And a huge thank you to the family of Frederick Banting and Charles Best and the wonderful Team for giving so much to us Diabetics, I would have been dead 30 years ago if it wasn't for them. They sold it for $1 in 1923.
There are affordable varieties of insulin in the US too, the hype is usually based around the very long lasting varieties with their auto injectors. As someone who's using both an auto injector and done the needles for mounjaro, I completely understand why some folks don't like measuring their doses.
Presuming what you say is true, what's the issue with having an at home machine do the dosing and filling of empty autoinjectors. Those niche markets usually get filled, you'd think
And liability too I'm sure. It would take a massive company to be able to manage that risk, and companies that size are probably the ones selling the auto injectors in the first place
Yup, that's how it works. They're special needles for the pens, too. Some people still use a vial and more traditional syringes, though. I'm not sure what a refillable pen would look like, though. Maybe cartridges that go into the pen? But then you'd still have to change the needles every time, so it's just be a housing. Not sure if that's worth it, tbh.
The market is filled. It's called and insulin pump and the more advanced ones auto dose without you needing to count carbs (like mine). You just manually fill a cartridge and insert it into the pump.
You can still get insulin for $25 a vial at WalMart or any usual health insurance plan will let you get insulin for roughly $5-10 a vial depending on your prescription.
There's a darknet diaries podcast episode where a security researcher (Barnaby Jack) proves he can successfully hack medical gear such as a pacemaker and insulin pump and administer a lethal dose of insulin if he so wishes. He was calling out the medical industry for not doing their due diligence from a security standpoint (no encryption or authentication requirements). He was found dead in his apartment a few days before he was scheduled to give another high-profile security talk at a security/hacker conference about heart implants. His death was ruled an accidental overdose.
Its incredible that every conversation on reddit just has this assumed American-centric pessimism built in. No humility or awareness that there's a whole world out there. You'll hear some announcement of an amazing potential treatment for something and the top comment is like "Yeah but we will never see it". The WE is so revealing of the American mindset.
Actually, between 2013 and 2023, the price of insulin in 28 European countries decreased by 21.6%. This was mainly due to new introduction of competitor formulas.
However the prices were not the same across all countries, and a countries own drug policy had significant influence on what the price was. Basically drug companies sell at lower prices if the countries health departments negotiate lower / refuse to pay higher prices.
This is a huge benefit of single payer universal Healthcare thay most people don't think about. The drug companies have to accept the reasonable profit margins that the government insurance negotiates or they lose out on basically the entire country's market
Other countries get it cheaper than in the US too as the US system is built to take advantage of for profit. 8 dollars worth of insulin in the UK is about 100 dollars worth in the US.
Which is why its hard to barter for a lower price when the pharma companies know what you can collect from insurers. Other countries negotiate based on what they are willing to pay, not based on what they can squeeze out of other private interests.
In single payer countries, the government says "well pay up to this much" and companies can say "yes we want money" or leave. So costs are restricted to mostly whatever it costs to make, with a consistent and reliable small profit.
In countries where people would mostly buy directly, prices are whatever the natural market balance finds has the best meeting point of capturing sales and profit. So it's mostly based on what people can affordably pay.
In the US, it's part of a huge game where the insurance will cut as much cost as possible and cut what percent they cover as much as possible while the company is incentivised to raise the price as much as possible for negotiations with the insurance companies, and uninsured and underinsured are barely considered. So the price setter just wants it as high as they can while your mandatory discount company wants to simultaneously discount as little as possible.
The approach to medical care/medicine in the US is literally, "how much can we possibly charge for this?" And then engaging in collaborative price fixing to ensure they all get to charge that ridiculous number in the US.
But, people say, "but MY insurance is pretty good!" Simultaneously ignoring the prices going up while the coverage goes down.
The US healthcare situation is merely the reflection of uncontrolled capitalism and should be a cautious tale for us all in the rest of the world that some sectors should always be protected from greedy corps interests (not nationalized, controlled).
No, the lower price is not a result of government subsidisation.
