Great video feature in today's NYT!

Really hard hitting piece on insulin price gouging today:

8 Likes

Powerful. The big three insulin manufacturers in the US are so over-the-top greedy, they are sorely in need of some adult supervision. When will the outrage reach a critical mass and lead to the obvious regulation needed. The so-called “free market” has failed us entirely.

2 Likes

Very compelling piece.

I’m not holding my breath waiting for congressional action after the recent hearings. The representatives had their ‘day in the sun’ brow-beat the insulin manufacturers and PDM’s in public. They’ve extracted the PR they need by showing outrage and concern. I can only hope urgent action is going on in the background.

2 Likes

You want to get really angry? Look who is setting prices! The PBMs, aka Pharmacy Benefit Managers. They started out about 25 years ago as electronic claims processors and now, almost entirely control EVERYTHING that does on in pharmacies, and they’re almost completely unregulated. They literally set prices in ALL pharmacies, chains and indies, across the land. And they do not play fair either. This group should be federally investigated but more people need to be aware! Ask your pharmacist about PBMs! Bet you won’t get a nice answer. It will blow your mind. My state, Alaska, is preparing legislation to get a handle on this out of control hidden cost to our drugs. IT’s almost like they’re the “Mafia of the Rx Drug Market.”
https://www.statnews.com/2018/08/27/pharmacy-benefit-managers-good-or-bad/

3 Likes

Thanks for posting.

Quit your hysterical whining New York Times…

Walmart sells insulin over-the-counter for $25 a vial… Novalin R, Novalin NPH etc. Diabetics, even those who are uninsured and in poverty can survive and thrive very nicely on R and NPH insulins and can afford Walmart’s prices.

1 Like

R and NPH is like going back to outhouse toilets with holes in the ground filled with lime and spiders.

Why should diabetics go back to hard to control methods while big pharma is greedily gobbling up dollars? It is not as though the cost of producing insulin is sky high and difficult. It is not!

4 Likes

The New York Times movie whined about desperate diabetics having to buy from street-pushers, having to go over the border to buy insulin, and being bankrupted by needing to buy insulin.

The “R” and “NPH” insulins are able to control diabetes just as well as the latest types of insulin and diabetics will live just as long under insulin therapy using “R” and “NPH” as they will under Toujeo, Humalog, Lantus, Levamir, Tresiba etc. It takes careful blood sugar monitoring and scheduling of meals to control your diabetes no matter what type of insulin you take.

Hysterical videos with people whining “I’m going to die and/or go bankrupt because of ‘big pharma’” is meant to do nothing more than arouse hysteria and mob anger at the pharmaceutical companies and pharmacy marketeers. These parties may be corrupt and evil etc but the “I need Toujeo or else I die” garbage is just not accurate or fair. Sorry, use NPH and buy a $10.00 ReliOn meter and $20 for a hundred strips, test your blood, find out your “peak” schedule, and live with it.

I’m a large animal veterinarian who pays for my Obamacare health plan on my own, and who has tight control over my diabetes using Humulin “R” and “NPH” and up till a couple of months ago, solely controlled my diabetes using the ReliOn meter (I now have a Dexcom G6). Nobody is too poor to control their diabetes with care and monitoring whether they have insurance or not.

I agree that the media goes overboard on a lot of subjects with a great deal of drama and histrionics. That said, have you started to dig your very own outdoor privvy and gotten oil lamps (ala Amish) to go with your self-imposed R and NPH?

I am a large animal owner and when my animals get old and arthritic, I don’t work them anymore (not even lightly like I did during their productive years) and I do give them expensive Equioxx to temper their joint pain. If I am not mistaken, Merck took Vioxx off the human market and now sells it through vets for large animal use as Equioxx. Should I go back to bute that caused stomach ulcers?

PBMs also benefit by the list price being insanely inflated so they can “negotiate” to their agreed rate and take a percentage of the reduction as part of their fee. PBMs are indeed one of the biggest flaws in our very broken system.

I’m sorry, but that’s an absurd statement. I’ve used R and NPH all the way back to when they were derived from animal sources. Each step forward in insulin formulation has improved my control and quality of life, as have blood glucose meters, insulin pumps, CGMs, etc. You switched from test strips to CGM. Why? Can’t you can survive and control your diabetes just as well without it?

The question at hand isn’t “Can you survive without it”, but “Why should you have to regress your control regime because of unjustifiable and outrageous price increases on the likes of Humalog and Novolog?”

10 Likes

What Paytone said!!!

