Many of us struggle with the high costs of diabetes. And things which should be seemingly routine and inexpensive keep getting more and more expensive. A recent Bloomberg article alarms me that the few companies that control key medications like insulin are systematically colluding to raise prices in the market. Look at the chart below. Is that pricing behavior that reflects independent decisions and and a fair and competitive market? Personally, I don’t think so.
###What do you think? What should we as patients do?
This is alarming. I already pay a healthy co-pay for Lantus and Novolog, but what really concerns me is what happens when I retire 6 years from now with less money coming in.
I’m not sure how to tackle this issue. Voicing concerns with the pharma companies, insurance companies, and local and federal representatives seems to be the only options, but I can’t say that fills me with much hope.
“If any drug should be available generically, it should be insulin,” Greene said. The new insulins are “not so much better that it justifies the presence of people who can’t afford any drug.”
I find it completely infuriating that there are not generic versions of Humalog or Novalog. How long have those insulin’s been on the market? I believe I switched in 1995. So that is 20 years I have been using.
Close. You probably switched to Humalog in 1996 which is when it hit the US market. I was one of the first people to get it and I remember it came out quite a few months after I got my first pump in May 1996. I used Velosulin at first. Humalog was quite an improvement.
I would be interested in seeing some epidemiological data analysis on changes in demand for insulins since that is one of the reasons cited for price increases.
With only two competitors in the market, no collusion is necessary to have pricing harmonization.
I looked in to this, and didn’t find anything conclusive. However, I did find 3 hearsay sources on the web citing mandated reduced prices in the EU, resulting in sales at a loss from the fully amortized cost, so Sanofi and Lilly are making it up in the US, where prices are not regulated.
I don’t place much confidence in hearsay, so make your own judgement. I will say that at the European prices for these two drugs, they never would have been developed. Ever.
The manufacturers claim increased demand for their products to justify price increases so…what is the change over time in the number of prescriptions issued, units used, numbers of patients, etc.
Part of what makes insulin so difficult is that it is a biologic. And that means there will be no “generic” there will be a biosimilar. And while there are biosimilar products on the horizon there is a big barrier to market entry. So although some of these insulin products are slated to come off patent protection they will still have a protected market. And the sad thing is that if Novo-Nordisk or Sanofi develop a new insulin they will probably choose to discontinue the old product rather than letting it be cheaply available in the market. Some people believe that the move to eliminate animal insulin products was at least partly driven by those same desire to ensure higher profitability.
Speaking of animal insulins, I used to shake on Purified Pork insulin when I’d get low. AAMOF, before I got my first meter, I’d hold my hands out in front of me to see if they were trembling. If they were, I knew I was dropping and about to get quite low shortly. When I switched to Humulin, that all went away.
I think this type of thing is happening for other drugs which have gone generic too- my father’s digoxin went up to some crazy copay, about 3x as much as it was suddenly. Fortunately he found a way around it I think with his doctor’s help maybe. There was some loophole which allowed the price to be raised after a drug has gone generic.
While it seems likely that price controls are controlled collusively by the very small number of companies making insulin, it also seems reasonable to think there’s other parties colluding, insurers, maybe government health systems. If those parties are involved, I’d say there’s a conflict of interest with their customers and that this would be interesting to assert to press them to lower prices. The problem with this is that the details are likely “buttoned-down” with attorney-client privilege and uncovering the evidence would be very expen$ive.
I think test strips would be a better piece of D-gear to go for it with as the evidence that insurers and governments are clearly wrong and are clearly conspiring to limit access seems much clearer with strips.
Price control by foreign governments is unfair to the US market based economy. If a foreign country places a price control on a companies product in order to be profitable it must shift the research and development cost to their customers in the free market, they settle for a lower profit in price controlled countries and instead rely on unregulated markets for the lions share of their profit margin.
I am not one for price controls but I do believe that one simple control needs to be in place. A company should be forced to sell at the same cost in a free market country such as the US as they do in other places. I could envision an exemption for humanitarian reason such as in third world countries but in the developed world the playing field needs to be leveled.
I think it is hard to argue that Pharma is not profitable. I believe it is the third most profitable industry segment and profit margins are about 30%. I find arguments that companies are being squeezed by price controls a bit hard to substantiate.
That’s because there are price controls in the US except the people controlling them are the pharmaceutical companies, rather than the market, a nice arrangement for big pharm. My questions would go a bit beyond that since health insurers have the data to make arguments about price, which would be in their interest. While many health insurers are non-profit, there are still executives who are compensated, likely based on organizational performance. The fact that insurance companies overpay so ridiculously for such a popular medication suggests to me that there’s some type of collusion. Probably their lawyers don’t take notes at those meetings but the trail spreads across our marketplace…
What does insulin being “biologic” have to do with a generic not being created? I think after 20 years pharma has recouped their development cost plus profit and it is time to improve the product with a new patent or open it up to the generic market.
This explanation may just explain this idea of monopoly or even conspiracy hype regarding insulin:
Greene says the point of their recent study about insulin costs isn’t to simply blame the drug industry. “We do not believe that there is a conspiracy to keep insulin expensive,”
I use the expensive insulin because I pump mine. When biosimilar becomes available I will give it a try for sure!
The strips are another story. Again, I use the strip product that my pump works with. If the generic product would do that I would happily use it.
As for what should we as patients do, I think we already have to fight enough for the stuff we need. I guess the way to “force” change is to stop using the products we need to survive. I am pretty fearless and often walk on wires, but I am not willing to do THAT!