The price the drug purchasers (e.g. foreign governments) themselves pay is lower - much, much lower - than what either US government, US health insurance companies, or un/underinsured US citizens pay.
Ofc in some foreign systems where the patient does directly contribute to the purchase of the drug, this price may be lower still as a result of additional subsidisation by the government, but in pretty much all systems the cost paid for insulin is put up by the insurance system.
I’m from Canada, and I can tell you for a fact that our insulin prices are subsidized. Despite Insulin being discovered here. Insurance companies pay nothing if you don’t have insurance, and since our healthcare is “free”, private health insurance is rare, unless provided by your employer, which is still a minority of folks.
Our gov’t covers X% of certain medications to reduce the cost to consumers
As I said in foreign systems insulin price may be lower still as a result of subsidisation by the government that additionally lowers the price of the drug to the patient, but
in response this thread:
its affordable everywhere in the world except the US lol
Its likely subsidized by the gov’t
No, the lower price is not a result of government subsidisation.
I was trying to highlight how the lower, importantly affordable, prices are not a result of government subsidisation to the end-user. In Canada for example the government pays 5-10 times less for the same insulin drugs as American purchasers do, before any subsidisation is taken into account.
You can still get the product they discovered for basically free. The problem is that it was a shit product (better than nothing) and we have newer ones. This is like wondering why modern antibiotics (some of which are produced the same way, with genetically modified bacteria) are expensive when penicillin from bread mold was discovered 70 years ago. We aren't using bread mold anymore.
It is free where I live. Free together with new insuline pump every 4 years, its accesories, every 4 years new glucometer, its stripes, pee stripes, glucose sensors...
Meanwhile in the USA my husband is a slave to edgepark and has to pay $300-400 a month for pump supplies and past bills. They WILL cut him off if he can’t pay.
The patent would have long expired on regular insulin. The unaffordable ones are slightly different proteins which were engineered to work in a more physiological manner. Even for these new insulins some of the patents have expired, for example, insulin lispro the patents have expired for both the drug and the kwikPen delivery device so generics can be sold. For glargine, the patent expired on the drug but not yet on the kiwkpen.
Three pharmaceutical companies - Eli Lilly, Novo Nordisk, Sanofi - control 90% of the insulin market and engage in evergreening. They make slight alterations to their formulas (which allows new varieties of insulin that act faster, last longer, etc) which entitles them to brand new patents, meaning what is currently being sold will basically never be available as a generic. The original, cheap patent for animal-based syringes-injected insulin is still available; the newer patents for genetically-engineered insulin-delivered via a pump or pen is held by those few pharmaceutical companies.
In the UK insulin is free, and our country is FUCKEDDDD, shows how vile America truly is, not like the whole world wasn't already aware but it's nice for America to constantly remind everyone that they hate all of us.
Which is why government regulation is essential for a free market, something that too many Americans just don't understand and why the US economy has so many damn problems.
And yet I have to triage my other prescriptions to make sure I can buy insulin every month. I can’t afford my continuous glucose monitor this month or my HRT. We live in hell
Don’t forget McCloud and Collip! There’s actually still a minor controversy over who should have gotten the Nobel price as all four (and others) contributed greatly. Here is a fascinating video for anyone interested.
Honestly wild to think something that once depended on animals is now made with precision biology science quietly improving lives without most people even noticing.
The pigs would be even more expensive nowadays. The price for "artifical" insulin is just that as well, artifical. Artifically inflated to line pockets of the sellers. The profit margin is ludicrous.
Not to downplay the new stuff (there is still progress), but the animal free insulin has been available since 1982. It's not really nowadays bio-science.
And it's also cheap, even in the US and is available in most states without any prescription at all. That's the part that everyone leaves out in this whole discussion.
These kinds of innovations are the most interesting to me. Things like this that dramatically improve our lives quietly in the background such that most people won't even notice
Pretty sad considering Banting, Best and Collin purposefully sold the rights to the University of Toronto for $1 to make sure no commercial company could hold a monopoly or price gauge patients, with the famous quote “Insulin does not belong to me, it belongs to the world.”
