The pricing is so clearly unconscionable and has been ignored for far too long, it's beyond outrageous. A few years ago, I was on a Grand Jury in NYC, when the ADA was going for an indictment of two young men (brothers) caught stealing one drug from some pharmacies in midtown Manhattan. The drug? Insulin.
Albeit limited in questioning per Grand Jury rules, I was still able to find out that one of the guys was a Type 1 diabetic, that both lived in Harlem, which has a much a higher rate of diabetes than elsewhere in the city, and that apparently they were, basically, giving the insulin away- charging, at most, $10 a vial. They'd been supplying hundreds of diabetics in their neighmorhood and saw it as a kind of 'mission.'
I do not condone theft, but there was something so desperate and so sad about the entire situation, I wouldn't vote to indict. Of course, as Sol Wachtler said: "A grand jury can indict a ham sandwich," so an indictment was brought down. I did, however, argue - to deaf ears - that the real theft was coming from the drug companies, which caused the need for those guys to steal.
I don't know what happened, down the line in the 'justice' system, to the two young men, but, frankly, I've always wished them well.
24
Do any readers remember the 2008 and 2012 presidential debates? I still remember the Tea Party "activists" shouting "Let them die!" I still remember soi-dise "people of faith" calling AIDS "God's judgment on gays" back in the early 1980s.
Make no mistake: this is Republican/"conservative"/capitalism's answer to the Final Solution for a far larger number of victims, a mindless genocide scheme that ignores science, Jesus's sole commandment, and public health--all to make larger and larger profits and rid of the chronically ill, the poor, the elderly, people of color, Muslims, LGBTQ people, and others.
It's what Romney was caught calling the "47% takers"--some 150 million fellow Americans--to somehow vanish at little or no cost.
This makes the Holocaust, which claimed six million Jewish victims (including my own family remaining in Europe in 1939) seem expensive and quaint.
Vote "R" to continue letting people die for corporate profits.
9
Greed is not good; greed will kill
7
The Capitalist Dystopia is here.
8
Vote Democrat as if your life depends on it.
6
For all of you out there who cant afford your medicine, not just Insulin but all the other ones, the republicans have a very simple plan for you: Die.
Vote democrat in 2020
10
"Almost one year to the day after her daughter’s diagnosis, Greenseid and her family were visiting Quebec City, Canada, in July 2014. Her daughter’s blood sugar started spiking and Greenseid feared her insulin might have gone bad, so she went to a pharmacy. With no prescription and fearing that her daughter’s life was on the line, Greenseid was prepared to pay a fortune.
Instead the box of insulin pens that normally costs $700 in the U.S. was only around $65 or so."
See: https://khn.org/news/americans-cross-border-into-mexico-to-buy-insulin-at-a-fraction-of-u-s-cost/
---------------------------------------
https://thehill.com/policy/healthcare/321597-sanders-introduces-bill-that-would-allow-the-purchase-of-drugs-from-canada
(That bill was defeated by the GOP)....yes, the same Bernie Sanders whom the NYT seems to regard as a joke.)
10
FYI viable option. At Walmart Novolin R quick acting and Novolin N slow acting each $25 for 1000 units. Roughly a months supply. No insurance needed.
34
@Ron Cohen This is not an adequate solution for many people with type 1 diabetes who have never used these insulins, or have not used them in years, and will need expert guidance to make the change to these insulins. The cost to produce these insulins is nearly identical to the insulin analogues such as glargine and lispro, and yet access to the analogues which are the standard of care for type 1 diabetes is now being artificially restricted to patients who rely on them.
In addition, there is no guarantee how long Novo Nordisk will continue to supply the Relion product insulins to Wal-Marts. It is not a viable solution for most people with type 1 diabetes and it may be dangerous to suggest this sub-standard alternative to those unfamiliar with how to use the "Wal-Mart insulins."
21
@LH
I am type 2 with medicare and Caremore. I get all my diabetic supplies, that includes two types of insulin, meter, sensors etc for $0 co-pay. This is a solution for retirees on a limited income in states where Caremore operates. A good first step. Type 1 sufferers need a different solution.
10
@Ron Cohen PLEASE stop telling people this is a viable option! This is a dangerous alternative unless you are under the close supervision and guidance of a physician. These insulins do not work the same way more modern insulins do. Because you can obtain these two types of insulin without a prescription, many people will switch to them to try to save money. This can have catastrophic consequences, and has, in fact, led to death for some.
The Reli On insulin is Regular (R) and NPH. R insulin is a short acting insulin NOT a rapid acting insulin, and therefore needs to be taken at particular times, and food intake must be scheduled accordingly. Because it is not rapid acting, you get much higher blood sugar spikes after meals. It does not work the same way as modern insulin does.
NPH is a long acting insulin, but much less effective than modern long-acting insulin. The dosing is completely different, which is where people get into trouble.
I get the allure of $25 insulin. I pay around $1200 a month for my Novolog. But, please don’t advise people to use this as an alternative without knowing the facts.
26
Please learn about how insulin works, what is insulin resistance, what foods raise your insulin levels, and how a ketogenic diet and fasting can revert and cure type 2 diabetes. You can start by reading Dr Jason Fung 2 books. You can cure type 2 diabetes and stop buying drugs.
3
But you can’t cure Type 1. Believe me, I wish you could.
