US residents pay $373 for 1 vial of Lantus; rest of developed world pays $62


The guy you may be thinking of was actually involved with an AIDS drug. The Epi-Pen controversy involved the company, Mylan. From Fortune.

Martin Shkreli—famously known as the guy that jacked up the price of a lifesaving AIDS treatment by 5,000%—finally saw his day in court, albeit for a completely unrelated case involving an unrelated company from his time as a hedge fund manager. The trial, just concluded last week, found Shkreli guilty of three counts of fraud for essentially lying to his investors about how he would invest their money and when they would be paid back.

The conviction, carrying a potential 20 years in prison, is no joke. Yet the notorious self-promoter took the opportunity to extend his 15 minutes of fame by creating a media spectacle of the trial. From making silly faces in court, to trolling female journalists online, to referring to the prosecution as “junior varsity,” the Pharma Bro let the world know he wasn’t fazed.


The reality is well in the middle of everything posted here.

Keep insurance (Payers) separate from drug cost. They are interlinked as I show below, but don’t correlate 1:1.

I’ve lived in the USA, Netherlands, Germany, Australia, Singapore and the UK.

Some realities:
Drug companies exist for profit.
Research (improvements) comes with cost.
Government intervention (including patent laws) kills free trade and competition
Healthcare has so much government regulation it is a monster that it can’t be compared globally.

I won’t bore you with my country by country comparison on insurance, with the exception that the care in the UK was so bad, I established myself in the Netherlands over a year before I moved there just for the healthcare.

Remember, the profits do have to be there for research. The rest of the world (ROW) drives price low through gov’t controls. The USA drives price high via patent laws. Non-USA pharmas take advantage of this too.

The problem with insulin cost on the USA is tied to patent law. The reality is insulin cost at Walmart is relatively low for not the latest version of insulin. $25/vial. N/NPH or 70/30.

So let’s talk about the realities.


You are probably correct. Thanks.


The Netherlands does something similar. The average price in Belgium, France, Germany and the UK is used to determine the maximum price of a drug. I wonder what happens if everyone is going to use everyone as a reference.




I believe this is what Canada does, too.

I think Canada also uses income level, though, in determining a reasonable cost for drugs. People aren’t supposed to pay more than 5% (I think) or so of their income on helathcare costs. (Wish they would do that with housing here in BC!!!)


When government start dictating prices in the USA, we will no longer be living in a capitalist republic. I am personally be opposed to this.

My premiums under the ACA — I’m an independent consultant — were just under $4000/month for a family of four. I dumped ACA and went to the open market and found a plan for just under $2000/month.

I am against government involvement in your healthcare.


I have seen no reference to the United States being a “capitalist republic” in its constitution, but someone more knowledgeable in American constitutional law can correct me in this. The United States already has plenty of government intervention into healthcare and has had this long before the ACA. Medicare is essentially what our Canadian system is, what some might call “socialist medicine”. The difference is it covers more but is restricted to a certain proportion of the population. Plus, $2,000/month is insane and out of reach of the average person , so there is the wonderful open market for you.


I think there are a number of things that could be done within the existing framework to allow increased choice and competition.

One of the approaches I had seen discussed but which seems to have gained little traction is to allow purchasing health insurance across US State boundaries.


It’s quite a bit closer than $4,000— the “government approved” out of pocket price for his family and mine


As some one who had his own business ford years, of I course I had no employer to cover anything, it just came out of my pocket, Which is the price of having your own business. Just like you get to pay all the taxes. )))

At least you had someone who would cover you. Pre ADA I looked at starting a business again. By then DX T2 age 63. It was $2000 a month for one person, and for the first two years no coverage for anything diabetes related. No drug coverage.

Stayed where I was until I aged into Medicare.


…which is why single payer and regulations mandating sensible drug pricing make more sense to me than the ACA, which seems like some kind of weird compromise that is the worst of every world.


I was able to start my own business precisely because I live in a country with single-payer healthcare and insulin that I can afford to buy out of pocket. If I lived in the United States I would not have the liberty to leave my employer and try this.


Well said. Glad you found something less expensive than ACA.


My premium is $22 with $700 max out of pocket using ACA.
Before ACA is was impossible for me to get insurance for any price.
Removing government out of paying subsidies on health insurance would be a disaster.
Employer-based health insurance pays no income or social security on the premiums which makes it just like a subsidy. Almost 300 billion a year. Total federal, state and
local government spending for 2019 is est. at 1.7 trillion. Yeah remove government involvement out of healthcare. That be really funny to watch. It would massively lower health care cost, but I doubt any hospitals would still be open.


As with any massive redistribution of wealth… those paying $20/ month will love it and those paying $4000/ month will not.

I personally am not comfortable with trusting the government to define who should be paying how much for what. These are the same people that pay $600 for hammers and toilet seats…

I’ve personally ordered far too many boxes of a dozen #2 pencils through government channels that ended up costing over $100 each by the time
the dust settled that I’ve just truly
lost faith in their ability in these regards…


There are endless examples of government waste, I don’t deny that but it doesn’t lead me to conclude government is always bad and the private sector is always good. What I think is absurd is when people say the government should stay out of healthcare, and some say it as if government involvement is some new crazy leftwing idea started by Obama and everything was perfect before. People seem to love Medicare, and the principle behind it (a single-payer government funded system that operates with the private sector, exactly like how universal healthcare works in many other countries) makes a lot more sense and seems fairer for everyone than the ACA. Healthcare is a massive, expensive, vital undertaking just like the military, police, etc. and I don’t see how government could not have a big role to play.


Not quite correct Terry.
My wife and I are both Canadian citizens living in Vancouver, BC. We’ve both been retired for the last couple of years. Our only income is from the Canadian Pension Plan and Old Age Security. Since that means we earn a bit less than $24,000 a year we have the following benefits:

  • Full medical coverage (MSP) - doctor visits, ER etc - at no cost to us
  • Full Pharmacare coverage with no deductibles for all prescription meds including insulin and test strips
  • Annual province wide bus pass for unlimited travel for $45 a year.
  • A subsidized two bedroom seniors apartment through BC Housing with $700 a month rent.
    Not sure about other provinces but I would be surprised if they are much different. If so other Canadians are free to move to BC if they are concerned about health care costs where they live.


It begins…
Viva la revolucion.

Health care in no way operates under capitalist principals.


Kurt, I am glad I am not living in a capitalist republic when I witness the corruption, militarism and disdain for the poor that is rampant in yours. You would rather pay $2000/mo. in a capitalist republic than pay $100 or so in a social democracy? My country is a socialist paradise compared to yours, and I would argue that we have more freedom than you. For one thing, we aren’t held in thrall by the corporations that elect governments and charge what they will for keeping people who can afford it healthy. Oh, we also have free elections, free hospital and doctor care, less censorship and don’t have to worry that the guy I am arguing with may be packing. And how do you think that a hospital system that is designed to make money for its shareholders is better than one designed to provide excellent health care at a reasonable cost?