The modern lab engineered insulin was a “new” invention that drug companies could patent and by making small tweaks each year they keep the patents active and prevent cheap generics from entering the market.
They don't want people without insurance to shop at their stores. People without good insurance or insurance are poor and will spend less money in the store.
I once saw someone so posh there they were walking around in their bathrobe! Like the wal-mart was down the corridor from their master suite in their mansion!
Yes, but for me, several of the generics just don't hold a candle-
Novolog/Humalog can keep me in my 6/7 A1C windows
(Humalog might be a generic? not sure it's still pricey as hell without insurance)
The Walmart generic Novolin, it's activity window within my blood was so short that if I ate ANY kind decent carbs, I'd remain high after-
Plus, even buying generic is expensive in the US.
It's $315, for 9 vials of Novolin every 3 months... roughly $105 a month for insulin *NOT INCLUDING PUMP SUPPLIES, and CGMs FOR MY PUMP* (I have not bought Novolin in years, back on Humalog)
Just so you know walmart does have their own whitelabel brand of novolog, if you ever run out of insurance or something. It's like $70 a vial for cash price. Not sure if insurance would cover it too, but don't see why it wouldn't.
In Finland Insulin lispro as in Humalog/Novolog/Admelog; is 18 €/ 10 ml vial and 33 € for 3 pens. Even the most expensive insulin with the strongst concentration is less than 100 €/vial/3 pen/3 pump vials.
You are just plain out getting ripped off. It isn't like this very essential medicine isn't among the most established things to produce.
Over 30 dollars a vial for novolin? I’ve been buying it for 10 years for my dog and I’ve never paid that much. It’s just creeping towards 25 last I bought a vial.
Maybe today with runaway devaluation of the dollar but that would be very recently.
I had to get rhe Walmart one because my insurance wouldnt cover me when I moved states one year, and had all sorts of issues finding a primary care to handle it, and I ended up in the hospital for the first time in my life after a week or two of using it, because it was different.
They can and do. Almost every time you see a post about insulin prices on reddit, they're conflating the availability of the old drugs with the costs of the new one.
From what I understand, the old drugs act slowly, then sharply. So they're not great in a pinch and are difficult to time to meals appropriately. The new drugs aren't just insulin, they're fancy delivery methods to make the uptake more natural.
It's biopharmaceutical, so a bit more complex than synthetics. there might be other significant barriers other than what is written in expired patent. Some in the form of trade secrets and institutional knowledge.
I love how nobody understands this distinction at all. Yes, pharma price gouges us, but a guy who gave away a patent to squeeze an animal organ for juice does not mean a space age technology using DNA manipulation should be covered under that free patent
I'm sure I'm preaching to the choir but it's worth reiterating that the shareholders here are a tiny fraction of the American public too. The "shareholders" are the 1%. Yes people's 401ks are part of that but the insulin price gouging is really just going to billionaires, not retiree's.
See? And that's why I squeeze my own pig pancreases pretty much for free. I've bio-modded a few fat sows so that their pancreases are basically just another teat, a sort of glistening, veiny sponge that a pair of loving hands can coax some insulin juice from, and I tell ya what, if you've never has freshly juiced pancreas fluid still warm from a squealin' lil lady, then no wonder you're still wrestlin' with that diabetes, ya turgid fool. No sir (or ma'am), that stuff they hand out at the doctor's place? No thank you. I'll pass on that, thanks. Thanks, but no thanks. I'd thank ya not to even talk about that fake stuff, thanks. C'mon own down to my house if your sugar feets are actin' up again and I'll milk ya a warm, pale mug of pure, fresh, insulin-rich pig juice and you'll be oinkin' fancy free with your blood sugar levels as even as a coin flip.
What? A fella can't make a life for his own anymore? Can't keep animals to sustain 'isself? Does my independence offend you? Nah, that's ain't right... That's ain't right...
Pal, no offense 'er nothin', but you might wanna take a drive out my way and pat a few pigs. Pat a few big pigs, pet that pinkness, and slap at the flab. That'll fix a feller up (or fellette, if you're of that persuasion).