10
Or follow Dr. Bernstein’s diet advice and live without the meds. Keep 1 vial for emergencies, use the generic to save $. And keeping your blood sugar at acceptable levels through diet is both free and sustainable. The problem is that few doctors are educated in treating diabetes without meds, and they pass on their misinformation to their patients, and the pharmaceutical industry wants things to stay exactly this way.
3
@Heidi Thorsen
Please refrain from commenting on topics in which you have no clue.
It doesn't matter what diet a type one diabetic is following, without insulin they die. period. The misinformation you peddle makes it that much harder to communicate the seriousness of this issue.
18
@Heidi Thorsen
Dr. Bernstein advocates a low carb health diet but does not say type 1 diabetics should abstain from insulin
7
It is interesting that people that sell illegal opioids can be prosecuting in some jurisdiction for people that die but people that die because drug companies abuse patents and charge the highest possible cost are call great business leaders. Republicans warned of death panels. But the reality is it is not the government but private for-profit companies doing it.
4
My husband is a type 1 brittle diabetic with no pancreas. Unfortunately that's not his only health problem. During an average month he picks up about 12 prescriptions a month and about half his time or more is spent in the hospital.
So what's the solution?
1) Generic insulin. For the love of God, there is no reason those big drugmakers should still have exclusive patents so they can charge exorbitant amounts for life saving medicine.
2) Regulated pricing. I think the FDA or government should regulate prices for life saving medicine. I don't think they should stop at insulin either.
3) Spread the word about Walmart's cheap insulin. They offer both a fast and slow acting insulin at $25 a vial.
A few years ago my husband had a blood clot and the only treatment was an injectable clot buster with no generic. They asked for $800 at the pharmacy. (And this was AFTER what insurance would cover! It would be so much worse with no healthcare.) We couldn't afford it at the time and luckily the hospital helped cover a portion, but this should NEVER happen when only one treatment is available for a condition that could kill you.
Drug makers have shown that if we don't regulate them, they'll charge whatever they want. They know they're the only game in town. What is the other option? People are dying as a result.
We need generics for all life saving medicine. And we need to regulate pricing, Drug makers have demonstrated time and time again that they value profits over life.
7
Prices need to be capped so that Pharmaceutical companies can only make a reasonable profit (4% ROI?) and subsidies provided to those that cannot afford the reasonable prices. The political problem is that you are taking away money from the pharmaceutical companies and asking for higher taxes from taxpayers to pay for the subsidies. But as others have pointed out, this is a matter of life and death so the free marketplace simply does not work.
4
Last month I filled a prescription for a drug for depression that has helped me but that my insurance will not cover for $500. A second option my doctor recommended that is covered requires step therapy and although I 've been on numerous medications, I don't feel like going through the hassle with my insurance. A third option is considered a "specialty drug" and would cost me around $400 per month. I am still in the process of trying to find a suitable substitute before I need to refill the prescription I paid $500 for. As an aside, I make a decent living and I can pay for these medications if it came down to it, but it is still very stressful. I can't imagine what someone who is struggling financially and doesn't have insurance must go through.
The retail cost of medication is a problem across the board and copays need to be capped on a wide variety of medications if the drug companies won't voluntarily lower the prices.
5
Sorry guys, but only a federal intervention into curtailing completely predatory drug pricing by pharma companies can solve this. Who has the guts to take on big pharma? Clearly not Congress or the President.
We need a champion - who is that?
Big Pharma needs to be in front of Congress WEEKLY until this abomination is cured.
Of course this won’t happen due to the executive branch and the senate. I purposely didn’t capitalize their titles, they deserve no recognition.
6
@Peter Henry
Pay attention. There is a champion--the same person who single-handedly created and fought for the CFPB, protecting vulnerable consumers--that is to say, ALL of us--while taking on the financial industry and big banks. Absurd drug costs?--she has a plan for that too.
9
When Eisenhower left office, he warned us of the dangers of the military-industrial complex. Now we are also dealing with the twin dangers of the industrial food complex and the "health care" industry.
The diabetes/obesity epidemic was caused by substituting industrially engineered "food" for actual food. Not satisfied with sickening only Americans, industrial food is on a rampage and the obesity/diabetes epidemic has reached almost every corner of the world.
Good--step 1 accomplished. Now its time for our "health care" industry to deal with the carnage. You'll never guess what happens--they tighten the noose around the necks of suffering Americans poisoned by frankenfood by squeezing out every last nickel of profit possible, thereby leading sick Americans down the road of bankruptcy.
An inspiring tale of exceptionalism at it's finest.
5
Props to the Times for this article and the previous week's story of the use/abuse of physicians and nurses by "corporate medicine". If more and more of this information becomes available to the general public then Democratic Socialism may not seem such a negative concept. As a family physician I have seen greed undercut my profession over the past 35 years...something has to give...and we on the front lines need to fight the good fight!
7
as long as drug makers are given a government sanctioned monopoly on drugs in the US market the price of insulin as well as other drugs will continue to inflate at monopoly rates. the re-importation of drugs from anywhere is illegal. until this monopoly protection is removed drug prices in the US will continue to skyrocket.
2
@allen. You know most the supplies come from China, right?
