away syringe when I hit the blood vessel. For some time I rinsed the needle in distill water. Here, in USA, pharma (and doctors) tell you to use syringe only once. I was told in 2004 by a good friend in Ohio that a an old fashioned MD told hime to reuse syringes and as precaution, if you so desire, rinse it with distill water.
I am just sharing my experience and highlight the hidden motivations of some and casual “follow the crowd” mentality by others. We the consumer pay.
If govt of India can negotiate such discounts, why not our government???