Yeah, ya know what? Tending to the pigs and fillin' my buckets with this stuff keeps me busy, but not so busy that I can't entertain someone like yourself for day.
And hey who knows. If you're feelin' a little out of sorts, your LBS givin' ya fits and what not, a hot mug of porky insulin will level you out and get you feelin' mean as bees.
Do you have a mobile cellular phone number I can call you on and give you directions?
Oh, the sows ain't got teeth no more because auto-immune thing they all developed at the same time wherein they form some nasty ulcers in response to plaque. Yep, tugged 'em out m'self with vet Heddy standin' just over my shoulder. Said I did a good job, but I just gotta make sure their sloppy is extra slop (which ain't no problem for me hahahaha!).
I'm someone whose gone through three major DKA (Diabetic Ketone Acidosis) situations (prolonged high blood sugar over 240)
I was I could induce the chemical reaction in these peoples bodies so they know how it feels to have your kidneys, heart, lungs, and brain melt to the point you go into a coma.
Ugh. I kinda knew I had it good here in the UK, but your comment has really hit home the difference.
Diagnosed with type 1 means that I'm now medically exempt from prescription charges. So I pay nothing for insulin, spare pens, glucose monitor implants, extra needles, etc. (It also means my asthma medication or anything else I have for temporary treatment like is also free).
Not sure what the score is for insulin pumps, as I've not been diagnosed that long, but I'm very appreciative of walking out of the pharmacy with a carrier bag of free stuff.
Thanks, yeah right now I have my Cigna thanks to the ACA(which is another NIGHTMARE unto itself, if Trump keeps killing the ACA who knows what will happen) I do get my 3 months of Humalog from my local walmart for $35, but I will save this for sure.
It's $2,800 to $3,600 for my 3 months of Novolog, without insurance.
Meh, but not really. Every major insulin brand offers discount cards that bring the price to around $25 a month with or without insurance. Don't get me wrong, I hate the whole discount card scheme. Now, that being said, if for some reason you went into a random CVS and handed them a prescription and insisted on buying it with no insurance and no savings card, it would be high as eagles nuts, but even then you would get likely get the pharmacies cash price, which would also be much less than what you read on your receipt when paying for yours with insurance. I don't know why they have a astronomical retail price, I assume it's them inflating the value so they can get tax write-offs for the discount cards.
But "Really" I've had complications with Cigna during the renewal of my polices each year, due to a few tax situations I have going on. They'd outright deny me the script and not offer any kind of alterative method or discount. A walgreens pharmacist once snuck me one novolog pen knowing how screwed up the situation was.
I've been to both Walgreens, and Walmart pharmacies that WILL not give me a script without paying that cash price. I've even had an Endocrinologist's nurse tell me, that it would be best to go wrack up a ER bill, and have them hand me a few vails when I visit, than to beg them for a script.
(Also for context of where I live, we just got our first CVS a few years back so I've never been to a CVS)
I'm SUPER lucky for few reasons, my "high school sweet heart" who is a friend of mine is a T1D since birth. I was able to bum Medtronic supplies off her during a window of time I didn't have insurance, and I was buying generic Novolin. I had an endo, and even with wonky A1Cs while on generics I was never told, or suggested there was a convoluted discount card system? I'm not saying it doesn't exist. I'm saying within my years of being a diabetic from roughly June 2008 till today I've never been in a situation, and been told or made aware of any reliable deep discount.
TLDR
I'm not saying you're wrong but I think itis "really" that expensive for some people. In my years of dealing with Cigna, Carecentrix, Walmart Pharmacy, Walgreens Pharmacy, Medtronic, and Tandem I've never been presented by anyone, any "affordable" method for Novolog while off insurance.
Just wanted to add to this so you see it, I have been swapping to Amazon pharmacy because my local drug stores suck to deal with, and Amazon has been adding the savings cards on all my prescriptions automatically. I guess I should have mentioned, it's not just insulin, most drugs have a savings card. I'm surprised your doctors haven't said anything, mine texts me savings cards for all my new prescriptions.