1
I suggest that the next time Big Pharma CEOs plan to go to a house of worship, they should visit a hospital ward instead where Type 1 diabetics are dying from lack of proper care. Visit people dying from any disease, really, that monthly prescription medicine could've cured or delayed, if only it were affordable. Of course, that won't make them change, but maybe they'll stop the self-delusion that they're deep down good people.
5
The price for a box of five Lantus pens is 49.46 EUR, roughly 55USD in France. The greed is the only explanation for higher prices
9
Guess which industry spends the most each year on lobbyists. Energy? Defense (sic)? Finance? Guess again.
6
That looks like a Solo Lantus pen for Type 2 diabetes. What’s the deal?
2
The day when we begin to import basic off patent medications is not far off, nor is the day the government begins to make them since it will not be violating any patents to do so. It may also begin to make the kinds of necessary antibiotics we are told Big Pharma won't make because the profit margins are too small.
If none of this happens than I suppose Lenin, who predicted that capitalism would sell itself the rope to hang itself will be proven right. It's as if we're reaching the point where the question of whether or not life on this planet continues is subject to a cost benefit analysis from which life may not emerge as profitable enough to be worth continuing.
3
And it is so cheap to make. My grandmother went from insulin to metformin but had to go back because metformin cost 50 cents per dose. That's how cheap insulin was! No more.
3
Oh please, no one needs to die, or even get sick due to lack of insulin. As many commenters have pointed out, traditional insulin formulations are cheap, available, and effective. And this point of view is supported by the clinical literature!
What Pharma has done is produce a lot of highly tweeted synthetic insulin formulations, put them into expensive delivery devices, then convinced doctors, patients, and guideline committees that they are essential. It's like producing filet mignon and telling you its the only food available.
Patients have commented here that these old insulins won't work well enough, or will be too difficult to use, or to convert to. Nonsense, they've worked well for decades.
If finances require you to be on a cheaper regimen, maybe it won't be quite as effective, or quite as convenient, but it will work. If your doctor does not know how to manage you affordable, find a new one.
7
@A Doctor
Please let me know which hospital or office you practice at so I can avoid it like the plague.
Clinical literature shows much more effective diabetes management using modern insulin analogs such as insulin aspart and insulin lispro. That means less complications and higher quality of life. Not trivial complications either: blindness, neuropathy, amputation, cardiovascular issues, kidney failure to scratch the surface. Perhaps you need to go back to med school?
The issue is that a vial of these newer and more effective insulins went from 35 to 275 dollars in less than 20 years.
You are literally causing your patients pain and suffering if you actually practice what you've written here.
9
@A Doctor I’m a doctor also. I spend hours on the phone and computer each week trying to get NPH and regular insulin’s, and 70/30 formulations of these, covered for my patients with type 2 DM. Patients who have dexterity problems or vision problems can’t draw up insulins in syringes without help from another person. The pens can be life-saving. There’s no reason they should cost $100s of dollars.
And if you have type 1 DM and grew up using glargine and lispro, why on earth would you switch to less nimble human insulins and risk hypos? A doctor who suggests you do this is misinformed.
Your comments are dangerous and I think you either don't take care of many patients with diabetes, or you are not asking them about problems paying for, or using, their insulins.
6
@WallaWalla
Allow me to clarify my comments. I am responding to the assertion in this, and other articles on the topic of insulin published in the NYT, that patients are literally dying because they can not get insulin.
I agree that management of type 1 DM has improved with innovations. I agree that there are many circumstances in which a given patient may need an expensive insulin or delivery device. And I agree that companies should not be profiteering on insulin, and price gouging. Everyone who needs it should have the most effective insulin regimen possible.
What I disagree with is the gross hyperbole with which this issue is presented; that patients are being extorted for money based on a threat to their lives. It just isn't true.
3
I am on Medicare and use Humalog and Lantus with Kwikpens.It now costs over $500 a month to get my prescribed amount of insulin. I am mostly retired and can't afford to pay this amount. So, I have been trying to get by on taking less than I should to reduce the cost. As a result my A1C has been rising. That is a measure of how well controlled your blood glucose is.
Too high will lead to the awful, serious complications of diabetes and higher medical costs.
6
Humalog and Lantus are both off patent. They also have bio-similar versions that are priced lower. Your Medicare Part D plan may have even negotiated a much lower price for these competitors.
Admelog is the bio-similar for Humalog. Basaglar is the bio-similar for Lantus. They’re nearly identical in form and function. You should consult your doctor, pharmacist, and insurance.
When people switch to lower priced bio-similar “generic” versions, it often reduces their out of pocket costs. Because insurers often place them on preferred drug lists or will only cover the bio-similar.
2
It’s worth noting the Kaiser News Report which indicates all Lilly is doing is issuing an “authorized generic” of its generic, just at half the price. There’s still plenty to be made on $137 a vial for the fast acting dosage — an abhorrent amount. Insulin at this price still kills — mom’s, dad’s, grandma, grandpa, brother, sister, aunt, uncle, friend — and everyhand that touches the medication from lab to market to ceo and insurance deniers — every hand is covered with the blood of someone who died due to this immoral and deadly pursuit of profit.
https://www.google.com/amp/s/khn.org/news/how-much-difference-will-eli-lillys-half-price-insulin-make/amp/
5
Of course the insulin pen shown I the photo is part of what makes this discussion more complicated than the headline.
