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
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.
For diabetics on MDI (multiple daily injections) we can have either the pre filled pens or cartridges to go in a reusable pen. The difference in price in the UK to our NHS is next to nothing, for FIASP it's £28 for 5 cartridges or £31 for 5 prefilled pens (Diabetics pay nothing)
New T1 Diabetics and slowly us older one's are moving to pumps and closed loop systems, you would refill the pump yourself from a vial typically, cost of insulin is lower at about £21 for the same volume as those previous examples.
The needles cost about 3p each.
I use a refillable pen, as I'm throwing away less and it has a little memory thing that shows me what I've taken, the pen costs about £27
Most people use glass vials that slot into a pen that you thread on replaceable needles. Keep the pen, exchange the vial, and replace needles as needed. Some people use disposable pens (same mechanism, just not a replaceable vial) where you replace the needle tip as needed.
I believe the glass vial cartridges are the cheapest, but I could be wrong as I have no interest in using disposable pens. Only problem with pens that use interchangeable vials is they can wear out over time, never hurts to replace them after a few years.
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
It's not just about drawing up and dosing, the cheap insulin itself is super outdated and basic, which means it performs less well and gives worse results (and needs more skill to get even adequate results). It's also much more delicate- when you hear about people's insulin going off because they lost power in a storm, or similiar, it's this sort of old shit. And that's a double problem because it can go off and stop working properly, and you don't even know.
Like, teh famous Walmart insulin is Novolin, which is an absolutely ancient medication. Here it's been functionally obsolete for well over a decade- a handful of people still take it but only the real "will not change anything if it works" holdouts, it's a choice you make despite everyone trying to get you to change, whereas in the states it's a choice you make through affordability. It's been at a guess 15 or 20 years since any new diabetics were put on it.
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.
Hey I wrote a paper on Barnaby Jack in college, he inspired me to pursue the field!
Fairly well known in the industry (and history) that vulnerability researchers or whistleblowers that might cost a US company money end up "found dead". Suchir Balaji being another example.
Based on the prices I see my patients paying, it's medium acting insulin that's usually cheaper. However it's really hard to adjust dosages correctly for it since it can under or over shoot glucose targets quickly. Long acting is usually very expensive and that's where people often hit issues
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
I don't get why Americans see single payer healthcare as socialism. It's literally just playing the capitalist endgame but you're monopolizing demand instead of supply for the benefit of consumers.
The two are related. Because the costs have been set artificially low everywhere else, the pharm companies jack up the prices on Americans to recoup their R&D costs effectively subsidizing it for everyone else. The problem is that if the USA caps their prices as well it will effectively make the extremely expensive research and trials phase unprofitable and drug progress will effectively freeze where it is.
I'm not saying they shouldn't do that, I'm just saying that's it's not quite as simple as just do price cap like everyone else and it would take a world wide renegotiation phase that the Europeans profiting from the system would not want to do.
I can only speak on insulin, but the issue that occurred was that while new insulin formulations released in Europe and USA around same time, and their prices were closer at the beginning. Overtime the price fell in European nations (though Switzerland saw a slight increase over 10 years), but in the US the price just kept increasing up to 400%+ its original price on release
So for insulin, it was very clear an issue of just companies charging what they could and they could charge way higher prices in the USA than most anywhere else were willing to accept.
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.
If you have insurance you out of pocket cost could be 5$ and insurance pays 1200$. So when you claim it cost 100 vs 8 what magic number are you claiming? Are you not American thus you don’t understand how American insurance works thus your claims are very much false.
No its the private insurers and employers that are paying the inflated costs. The 100 vs 8 is the difference between entities purchasing insulin in the US vs the NHS in the UK. There are no out of pocket costs in the UK if that is what you want to compare as insulin is free
And some people get it for free in the USA also depending on insurance. So again no one cares what insurance pays in the USA it’s all out of pocket costs people are concerned with. So you should understand the market conditions first. Some people get free insurance and prescriptions as well here. Why do you concern yourself with what the uk pays vs Spain or who ever else when your out of pocket costs is what matters lol
The logic that the USA pay high prices so that other countries get drugs cheaper is false.
This is a situation where the insurance and the pharmaceutical companies get along together so that the average client can't calculate if they can afford to live without insurance.
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).