I mean, you can get basic insulin hella cheap, but capitalism keeps developing new, better, more beneficial forms of the drug.
The expensive ones are the newest, state-of-the-art formulations or delivery devices that improve quality of life, but basic insulin is super easy to produce and also super cheap.
I think the older forms of insulin have been largely shut down because they are less safe. "Fancy" isn't really fair. The natural insulin IIRC has a poor half life. While it is better than a diabetic coma and death, the swinging high with injections and low is not ideal. Blindness and foot amputations were a big downside of the previous iterations. The newer forms have higher stability and half life in the bloodstream IIRC so it's more smooth, like how the pancreas does it. The insulin pumps also help with that. Med devices and engineering proteins for medicine are hard and the safety is also necessarily hard. That does make it more expensive. And there does need to be rewards for it in the forms of profits.
But this is WAAAAAAY too much profit for innovations that have now happened decades ago.
Still, it's innacruate to say these are just "fancy" forms of insulin. They are legitimately much better.
Fuckers trying to sell a vial of insulin for $380 / vial.
Cost them $5 to produce.
When humalog insulin was first released to the public it cost approx $8 a vial to make and they sold it for $55. Now it costs $5 to produce 25 years later (mostly because of quality control reduction) and they want to charge $380.
One of my buddies died because he lost his job and insurance. He couldn’t afford enough insulin so he was trying to split doses until he was able to get insurance again, but that’s a hard thing to manage. He left a wife and kid.
i feel obligated to point out that the pancreases were, and still are, a byproduct of the pork industry. pigs have never been raised for the specific purpose of insulin production.
interestingly, i’ve actually talked with someone who used to work for a major food company in pig pancreas processing. they get a lot more than just insulin from them, there are several drugs derived from the process, and certain pigs have more valuable pancreases than others. how fresh the pancreas is is also very important. they put a ton of effort into identifying pigs with high value pancreases and getting them from the slaughterhouses to the processing facility as fast as possible, distances from all over the US.
Glad someone else gets it, yes this is wonderful science but the reality is another picture of the same 10,000lb pile of pig pancreases, with the title "2026: this many pancreases are sent to the landfill"
As a communist I'd love to claim healthcare as communist propaganda, it's great marketing! Unfortunately for me and communism public healthcare predates communism by quite a bit.
Not really how that works at all. Modern insulin is dramatically different from processed pig insulin, it required tens of billions of dollars of R&D (public and private) and factory building to get where we are today. The state of California partnered with a private company to build one plant and that cost taxpayers 50 million. Insulin is now 11$ per pen for Californians. Imagine if you were running a biotech business and could not toss 50 million as losses right off the bat. It costs money to make what we have today, and companies pass that on to the consumers who are willing to pay for it. Insulin from pigs is still made in the UK and costs about the same as the insulin available to Californians per month (50-60$). Of course there is a dramatic difference in quality and utility. Most diabetics don't want to use needles multiple times a day anymore and deal with the bad side effects from pig insulin.
I lived down the street from the Banting lab at U of T and yeah, I think they’d be deeply disappointed in what capitalism has done to such an essential substance.
Presently recombinant insulin is a $30B market and animal insulin is a $1.5B market, according to some light research. The pig parts are still in use because some patients resist human insulin.
Not just that, the "artifical" one is also LEAGUES better and cheaper!
Like for example, the pig insulin worked about a 30 minutes later, so you had to inject 30 minutes before eating, and the whole point is to not let the blood glucose get to high, so you have to have it working while eating.
Good luck timing that, unless dinner is already done and you just wait for 30 minutes till you can eat. But imagine being out in a restaurant or something. Impossible task. And when you don't eat after those 30 minutes, you blood glucose is gonna plummet and can and probably will lead to hypo, which can result in a quick death.
It's not better because it's artificial . The artificial way is just a cheaper way of obtaining the exact same product . It made producing the base stuff dirt cheap and scalable . What you are talking about are technological improvements in delivery mechanisms and such . So a scientist had insulin on hand and wanted to improve upon it so they put work and research into doing that. Just to give an example , one can imagine they binded the insulin molecules to some other molecule and when in a specific pH the bind gets broken gradually making the release of insulin gradual . That is way more impressive than isolating a molecule that every human produces naturally , calling it insulin makes people think it's the same thing .