Insulin is available for $25 a bottle at Walmart, in most states, without a prescription.
One reason insulin is unaffordable to some patients is they are opting for the most expensive forms of insulin; you have to pay for all that convenience and engineering.
Nevertheless, Big Pharma has been unconscionable in pursuing the bottom line over health and life.
4
@Claudia
The $25 dollar insulin makes it extremely difficult to manage this condition. It may be cheap, but quality of life is seriously compromised, not to mention the long-term consequences like blindness, amputation, kidney failure.
It's not acceptable that the modern insulins, that have existed for decades. have gone from $35 to $270 in less than 20 years.
Insulin pens are more expensive than vials, but that is beside the point when both have experienced egregious price increases.
5
@Claudia insulin pens are cheap to make. So is the insulin inside them.
But they are much easier and safer for our patients with vision and dexterity problems to use. You may not have personal experience with this so ask a diabetic who uses insulin or a nurse, pharmacist, or doctor.
Don’t work against modern medicine and what it can do for people if we just make it accessible.
2
Well, this is good news for the Federal Reserve which has been struggling to create rising prices for some time now. This involves diluting the value of the dollar. You see, economists tell us it's a good thing for the economy when the dollar buys less insulin, not more because buying more insulin with less money would be mean -- DEFLATION. Horror!
2
Insulin price gouging is just the tip of the iceberg. The whole pharmaceutical market is greedy and guilty of price gouging. It is way past time that Congress start setting prices for drugs in this country.
1
Under our capitalist system and health-care-for-profit application of capitalist ideology, if you cannot afford insulin then you die. Under capitalism, this is not a problem.
If you don't like it, then abolish capitalism, drop your capitalist ideology, and change the system.
If health care should not be allocated on the basis of who has enough money to outbid other people, then health-care should not be delivered by capitalist market mechanisms. And if you believe that health care (or education, or access to clean water and air, etc.) are human rights, then perhaps you really want socialism.
1
The R&D spending of US pharma companies in 2016 was $90BillionUS. World wide the rest of the private pharma industry spent just shy of $67Billion. Clearly US companies by far spent the most on developing new drugs.
The US companies have recently committed to a goal of R&D to be 10% of sales over each of the next 3 years, implying sales of $900Billion/yr. The question many here are asking is where the other $810Billion goes.
In the years '08-'17 nearly $600Billion went to dividends and stock buy backs and in '14 alone, $3Billion+ went to company CEOs. https://www.nytimes.com/2019/02/26/opinion/drug-pricing-senate-hearing.html
For the largest companies, these numbers don't include the billions spent acquiring smaller companies instead of developing their own drugs. Or the margin one division of a company charges another division for its services, and similar accounting slights of hand.
The US expenditure on drug research has a heavy government component, $36.3Billion in 2017, a little more than a quarter of the total.
The question economists have asked for several years: What if the NIH took on the burden of drug R&D, recruiting University and public hospitals to do the research? And then licensed drug companies to produce the resulting medicines under price regulation similar to utilities in many states?
The answer for many experts is lower prices and research allocated by need and not profit. https://deanbaker.net/images/stories/documents/cnswebbook.pdf
1
Insulin prices are sky-high; the price of Abilify has tripled; but worry not about your opioids--I bought a prescription for it for $1.50 last week (with Medicare D assistance, but the price must still have been low).
2
We should be ashamed at depriving people of insulin in proper drug formula. I had a client who two years ago could not afford the severely increased price of insulin. Their doctor and pharmacist could only scramble so much to beg, borrow, and buy insulin for this person. They are on disability on a very low income. Their fault? Hardly. They worked for a manufacturer (now defunct) who exposed them to harmful chemicals; they have other physical issues; they cannot work and now are aging. Where is the help? Where is the humanity? What greed is driving this or do we even need to ask that question.
6
Only in America........
4
Overturn Citizens United and many of the achievements of the merchants of death known as the GOP go away. While some amount of regulation is probably necessary, I fear it will stifle innovation.
1
Something else I have been thinking about since I posted earlier - using traditional vials + syringes instead of the pens.
In my experience, the vials are cheaper than the pens - this might vary based upon manufacturer and/or location, but it is an easy question to ask your pharmacist. The pens are definitely cool, and more convenient, but I don't think that convenience outweighs making sure you have access to the insulin first (with a vial).
I carry my Lantus and Novolog around in one of those little cases you get with a new blood sugar testing machine. In high school, my buddies nicknamed it the "blood purse". :) but I have been carrying my insulin around this way for more than 20 years. Not as easy as sticking a pen in my jeans pocket, but just as effective.
Also, I have never used a needle just once, and then destroyed as recommended on the B-D packaging. Syringes are pretty cheap to begin with, but that's another way you can save....
2
Your idea of savings by reusing syringes is not medically recommended. If you really want to save, you could get the old glass syringes that had to be sterilized with boiling water and we’re used over and over.
Thank you for producing this video and reminding the public of the inadequacies and injustices of the healthcare industry in the US, for diabetics and others suffering from chronic illness.
I live in Madrid, Spain and manage my type 1 diabetes in conjunction with the national healthcare system, Seguridad Social. My insulins are NovoRapid and Toujeo, produced by Novo Nordisk and Sanofi, and they cost about 10 euros a month (less than 12 dollars). All of my test strips and needles are provided for free, as long as I visit a clinic and check in with my nurse every two months. I know other diabetics here and all of us agree that the system works -- it is affordable care, for all.
