How Insulin Became Unaffordable


#1

Harvard Political Review article (link at bottom) seems to be more on top of the “funny money” business - kickbacks - that those in the pharma industry use to escalate prices at the cost of consumers.

My personal history:
35 years ago a vial of animal-origin Regular or NPH was about $7 at the pharmacy.
25 years ago price had risen to closer to $13.
20 years ago I transitioned off animal-source to humullin R and N, about $25 at pharrmacy.
Above prices, I all paid out-of-pocket. Was not a big problem even though (for most all the time) I was a student with just a part time job.
10-15 years ago I transitioned from R and N to Humalog and then Lantus. Price at the time was $80-$90 a vial but I now had a real job and decent insurance that paid for almost all of it.
Today the prices are $200 (or more) per vial.

http://harvardpolitics.com/united-states/how-insulin-became-unaffordable/


#2

I changed insurance - and therefore mail-order pharmacies. The old one (OptumRx) was still on auto-refill and they called me this week to let me know that my order was on “co-pay hold” (because I was no longer on United Healthcare, and they didn’t have new insurance info). Cost for 6 boxes of Apidra pens: $3400! That’s $566.67 per box!


#3

Wow


#4

I posted this on my FB page. There is a survey on Children with Diabetes site, where they are gathering research on this problem. Optum has now said there is no “Tier lowering” with my plan. Humalog is now Tier II and Novolog is now $391 per vial or more. My HMO failed to report this change in tiers, and did not notify us at the end of the year when we had to sign up for health exchange plans. OPTUM is clearly unconcerned about anyone but themselves. Fortunately, I have a back stash and am using the Novo card to get a discount. I have vials down to $25 but I can only get one per month. This is truly unacceptable. I have a grievance in to my HMO board, but I am sure it will result in nothing. Btw, I have a severe Humalog allergy and I was one of the first in the US to be able to use Novolog.


#5

I just let an Optum worker have an earful. They called to inform me that I should ask for a tier lowering for Novolog, and then I reminded them my plan does not allow that. Then the topic headed off to the fact that my insulin was therefore going to stay at around $400 for one vial. Well, kickbacks, that is what I told the lady. Optum and other companies are paid to promote certain products. I’m pretty disgusted. I hope you all will go to that Children with D site and take that poll as they are trying to do something about this problem.


#6

I was diagnosed in 1967, and a 10cc vial of insulin, any insulin, was $1.40. My discount pharmacy charged $1.26. Now, I didn’t keep a list of the price increases along the way, but with inflation, that vial would cost about $15,00 today. Instead, I find my Levemir costing $120 for 15cc, and NovoRapid $76. I have to wonder if the cost of making human insulin in a lab is really that much more than extracting it from Cows, Pigs, and Sheep would be? These are Canadian prices. Still, I think the pharmaceutical companies are making far more than they should off our diseases.


#7

Big pharma has countless cash cows. Insulin is but one of them. I feel lucky that I have a couple of medications that I get for free from the manufacturers because of my income level


#8

Insulin does not come in generic. I used to pay 25, 27, 30 and now $45 dollar co pay for insulin. Now I am lucky that it is for a 90 day supply. But insulin has been on the market since the 1920,s. Why is there NOT a generic? I was told that producers of insulin pad the pockets of Congress.


#9

I paid around $12 back in the late '70s.


#10

Yes, I’ve had diabetes since 1965, and I remember that as a single person in college (1970?) it was around $8.00 a bottle. Yes, the humalog was a bit of a jump, but still relatively reasonable. These prices today are crazy! Maybe Congress could investigate some of these drug practices instead of wasting their time on many other investigations that have little practical difference!


#11

It bothers me that these articles always start with the heart rending story of a PWD dying because of not being able to afford insulin.

I fully agree that there is a perverse and immoral rebate program concerning insulin going on between manufacturers, wholesalers, PBM’s and insurance companies. They need to have their feet held to the fire. Analog insulin prices to the consumer are ridiculous.

However, as a T1 for 47 years, it rankles me that PWD’s are dying because they can’t afford insulin. If I was in that position I would go down to my local Wal-Mart and get a vial of NPH and Regular for $25/vial. I did fine with those insulins for almost 30 years.

If you can’t afford analog insulin, that is a valid reason to complain. But it is no reason to die.


#12

That is a good point. You and I have enough experience (more than just about any practicing doc) in using insulin, though. A more recently diagnosed person, might not have the knowledge or confidence or experience to change insulin type like that. And probably is completely unaware that this stuff is available OTC at Walmart for reasonable prices. Their doc may not be aware either.


#13

Then that doc shouldn’t treat T1’s. And if the PWD can’t afford insulin but can still go to their doctor, then the doc has a moral responsibility to give that patient options.

Also, a good reason to promote the DOC where information like this is readily available.


#14

They change the formula and call it a different name, patent doesn’t expire


#15

I have realized over the years that I havenotgotten all of Thai formation I should have with regards to insulin. My sister is not being treated correctly by her regular doctor and and needs an endo. But when endocrinologists learn you have been diabetic for a while, they think you know everything by now. I was diabetic for10 years before anyone taught me carb counting. That is only because I found a couple of people on a website discussing it. When I asked my nurse her jaw about dropped to the ground because she did not know I had never been taught. Also they have changed the rules on me so many times. I have been diabetic for 23 years and have just been told to check ketones for highs. There is a program that just found out about that will help patients get affordable insulin. But it was pure luck that I found out about it.


#16

True! There’s always Regular.


#17

Unrelated, but hoe do I shut off auto correct? Lol


#18

Are you aware that there are folks who are highly allergic to NPH? I’m one of them. I’m allergic to Beef insulin AND NPH. I had to research the issue myself because my jerk of an endo didn’t realize I was allergic, so I had to first go to the library and pore through the largest medical book in stock, and then armed with that info, I KNEW I was correct. Following that revelation, I went to another endo, who quickly confirmed my issue with those insulins and RX’d long and short acting Pure Pork insulins for me. Problem resolved in about 2 days. After that, I switched to Velosulin for my first pump, and then Humalog the moment it was available.

I think I’d rather die than take the insulins I’m allergic too–it was that bad.


#19

I will go to the site. Has anyone noticed that Medicare and ADA are not making the right D treatment options for US? Example, if you are on insulin, they let you have 4 test strips per day. If on medication, you get one. Yet when you are diagnosed you are told to test often. Ie, when you are sick, before during and after exercise, when you driveetc… I can drop to 30 extremely fast without getting symptoms. So I have to educate my Dr and tell him if he writes the script for 10 or more per day, insurance will cover it. Sometimes he gets so used to insurance companies saying they will only cover 4 strips per day. But they will if the doctor prescribes it as such. I know I get wordy. I just like to share what I have learned.


#20

Ever try Lente? I think that’s also available for about $25/vial.