1 Like

Well said. Speaking from my own 20 years’ experience on R/N, I would not deny that you can “survive and thrive” on it—well, survive anyway—but at considerably more effort, a considerably more restricted quality of life, and considerably more day to day concern about severe and unexpected lows. Yes, it’s better than dying of DKA, but it’s not “whining” to point out that the actual production cost of modern insulins is less than $10, and that what has elevated the list price to 20-30x that amount is monopolistic price fixing and a kickback scheme with the PBMs. When this stuff was introduced it was priced at a level that you could buy it out of pocket if you had to and still be able to pay your rent. The fact that inferior insulin is still available at Walmart doesn’t make this situation acceptable. R/N is riskier, quite different from what most diabetics are trained on, and if you lack insurance you’re not going to have a physicians assistance in transitioning to it.

6 Likes

Yes, you are absolutely right. I used the R/NPH MDI regimen for years. My risk of dangerous lows was high, especially overnight. It scared me, it scared my husband, it scared my children after he died. The boys were 10 and 12, but they knew what to do when I called to them in the night because I couldn’t move, my speech slurred and my skin cold. Since I went on a pump, with Novolog, I haven’t had one of those episodes, and my A1c is under 7 for the first time in my life.

Fortunately, I don’t have to go back to that, because 1) I have a pump and 2) I’m on Medicare. Insulin isn’t an issue for me anymore, and I don’t have to fight with the pharmacist about how much they’ll give me this month.

Good for you, Fred, that you have a G6. I’ll be on the waiting list for that at least until the end of the year, because I’m old. And, for all that, I’m still in better shape than I was on R/NPH.

8 Likes

Yes, let’s go back to prehistoric times and “thrive.” :roll_eyes:

Yes, I agree. My older sister and I were both diagnosed with Type 1 diabetes 48 years ago. I have been on Tresiba for about 1.5 years and it has really helped me minimize my nighttime hypoglycemia. My sister tried Tresiba but she felt she was allergic to it. Not quite sure what her symptoms were but I think she gave it a good shot. Not sure how common that is in diabetics…

Couldn’t have said it any better myself. How I managed to use R/NPH/Lente (all beef/pork derived) for 30+ years and didn’t develop serious long-term diabetic consequences is amazing.

Did I survive? Yes. Did I thrive? Depends what your definition of thriving is. I regularly had night-time hypos that left me unable to move or even speak for the following 18 hours. And there were no CGM’s or meters in those days.

@Fred_E If you’re happy using R/NPH that’s great, and it’s wonderful that this protocol works for you and you’re satisfied with your level of control.

3 Likes

The thing is, standards of treatment do change. R/N is still available, but so are Chemstrips, and for that matter you could still use glass-and-steel syringes and test your urine BG by the old stove-top method. At this point the analog insulins of the Novolog & Lantus class have been around for 20 years. Not even talking about variants like Fiasp, or not particularly-recent ones like Toujeo. This isn’t experimental treatment, it’s the base standard. When it was introduced, it was widely stated that the costs would come down with time, as they would do if normal market forces were in play. Instead, the opposite has happened by orders of magnitude, and that rules arguments based on the sanctity of the free market out of court. If the players collude with each other or regulators or other opaque and unaccountable entities—or all of the above—to artificially inflate prices, then there’s a strong argument for regulatory intervention.

2 Likes

Costs coming down? Don’t make me laugh. Or is it cry. :slight_smile: Gotta love marketeers. NOT!

1 Like

Exactly! I use R in my Omnipod, who doesn’t?! Alaska Medicaid was paying $410/vial until I started raising cane then others jumped on board and got the price lowered. Not all of us using Medicaid are poor AND ignorant. :wink: The PBMs have taken over pricing, without much regulation too.

When I was down in Florida, and ran out of insulin, I was SHOCKED to learn I could buy regular insulin OTC for $25 with an MDs RX or $99 without an Rx - two years ago! This was at CVS, which is owned by one of the nation’s largest PBMs. Look up Pharmacy Benefit Manager if you want to know who really sets the prices in this country. They need to be abolished. I use R in the Pod, and U200 pen for Triseba. Trulicity gave me a gastric attack like NOTHING I’d ever felt … pain for two days, in hospital. Lantus never did a thing for me. It took about a month to get used to the U200, lots of lows until I figured out how to use it. Now, aside from the weight gain from using it (whch I am working on), I have the best A1C in the last 15 years!

BTW, the cost to produce insulin, regular ol’ insulin, is $76 PER YEAR PER PATIENT. I’ve checked this out for several years now, battling unregulated price controls by companies that 25 years ago were nothing more than claims processors! It’s insane. And these politicians claiming $250-500 PER MONTH are insane. That’s just giving in to the pharma and pbm’s that donate to them, imo.

1 Like