It's difficult to imagine ever moving back to the States with my pre-existing condition and the costs it would imply. Unless something changes...
6
A prime example of why our health care system needs to change. It seems the pharmaceutical and insurance companies are the dictators of a patient's health care by making decisions that only a doctor and patient should have the authority to decide upon. No one should die due to not being able to afford medication while the heads of the insurance and pharmaceutical companies are traveling around the world on their yachts. Despicable.
6
Our political leaders don’t care about the public welfare. We can’t give them millions in campaign donations, so we don’t count, but our votes might.
3
I would like to form a nonprofit to formulate insulin and sell it for a reasonable price. I know there are issues if patents, etc. Anyone have an idea on how I could start this?
4
I'm a type 1 diabetic. Benton & Betts, took $1 for the rights to insulin therapy, which they discovered about 100 years ago today. It was one of the great medical descoveries of all time. Think what they could have made if they decided to "monetize" there findings. These great men knew what life was all about. It's incredible how far we've fallen since then.
8
@George Murphy It's was Dr. Banting a surgeon and Best a scientist who did it in 1921 at the University of Toronto to whom they sold the patent for $1.00 to keep costs low saying that the discovery belonged to the world
5
What about albuterol for asthma/copd? It was dirt cheap until it was reformulated to avoid CFCs. After that reformulation it went back on patent and now it's $85+ per inhaler.
Good old American medical system.
5
Tell me when the march is and I will join you in the streets of Washington and camp out until Congress acts. Or how about this? Back a dump truck full of used syringes and empty insulin vials on Mitch McConnell's front lawn. It's the heartless "capitalist" Republicans who are endangering the lives of diabetics and bankrupting them.
5
So much for the United States being a 'Christian' nation.
The god of Mammon, greed and misanthropy rules....with the Greed Over People prosperity gospel political party shining brightly as its North Star.
Don't let your children grow up to be Republicans.
4
Reading the replies to this article it's apparent the US puts the health of it's citizens at risk.
If that sounds too inflammatory, look up the amount of money spent by lobbyists to influence lawmakers who represent our interests.
Now look at the percentage of lobbyists who are influencers, advisors of the adminstration, and former lawmakers.
Our interests have been reduced to commodities exchanged for power and money.
.
Now we can't even discover how our voting rights, our census were influenced.
This isn't China, no wonder people outside this country are shocked.
I know the NYTimes has been writing about global corruption, but should we sink to pointing out the stick in their eye while ignoring the beam in our own?
If we tolerate a government that refuses a duty of care, to uphold the rights of citizens what does that say about us?
2
They have to buy insulin or they'll die. You'd be a fool not to take them for everything they have.
This is how capitalist medicine works.
69
And it'd have to be a corrupt, rotten country to allow vulture capitalists to take over the country's medicine, elections, and tax code, Joe Cox.
24
I am a pediatric endocrinologist and this just kills me. We have an amazing drug for type 1 diabetes and people aren't able to get it. It would be amazing if a major pharmacy stepped up and said that all insulin is going to be sold at cost to them. It would be amazing for patients and could be excellent PR. Local pharmacies do offer some prescriptions for free on the assumption that people will likely buy other things. This is only a small amount of the financial burden on patients and families (e.g.pump supplies, strips, lancets). Even more, patients with Medicaid do not have access to the latest technology (latest continuous glucose monitor) and some of the newer insulins, but I digress. Walgreens/CVS, step up!
(these opinions are my own and do not suggest endorsement from my employer)
8
Every diabetic should get free insulin, from a government program. And the government should negotiate with the drug companies to get the lowest price.
4
As someone with Medicare Part D and a supplemental rx plan from AARP, I have my own horror stories about the cost of drugs like cyclosporine (created in 1975 and used for transplant patients or patients with autoimmune disorders) and ACTHAR (the human hormone ACTH, isolated in 1952, now derived from pigs, much like insulin).
What I have learned is this: don't assume your insurance is the best bet. In the case of cyclosporine I have found that goodrx.com can offer me a better price than my insurance company co-pay, AND the "sticker price" does not count toward the donut hole.
1
I'm a physician in Boston. I recently cared for a young patient who nearly died from diabetic ketoacidosis. This young person had been released from her parents' insurance only months before, and had no prescription coverage for her two insulins (despite having private insurance she purchased on her own, it did not cover her insulin prescription she had taken for over a decade). She was relying on donations of insulin from a friend, and couldn't stretch it quite far enough, and she came within hours of dying.
My solution, arrived at after a frustrating 2 hours spent on the phone with Sanofi's patient assistance line and getting nowhere, was a wholly inadequate patchwork one. I called a friend who uses the same insulin who gladly shared extra pens with this patient for a three month supply.
The juxtaposition of Sanofi Aventis offices just a few miles from this scene of one young person with diabetes delivering life-saving insulin to another is painful. The insulin that costs $6 a vial to make is being sold at $350-400 a pop. Modern medicine is being made wholly inaccessible to thousands of Americans who need it.
Doctors, nurses, and pharmacists have been aware of this problem for years. Now people are dying. Pharmaceutical companies with their criminally-priced medicines need to be held accountable.