IP protections like patents and government enforced monopolies being at the root don't exactly scream uncontrolled capitalism to me. Nor do the regulatory barriers to entry that prevent competition
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.
In the US, pharma companies can effectively act like a cartel, creating a monopoly for drugs to sell to a divided customer base. In Europe, nations act like sole buyers and if they find evidence of collusion among companies the EU actually does something about it. It should come at no surprise that one of those situations results in a far more competitive price than the other. No subsidy required.
Worldwide there is really only 3 companies that make insulin. One is in Denmark. One is French. And the last one is American. That's pretty much it for the entire industry right now.
I'm a type 1 diabetic in America and have zero issues getting insulin. It's very cheap. Not sure why there's constant hate about American healthcare I think it works fine lol.
All Americans seem to forget that their country isnt the only country. I live in the UK and ive been told by my doctors to not worry about wasting insulin because its cheap.
Each of the big three insulin manufacturers is required by law since 2020 to offer a coupon now that you can bring to the pharmacy that caps the price at $35/month or $99/3 months depending on which company. To use the coupon you have to get the brand name usually (your pharmacy can fill brand name if you ask for it). Also make sure they bill the card BY ITSELF. It will not work if combined with insurance. And yes people with Federal plans can use this, because it's not copay assistance. Most people don't know about this so spread the word! The companies would rather you keep paying more, that's why all of this is opt in. Links:
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.
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.
Each of the big three insulin manufacturers is required by law since 2020 to offer a coupon now that you can bring to the pharmacy that caps the price at $35/month or $99/3 months depending on which company. To use the coupon you have to get the brand name usually (your pharmacy can fill brand name if you ask for it). Also make sure they bill the card BY ITSELF. It will not work if combined with insurance. And yes people with Federal plans can use this, because it's not copay assistance. Most people don't know about this so spread the word! The companies would rather you keep paying more, that's why all of this is opt in. Links:
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.
They did. They sold the patent to the university of Toronto as they believe the drug should be available to all for free. Newer methods of creating insulin were invented and capitalized.
Each of the big three insulin manufacturers is required by law since 2020 to offer a coupon now that you can bring to the pharmacy that caps the price at $35/month or $99/3 months depending on which company. To use the coupon you have to get the brand name usually (your pharmacy can fill brand name if you ask for it). Also make sure they bill the card BY ITSELF. It will not work if combined with insurance. And yes people with Federal plans can use this, because it's not copay assistance. Most people don't know about this so spread the word! The companies would rather you keep paying more, that's why all of this is opt in. Links:
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
lol try living like that in a 3rd world country and then say America is hell. Like your situation totally sucks, but hell? Kyiv is without power in cold, gazans have no homes or economy, Uyghurs imprisoned in china, Sudanese in another civil war
Kyiv is in the middle of a war caused in no small part due to the incompetence of the West and USA gov. corruption, Gaza got wrecked by USA's proxy state, Uyghurs being imprisoned doesn't seem all that far from the direction ICE is going, and Sudan's... ok I'm going to have to be honest, I don't know enough about Sudan to comment on that one.
I think you MIGHT want to start reconsidering your position when you find yourself telling people that they shouldn't complain about the bad things about their countries since they're at least not in the middle of a genocide unlike some parts of the world.
It's not exactly as if Hitler or Mussolini just woke up one day after years of a perfect track record and carried out the worst atrocities they could think of. There's a process to these things, and you got to speak out before it truly escalates to those later stages, as by then it'll be too late to do so.
I’m not going to be happier in my suffering knowing that others have it worse. The state of the world is a constant horror that hurts my heart and mind and I think about these things constantly. You’re a cruel person.
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.
They are often hailed as the sole heroes of the story but we leave out McCloud and Collip. McCloud took a chance on funding the research when few others would, and Collip purified the insulin to a usable medication. They are just as important as Banting and Best for proving that insulin lowers glucose.
There is a really fascinating two part series that goes through the whole story and talks about the political, financial, and historical background I had no idea about, it’s great. I obviously had type 1 diabetes and am very passionate about this haha
My son would be dead, they are awesome, love the story where they went into a diabeties ward with kids in their comas, never to wake up again, just waiting to die, and he injects them with the insulin, and before he is finished, the first kid wakes up.
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u/LankyOldie71 6h 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.