Really hard hitting piece on insulin price gouging today:
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 âfree marketâ has failed us entirely.
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Very compelling piece.
Iâm not holding my breath waiting for congressional action after the recent hearings. The representatives had their âday in the sunâ brow-beat the insulin manufacturers and PDMâs in public. Theyâve extracted the PR they need by showing outrage and concern. I can only hope urgent action is going on in the background.
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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 theyâre 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 wonât 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. ITâs almost like theyâre the âMafia of the Rx Drug Market.â
Are pharmacy benefit managers the good guys or bad guys of drug pricing? - STAT
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Thanks for posting.
Quit your hysterical whining New York TimesâŚ
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 Walmartâs prices.
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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!
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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 âRâ and âNPHâ 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 âRâ and âNPHâ 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 âIâm going to die and/or go bankrupt because of âbig pharmaââ 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 âI need Toujeo or else I dieâ 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 âpeakâ schedule, and live with it.
Iâm a large animal veterinarian who pays for my Obamacare health plan on my own, and who has tight control over my diabetes using Humulin âRâ and âNPHâ 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 donât 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 ânegotiateâ 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.
Iâm sorry, but thatâs an absurd statement. Iâve 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? Canât you can survive and control your diabetes just as well without it?
The question at hand isnât âCan you survive without itâ, but âWhy should you have to regress your control regime because of unjustifiable and outrageous price increases on the likes of Humalog and Novolog?â
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What Paytone said!!!
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Well said. Speaking from my own 20 yearsâ experience on R/N, I would not deny that you can âsurvive and thriveâ on itâwell, survive anywayâbut at considerably more effort, a considerably more restricted quality of life, and considerably more day to day concern about severe and unexpected lows. Yes, itâs better than dying of DKA, but itâs not âwhiningâ 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 doesnât make this situation acceptable. R/N is riskier, quite different from what most diabetics are trained on, and if you lack insurance youâre not going to have a physicians assistance in transitioning to it.
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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 couldnât move, my speech slurred and my skin cold. Since I went on a pump, with Novolog, I havenât had one of those episodes, and my A1c is under 7 for the first time in my life.
Fortunately, I donât have to go back to that, because 1) I have a pump and 2) Iâm on Medicare. Insulin isnât an issue for me anymore, and I donât have to fight with the pharmacist about how much theyâll give me this month.
Good for you, Fred, that you have a G6. Iâll be on the waiting list for that at least until the end of the year, because Iâm old. And, for all that, Iâm still in better shape than I was on R/NPH.
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Yes, letâs go back to prehistoric times and âthrive.â 
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 diabeticsâŚ
Couldnât have said it any better myself. How I managed to use R/NPH/Lente (all beef/pork derived) for 30+ years and didnât 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 CGMâs or meters in those days.
@Fred_E If youâre happy using R/NPH thatâs great, and itâs wonderful that this protocol works for you and youâre satisfied with your level of control.
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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 isnât experimental treatment, itâs 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 entitiesâor all of the aboveâto artificially inflate prices, then thereâs a strong argument for regulatory intervention.
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Costs coming down? Donât make me laugh. Or is it cry. 
Gotta love marketeers. NOT!
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Exactly! I use R in my Omnipod, who doesnât?! 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. 
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 nationâs 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 Iâd 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 olâ insulin, is $76 PER YEAR PER PATIENT. Iâve checked this out for several years now, battling unregulated price controls by companies that 25 years ago were nothing more than claims processors! Itâs insane. And these politicians claiming $250-500 PER MONTH are insane. Thatâs just giving in to the pharma and pbmâs that donate to them, imo.
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