13
http://www.news.sanofi.us/2019-04-10-Sanofi-provides-unprecedented-access-to-its-insulins-for-one-set-monthly-price
They have a new patient assistance program for the uninsured. $99 a month.
Their patent on Lantus expired years ago. So they have intense Basaglar competition. I think some of their other patents are also lapsing in the near future.
1
@LH
If the buyer will pay it, it's supposed to be a free and mutual agreement with the seller in the view of many conservatives who think that free markets are a reality which are only distorted by efforts at regulation. Clearly, buyers are not free and sellers are being indifferent about what that means when the product is needed to sustain life. In any context of human outside of this free market view, this behavior would be considered both evil and criminal. But not here and not now.
2
@H this program turns outs to be remarkably restricted and doesn’t help most people who have (inadequate) insurance.
3
We must VOTE out the Republicans who are in bed with Big Pharma! It’s criminal to jack up the price of a drug, like insulin which people NEED in order to stay...ALIVE!
3
High purity pig insulin should be a generic product by now and an option for those who cannot afford the new human insulins. This high purity pig insulin certainly kept innumerable diabetics alive for many years before the newer incredibly expensive insulins arrived. Where is the medical leadership going to arise to save us from this awful tragedy of unavailability of reasonable cost of a substance discovered in the early 1920s.
@WSF...The cloned human insulin Humulin has been off patent since 2000.
2
Pork insulin and beef insulin have some side effects which new insulin’s don’t. With pork insulin for instance, subcutaneous scarring left damaged tissue under a patient’s skin. After many years, the results were painful and disfiguring. That is far from a great solution to the problem.
@W.A. Spitzert
i wonder why that has not changed the price?
Does anybody know how many people are rationing their insulin and how many have died from the lack of it? We need those statistics.
1
Get people started on a whole foods based ketogenic diet and most of them will stop needing to use insulin in a reasonably brief period of time.
3
@Todd - Please educate yourself before you blame people for their medical conditions. Type 1 diabetes is genetic - not caused or cured by diet. https://www.mayoclinic.org/diseases-conditions/type-1-diabetes/symptoms-causes/syc-20353011
44
Even still I would die- that is what makes it type 1 diabetes
102
This is a false statement for many people with type 2 diabetes and all people with type 1. You can reduce your insulin usage by eating low carb (whole foods or organic has nothing to do with it.) Insulin is still needed. Your body produces its own sugar to fuel itself when you are startled or stressed. It’s an ancient instinctual response to perceived threats.
I have type 1. I’ve used insulin for over 30 years. I’ve eaten low carb, Atkins, South Beach, Keto, shop mostly the edges of the store... still taking 40
34
I had two brothers who were Type 1 diabetics, they are both deceased. I am a Type 1 diabetic. I consider myself fortunate to have become adiabetic when I was in my 40s - when glucometers were portable, insulin was improved, and the "intensive method" practiced. My brothers unfortunately became diabetics years before then, each at age 6 when they had to made due with beef and pork insulin and could not know exactly what their blood sugars were outside of a doctor's office.
But to add insult to injury, until healthcare reform was enacted, my insurer (company based) denied my endocrinologist's prescription for an insulin pump.
Now this. There is NO EXCUSE for these jacked up prices - especially on recombinant DNA insulin, which is the current insulin. This technology produces DNA insulin, in bulk, replicating cells so fast that it can be produced in vats 4 stories high, It easily can meet demand worldwide.
& it's controlled by a patent. Who did Trump appoint to run the Dept. of Health & Human Svcs? The former head of Eli Lilli. Trump & his entourage are inhumane.
Mitch McConnell, determined to destroy healthcare reform, people in wheelchairs protested outside of his office, is a prime example. There are videos showing them getting bodily removed from their wheel-chairs, dragged down the hall, & placed in a wagon to be detained in jail-their chairs left behind.
It's where Donald and Mitch belong.
7
I’m sorry for the loss of your brothers. I began my diabetes journey in the 1970’s before glucometers, pens, pumps, long and short acting insulins, etc.
Your words are so true. Modern medicine has made diabetes management so much easier than the days of urine in a test tube to see if you were “throwing off ketones.”
That so many people are unable to afford the basic medicine they need to survive is something I can’t understand in the richest country in the world. It’s like we care more about money than people.
1
90 to 95 percent of diabetes cases are Type 2. As Americans increasingly become overweight and obese, it is clear that Type 2 diabetics are driving up the price of insulin. Stop blaming pharmaceutical manufacturers when the primary reason for high insulin prices is people who eat too much and perform little or no exercise.
https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf
@Dan M, you seem to have drunk the old Kool-Aid that the reason I have diabetes is that I eat too much and don't exercise. There are very real causes of diabetes such as family genes and high-carb foods. Let's say I want to eat fewer empty carbs. Show me the "Percent of Recommended Daily Allowance" of sugar in a serving of peas or a bowl of cold cereal. It's not on the nutrition label because the sugar industry lobbied to keep it off, in the interest of profits. Scientists have noted that sugar, and especially high-fructose corn syrup are more addictive than heroin. And addiction=higher profits.
