What is a unit?

I’m confused. I’m reading an article about the cost of insulin in rand.org where they state the following:

“The average list price for a unit of insulin in Canada was \$12. Step across the border into America, and it’s \$98.70.”

My question is, what is the unit they are referring to? With diabetes, a unit has a specific meaning. For U-100 there are 1,000 units in a vial. Are they referring to a pen, which has 300 units? I think they are using the word unit to refer to two different things? I should be able to figure this out! Maybe it’s really simple and I’m just missing it (entirely possible!)

There are 100 units in one ML.
That’s why a 1 ml syringe holds 100 units.

Doesn’t matter how it’s held or what device.

If it’s u100 then it’s a milliliter divided in 100 units

But some pens are u300 insulin. Which means you need one third the volume.

But hose pens are standardized. So if you take one unit of u100 it should be the same effect in a u300 pen. Because the pen delivers less in a u300 pen.

So they are trying to make it so it’s the same dose no matter what form so you can’t make a mistake.
However people who think about it might divid the dose.

So don’t think about it. Take the number of clicks you want on either pen. But you need to do the math when you use a vial

My own research shows that average price for one mL (100 units) of Humalog in US is \$13.47 while in Canada it’s \$3.16.
Multiply by 10 for a 10 mL vial, or by 15 for a box of 5, 3 mL penfills.
Does that sound about right? If so, someone is getting gouged!

Whoever wrote the article is unfamiliar with insulin. Unit can refer to a piece of something or a unit of something, it just so happens a unit of insulin is used as an exact measure with insulin. So using a unit to identify say a vial or pen of insulin when referencing diabetes becomes confusing at first to read if you are familiar with insulin. This is just another article that the lazy “journalist” didn’t spend anytime time actually looking up information, it’s easy to find.

But yes, the US is getting gouged by Big Pharma.

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@Michelle43 @Marie20 has the right of it. Most so called journalists are often ignorant of the subjects they report. They tend not to go to actual knowledgeable people to get the correct information, just writing off the top of their heads. This is especially in medical and/or science.

It’s not all of them, but enough that whenever I read an article about a study, I try to find the actual paper to read for myself.

I don’t know where they got these dollar amounts, but I am guessing that they heard that diabetic’s referring to units of insulin, not realizing that insulin is dosed by units and not normally sold by units.

There is a need for a stern editor with a sharp blue pencil.

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They’re talking about the economic term “standard unit” which they define as a vial. Which you’re right is so confusing!

The average price in America being \$98.70, is probably a mix of \$25 Wal-Mart R or N insulin and \$400 analog insulins. And I think they’re using prices from 2018 or so.

The full study where they define “standard unit” etc: https://www.rand.org/content/dam/rand/pubs/research_reports/RRA700/RRA788-1/RAND_RRA788-1.pdf

The problem with insulin pricing is that Canada can and does negotiate the prices of drugs used in Canada.

In the USA, Medicare the largest entity to purchase insulin is prevented by law to negotiate prices.

That’s why we have such a big difference. It’s completely wrong and shame on the drug makers for charging these prices just because they are legally permitted to.

The drug companies set up these programs to help out low wage earners in order to hold wink us into thinking they are thoughtful about the people who use their drugs.

They don’t care they will continue until someone gets the jewels to change the law.

And I work for a pharmaceutical corporation.

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The figures are garbage; they either refer to a months supply of insulin or to a 10ml vial (the traditional supply vehicle.) For a T1 a months supply of insulin is pretty much determined by what we eat, so it’s intensely judgmental.

The quoted figure is clearly bogus - too many decimal points. The current US figure is \$100/month (regardless of quantity) as a result of some curious back door negotiations that will never be revealed. Of course you have to daintily dance through donuts to achieve that; fill in the rebate forms, go to the approved pharmacies, kurdow.

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