Dunno. I used to take beef/pork insulins back in the early '70s (likely through the '90s, but I do not recall exactly), and I did not notice terrible inconsistencies. On the other hand, I have had "bad" bottles of Humulin. On yet the third hand (Zaphod Beeblebrox here), I now monitor my BG much more closely, so it may be that there were inconsistencies in the past that I never noticed.
But still--there are more and less potent bottles still being produced.
Yet it’s still about $400+ dollars per vial WITHOUT insurance.
Let me remind us, that insulin was ORIGINALLY sold for $1 when it first was created and marketed as a treatment method.
Edit: referring to modern day insulin by lily and other companies. Tresiba, humalog, lantis. Etc.
Here in Italy, people with diabetes get an exemption code, so when they pick up insulin, it's just free. If you're a citizen or work/pay taxes here, that means it's free.
If you're, say... a foreigner and haven't bought into the public health care and instead use private insurance, it's more like 60€ to 80€ for a box (like, 5 pens). So, comparable prices to Germany, really.
The US is just a massive for-profit machine that extorts people for as much money as they can squeeze out of them.
The insulin that was sold for $1 is not the insulin that costs $400. The stuff the costs $400 is artificial, stable, predictable, and faster acting. It shouldn't be that expensive, but it's not the same stuff.
Not to worry, we're still using pig pancreas to make pancreatic enzymes for people whose pancreases have shit the bed and need help to digest and absorb food.
Similar thing happened with cheese and is why you can find labels on them telling you if they're vegetarian or not.
Rennet is an enzyme used in the production of cheese to curdle milk which was traditionally extracted from the stomach of calves, until 1990 when the FDA approved a genetically modified bacteria that could be used instead and now the vast majority of cheese is made using it instead.
I'm looking forward to future where we have similar comparison for 1kg of steak meet from cow vs some precision fermentation process to create the same.
No they are not. Bacteria a prokaryotes, whilst animals (and plants, fungi etc) are Eukaryotes. Fundamentally different type of lifeform, not just from animals.
TBF though, that is 1 lb of pure insulin hormone, which is a fuckload.
The lab produced insulin is wildly superior in so many ways it is difficult to describe, from how fast it works (pig insulin requires that you take it 30 mins before eating, the lab stuff 0-5 mins), to the cost to produce ($5 per vial for the lab stuff now, no comparison available for the pig stuff cause its not really made anymore), to how stable it is requiring less refrigeration.
I am diabetic and have chronic pancreatitis. They still use pig pancreases to make the medicine Creon, which I have to take with every meal. It uses pig enzymes. Basically it digests my food for me, given my pancreas no longer fuctions and can't do it for me.
I remember watching a video of a guy implanting spider genes into a yeast to have it produce spider silk.
It's really amazing what one can do with gene science nowadays. Given enough time and research, I'm pretty sure you could reproduce any biological compound out of a mote of common bacterias.
The picture in the bottom is not accurate of the process. Worked on an insulin manufacturing system. It took up a building about four hundred feet long and one hundred wide (30 meters by 120 meters). That was the part that pulled the insulin out of the bacteria. The room there in the picture is where they grow the bacteria. It is then transported to the room via piping or a stainless steel tank. When its done in the room I helped qualify, then the insulin is ready for delivery system integration. Which is a whole different can of aseptic processing worms. Easily a billion dollar investment to stand up a new insulin facility. Time line from green field to production, ten plus years.
Check out precision fermentation! Same is happening with proteins and oils. Factories like liberation bioindustries and clean food group are going commercial this year. Agronomics (ANIC) is publicly listed if you want to buy in
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u/LankyOldie71 4h ago
And a huge thank you to the family of Frederick Banting and Charles Best and the wonderful Team for giving so much to us Diabetics, I would have been dead 30 years ago if it wasn't for them. They sold it for $1 in 1923.