Yes, Americans are increasingly obese and unhealthy. I say that's primarily a result of the marketing prowess of Big Food, the waffling of the FDA. and the lack of nutrition education in schools. I find it ludicrous that anyone attempts to defend the high-fructose tomato sauce in school lunch pizza as a "vegetable."
If we're talking the price of insulin here, and not trying to hijack the discussion by blaming victims, I suggest that the unconscionable rapacious cost of insulin is simply greed.
7
@Dan M - The vast majority of Type 2 diabetics do not take and are not prescribed insulin. Their meds run from metformin to glyburides, none of which have anything to do with insulin. Type 2 diabetics are able to produce their own insulin. They are not involved in any way in driving up the cost of insulin.
4
@GWPDA According to the CDC website, only 5% of diabetics are Type 1. For 2011 (most recent data available) 30% of adult diabetics or 5.8 million people in the US used insulin.
As a senior with Medicare and supplemental insurance, I feel the pressure of healthcare costs every day. I have already received letter from insurer that my health insurance premium will be higher next year. It seems that the healthcare providers want to suck us dry. But I have no way to fight back except that our elected officials representing us hopefully can do something about it. I am still waiting.... and I have deep sympathy for those with diabetics problems. And I can feel the pain, too.
3
You can buy it online, for instance
https://www.canadianinsulin.com/
1
I am older and getting my insulin for type 2 from insurance. The problem with this is all the insurance companies right now are making ALL OF US take a 24 hour insulin named Basgalar, even if you did better on another insulin. The pen does not work well and takes a lot of strength to use it, also many of us gain weight while using it. And need to take more of this insulin over others. Yet your pharmacist will tell you " oh no, you were on the wrong insulin and this one is better for you, which is bull. Anyway I have tried to change insulin and the insurance companies will not cover anything else.
47
@stacey
I have run into this issue as well. I am a Type 1 diabetic, diagnosed when I was 2 years old. I am now 40, but have been taking the same insulin types for more than 10 years.
I am also lucky enough to have employer-supplied health insurance, so the cost is manageable. However, every year, I wonder what insulin will "win" the contract, and what I will be forced to take as a result. For example, my body seems to react more predictably with Humalog, so I prefer to take that for my short acting insulin. However, Novolog has been the preferred choice from the insurance company the last few years...so you either take the Novolog, or you pay "sticker" for Humalog. It forces you to medicate based entirely upon economic factors, rather than what works best for me.
I also think it's rich that I get a letter in the mail from some M.D. affiliated with the insurance provider, telling me that while MY doctor, who knows me and can take into account my 38 year diabetic experience with my own body when prescribing insulin, prescribed Humalog, the insurance provider's preferred short-acting insulin is Novolog. It's always great to get a medical opinion from someone who has never met you or examined you.
With all that being said, I do not lay the entirety of the blame with the pharma companies. The system has many components, and it's obviously going to take creative thinking and compromise for pricing to change.
19
@stacey....This is because your insurance company is getting a more favorable rebate for the insulin they insist that you buy.
17
@David And to think the Republicans whine about government healthcare telling you who see and what to take.
22
What is true for insulin is true for for so many other drugs. The 600$ epipen, the HIV drug that is is 1700$ here but 8$ elsewhere,the 1$pill that is .10cents in a country with national Health Service. Then there are marvelous drugs that are no longer produced because the profit margin is too small . Our insurance premiums are full of profits for the insurance companies. But those who want change are called radical socialists. We have a political system that is financed by those who do not want a more consumer friendly economy. Until more people “are mad as hell and not going to take this anymore “,not much will change.
3
What a country! More greed, greed, greed and the drug companies are some of the worst. I take an OLD malaria drug for an autoimmune condition. At this point it should be a few dollars, but it is NOT. I have the money to pay for it, resentfully, I admit, but what about some poor person on SS that cannot afford this? When will we stop electing people who do not act in our interest? We need elected officials who fight these huge companies and remove their power to charge whatever they damn well please. VOTE!
2
Health care is the biggest loot in USA.. by few over all of us. And the worst part is, these profiteers never makes any medicine; they just sit in the middle and make their money by hurting / killing Americans.
1
Finally! NYT has ignored this story for so long.
But yet again the NYT gets the facts wrong. The price for insulin was in fact $34 a bottle, but it is now NOT $275... it is $400! How hard would it be to go to or call any pharmacy in Seattle where I purchase insulin. The most common “brand” is Humalog and made by Lilly... go to a pharmacy in Seattle and buy a bottle to find out.
Imagine the terror we type 1 diabetics live with... without this product we die! My payments to the pharmaceutical industry are more than my rent! That’s WITH insurance. How is this fair? For an incurable autoimmune disease I got when I was 3 years old I will be financially burdened and living in fear for the rest of my life; 45 years now I’ve Ben paying and every month I wonder if I’ll be able to afford to live the next.
Those with Type 1 diabetes are making those that hold stock in the companies like Eli Lilly and Medtronic rich. Voting for Republicans that support this gouging is repugnant and immoral.
6
Insulin kept my husband alive for more than 50 years. It's insane that the cost has risen like this, but that's unbridled capitalism for you. This is what you voted for, all you who support the corrupt GOP and its kowtowing to everything $$$, and ignoring we, the people. Don't you get it yet?
