Amazing. You’re still getting a bargain compared to me…
On the endo visits anyway. It is astonishing how much you’re paying for insulin! Amazing how for we’ve lost our way with medicine…
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Just curious, is there a generic of Lantus available in the US? I don’t remember it being for sale in the US when I was living there…
I can’t believe the prices, even comparatively to ten years ago, a vial seems to have risen about 50%.
Here in Japan, the lancets are outrageously overpriced, and I do my best to bring them from the US. Not to mention it’s hard to find them in 33G here.
There will never be a generic analog insulin in the US. There will likely be a biosimilar, but it will be priced similar to the branded and will likely be controlled by one of the top players (and hence will not be much cheaper). I wrote about “shenanigans” in 2015 after hearing Irl Hirsch talk at the ADA. The fact is the market is broken as others have said. Medicare cannot negotiate drug prices and insurance companies have no incentive to compete for lower prices as long as they can charge premiums which cover current year costs. In fact if prices rise, they are even happier as that is more “revenue.”
And the “collusion” in the market place is highly suspect and in my view warrants an investigation as a violation of the Sherman antitrust laws.
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Agreed 100%. I’ve been tracking Novolog and Humalog price increases since 2012. Since that time both insulins have increased 80% yet always remained less than a dollar difference between price. A reliable source at the DOJ told me about a year ago that there is an ongoing insulin price fixing investigation. It would require proof of actual collusion between the companies, rather than shadow pricing which is what they will claim. I’m not holding my breath. And even if the DOJ proves collusion, that doesn’t mean the prices of insulin will go down or that anyone other than the government and shareholders will be compensated for the price fixing.
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And the latest news is from the NASDAQ announced that the stock price of Eli Lilly plunged 6% “amid concerns of unfair price hikes for top drugs.” Stock prices don’t “plunge” because the market is concerned about the social good, it plunges because the market thinks that this may foretell a financial consequence for the business.
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We HAVE to organize. We have to be vocal and make the public listen to our story. Our only hope is a Shekrelli type backlash. Otherwise, we will all be broke and/or dead.
The ironic thing re Eli Lilly-- they seem to be lagging behind the other two in terms of technology and innovation (at least IMO)-- but they seem to be leader of the pack when it comes to jacking up the price of their 1990 technology and the other two are quick to follow suit.
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The non-analog insulin that came closest to Lantus, was Ultralente.
It was never very popular or very flat and Ultralente was discontinued in 2005.
Folks here like to slam NPH, but really NPH was a lot more predictable and useful than Lente or Ultralente. Just my opinion!
4x a day NPH I found made a pretty decent basal. I did that for several decades before switching to Lantus. NPH wasn’t perfect but really neither is Lantus (which I split into twice a day because it never lasted 24 hours for me).
My perspective is that is sort of like pointing out that your preferred corner of hell is not nearly as hot as the other choices. 
OK, fine. But I just don’t see me actually being able to follow that regime.
I remember about 8 years ago following the posts on another board of “Doris”. Doris used MDI with a vengeance. Her basal insulin was Levemir twice a day. For meals she would bolus with a fast acting insulin to cover carbs and with R insulin to cover the BG rise from vegetables & possibly also protein. (I’m hazy on the details).
I think that worked out to like, what, 2 + 3 + 3 or at least 8 shots a day? Doris’ goal was to have flat BG on MDI so I’m not sure how often she did a correction bolus. But if she did correct, then obviously that would add to the total.
Bottom line: from my personal perspective, talking about 4x a day NPH does not make it sound more attractive.
Attractive is in the eye of the beholder. I average about 7x a day, all told, and have no problem with that at all. I get that wouldn’t work for you. It works great for me, and gives me the precise control I insist on. Different strokes, etc.
Sadly they aren’t (or haven’t been found to be) colluding together, and as the investigation by Bloomberg pointed out while it is a active shadow market, which is against the consumer, it sadly isn’t illegal. It’s utterly immoral and detestable but sadly legally they can carry on regardless.
In 1926 to produce a vial of insulin by hand cost under $1 (about 82c actually but let’s round it to $1 which is too high anyhow). With inflation today that vial would be $12. A desktop radio in the same example would be $426 today. But we’ve moved from hand making things into mass production, and the radio would now actually cost under $2. Yet with the broken patent market protecting the three big companies, the profiteering, greed and everything else, even ignoring the fact they have the economies of scale and the massive production infrastructure they have, a vial of insulin can cost $476.
Interestingly, that same vial is sold worldwide. All at varying pricing depending on market. In Kenya for example that vial costs $118 which seems a bargain when compared to the US market. But the average wage in the country is $72 per month. Insulin is something many patients can’t afford!
We in the UK have the NHS which pays everything for us (yes it’s seen as the awful socialist evil creation by certain elements in the US) so the costs go directly to all tax payers thankfully. Yes we forgo choice in what we use to a greater extent but the financial burden is thankfully taken away from us. So how much do we as tax payers pay per vial? $25.
So the same product from the same companies range in price from $25 to $476 depending on the market it is being sold in. They claim it costs more for certification in one market than the other which is wrong as it actually costs, and takes the exact same time. They claim it’s for research which is wrong as it’s posted how little is spent on research in the shareholder reports, and the fact that 92% of all diabetic (and cancer) research is funded by government and charities. The closest they get to research is product development where they take the discoveries made by others and turn into products to protect their own markets either from a possible hit it would have to their sales, or to protect a patent coming near it’s end of life as is currently occurring and is also why we are about to see a whole batch of new insulins from the big three.
Competition law is broken. The patent system is broken. Healthcare in general is broken. And the politicians are equally as broken for being in these companies (and others) pockets.
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OK, what exactly is your criteria, is it total number of shots a day?
From the 1980’s until mid-2000’s I did MDI, 4 shots of NPH+Regular a day. You can mix NPH and Regular in a syringe.
From the mid-2000’s on… I do 5 shots a day of the analog insulins. Can’t mix them. I personally (like many others) do not get 24 hours out of lantus. So I end up taking 2x Lantus a day and 3x Humalog.
I will agree the analog insulins are an incremental improvement over R+N. I don’t think they’re the hugest improvement.
Except that it’s actually a lot less than that, because the process used in 1926 depended on animals, was very costly and based on an inherently limited supply; whereas today, the process is orders of magnitude more efficient and is done entirely in the laboratory. So the price gouging is actually worse than that makes it sound.
Actually it doesn’t, because the U.S. regulatory agency (the FDA) is in the pocket of big pharma and places deliberate roadblocks in the way of certification for products that compete with the only domestic manufacturer, Lilly. That’s why degludec was available in Europe years before it was allowed here, as the FDA repeatedly required “just one more test”.
You have to admit, it’s nice to be able to erect what amounts to a protective tariff without going to the bother and expense of legislation.
Or they can place unjustified warnings and unnecessary patient testing requirements on anything that competes with the status quo… Regardless of what the studies and expert committees indicate… Again just building roadblocks to protect their buddies. Don’t even get me started on afrezza. Between the deliberate and premeditated malfeasance of the fda and the industrial sabotage of sanofi-- it’s literally enough to make me sick to my stomach.
It really does not bode well looking forward for anyone with this or any other chronic condition, when new even the regulatory agencies are in cahoots with big pharma effectively preventing game changing innovations from reaching the people who need them.
What goes around, comes around… (I hope!)
This must be changed at the governmental level. It is a political issue. We in the United States pay seven to ten times the amount Europeans pay for insulin and drugs in general. The only politicians I have heard addressing this issue is Bernie Sanders and, believe it or not, Donald Trump. This has not changed under Obamacare because the insurance companies are not prohibited by the government from artificially raising prices. Our health care system is broken. We need universal health care.
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Insurance company is paying for Afrezza now, after appeal. Breathing HUGE sigh of relief. Her copay is now $30. Afrezza works so well for her and I feel she is safe at college now. I know that if she doses for a bedtime snack or eats later in the evening as so many college students do, this insulin will be out of her system in 80 minutes maximum. Very grateful. Can’t wait to see those diabetes centers open in New York and New Jersey so PWDs like my DD don’t have to go through the tortures of the damned finding an endo in the New York metro area who will prescribe Afrezza. Thanks to Afrezzauser and all the other Type 1 adults using Afrezza who made it possible for me to find a doctor to prescribe.
Knowing this why are we not voting for Bernie Sanders? Universal Health Care trumps all other issues for me at the moment.
[quote=“David_dns, post:33, topic:50935”]
Actually it doesn’t, because the U.S. regulatory agency (the FDA) is in the pocket of big pharma and places delibarate roadblocks in the way of certification for products that compete with the only domestic manufacturer, Lilly. That’s why degludec was available in Europe years before it was allowed here, as the FDA repeatedly required “just one more test”.[/quote]
The FDA is oddly very helpful to companies getting things certified as long as the companies follow procedure. To quote someone who does this for a living it’s the same process in either market, and the only reasons products get released at different schedules is either they mess up in submissions necessary, it’s a marketing decision and nothing more, or they are stagger the costs by only entering one market at a time. Novo’s response to the delay was that it was disappointing but acknowledged problems with the submission for Tresiba…but this again is off topic so best get back to ignoring it.
Tresiba is also twice the price of Lantus, so that usually means the older products will keep increasing is price until they match the new product going off how this has worked over the the last few decades.
[quote=“Julia61, post:37, topic:50935, full:true”]
Insurance company is paying for Afrezza now, after appeal. Breathing HUGE sigh of relief. Her copay is now $30[/quote]
Considering it’s Sanofi that seems oddly “cheap”, that was per month $30 right not per dose? Know over here it costs (the gov) $3 to $7 per day’s dose (depending on size of dose) for it. So it sounds like the different pricing for different markets in this case is working in your favour for once!
[quote=“Julia61, post:38, topic:50935, full:true”]
Knowing this why are we not voting for Bernie Sanders? Universal Health Care trumps all other issues for me at the moment.[/quote]
Really was sad how “obamacare” got shot down so badly. Can’t get over how utterly third world your medical system is (no offence) in many regards. It’s great for choice but in making people pay or suffer life destroying debt due to disease or accidents etc. is just bonkers. From what I’ve seen of Sanders he seems an interesting candidate but the question really has to be could he ever manage to get it through without all the compromises that Obama suffered getting it as far as he did?
Her copay would be determined by the terms of her insurance policy, not by sanofi.