3
Another of the dumbed down editorials -- I can read like most of your readers NYTimes. Voice over for the visually impaired is fine.. but endless videos are not and there are those of us who are hearing impaired. Please provide print content for everything. This is supposed to be a newspaper!!
this is also the second op0-ed you have run on the topic. What if anything has happened since the first op-ed ran?
Obviously, we need single payer universal healthcare and I doubt that Joe Biden is the guy to support that. WHAT IS WRONG WITH AMURICANS ANYWAY? Exceptional? Indeed.
Raise taxes (bring back the luxury tax, reinstitute meaningful estate taxes) pay for it... get rid of the middle men aka insurance companies. (Wall Street speculators). ) TIME.
1
The lobbying group for the pharmaceutical industry spent about $27.5 million on lobbying activities in 2018.
Top 20 Recipients
1 Casey, Bob (D-PA) Senate $538,003
2 Walden, Greg (R-OR) House $452,200
3 McCarthy, Kevin (R-CA) House $394,450
4 Heitkamp, Heidi (D-ND) Senate $347,909
5 Paulsen, Erik (R-MN) House $320,150
6 Brady, Kevin (R-TX) House $315,550
7 Neal, Richard E (D-MA) House $282,250
8 Donnelly, Joe (D-IN) Senate $271,195
9 Tester, Jon (D-MT) Senate $257,960
10 Roskam, Peter (R-IL) House $253,053
11 McCaskill, Claire (D-MO) Senate $249,055
12 Heller, Dean (R-NV) Senate $248,417
13 Pallone, Frank Jr (D-NJ) House $247,700
14 Walters, Mimi (R-CA) House $247,425
15 Hatch, Orrin G (R-UT) Senate $237,989
16 O'Rourke, Beto (D-TX) House $235,706
17 Barrasso, John A (R-WY) Senate $229,900
18 Guthrie, Brett (R-KY) House $228,950
19 Blackburn, Marsha (R-TN) House $227,696
20 Ryan, Paul (R-WI) House $219,370
Center for Responsive Politics.
5
@Patty O
Looks like this is not just a Republican problem.
2
Big pharma is committing murder. Right before our eyes.
4
The Medical Industrial Complex makes the Devil look like a choir boy.
2
What we have here in America extortion-care not healthcare sponsored by your neighborhood republican party and incompetence, at times collusion of democratic party.
5
One thing that would lower the cost and make things more affordable to those with Type 1 diabetes would be to cut funding to those people with Type 2 diabetes who are overweight or obese, and use the savings to help Type 1 diabetes and non-overweight Type 2 diabetics.
1
This topic deserves more than a video oped with two paras. It deserves some real investigative journalism.
1
Shameless Profiteering to benefit the capitalist lifestyles demanded has nothing to do with Insulin.
It’s just ugly greed that is worshipped by our present society, nothing personal.
1
It’s clear that the sellers consider their buyers just suckers who can be milked like cows because they can buy or die. That is the face of people who have been seduced by power over others and impunity to prey upon them by fools who pretend it’s the price of economic freedom.
1
Greed kills—with absolutely no mercy or remorse.
1
Maybe drug cartels could start selling insulin for type 1 diabetics instead of cocaine for Wall Street bros.
3
Richest, greatest, most greatest country in the whole history of the whol wide world...but...frredum!
Freedom to price gouge. Freedom to kill for excess profit.
And you stand, religious America, for pro-life? Hypocrites.
And your women’s soccer team has no class too!
2
And we need a wall because....?
2
@Lisa
Well, possibly because our programs are not covering those who are *already* citizens very well. There are a lot of very needy people beyond our borders. I know, I know, build schools (and health care for illegals), not bombers. But back here in the real world...
1
Predatory capitalists and their political allies can't resist the opportunity to squeeze out the very last dollar from dependent customers. If socialism comes to the United States, this kind of behavior will have played a big part in promoting it. I hope we end up with Democratic Socialism (Progressive Capitalism as Joseph Stiglitz calls it.) Resistance to progressive change could build demand for something much more radical.
The climate crisis is bringing us to a point where massive changes will take place in our society, in our economy. Institutions will come under enormous stress. Industries will grow, and some will collapse, disrupting medical coverage for millions. The way medical care is currently provided or not provided is untenable.
Businesses and their political allies need to realize which way the wind is blowing (literally and figuratively) and adapt. I don't think they will. The rich are too greedy. Greed = Stupid.
1
"Diabetic Jailed for Stealing Insulin"
No, this isn't a CNN scare headline, just a reasonable conclusion of where healthcare is at.
2
I guess a close relative of a Republican congressperson or Supreme Court justice must die before this will be taken seriously.
4
In the USA, you are n/ot a human being, but just a consumer. Pay up or too bad for you. Other have the money.
3
Capitalism is a failed experiment: The purpose of life is not to get more than everyone else. The purpose of life is to improve your understanding of the world and yourself so you can help yourself master your own worst impulses, like greediness, to make the world a better place for everyone including yourself.
The end game of capitalism is Winner takes all! But the actual price is everyone loses including the self proclaimed winner.
What have we lost. Many human beings die everyday and the direct cause is capitalism; greed run wild. Who have we lost, who might have improved life for everyone in ways we cannot imagine or in ways we can and do? Who has been thwarted from contributing because the greedy don't see a buck in it for themselves. We are now losing our life support system because of the form of stupidity known as greed.
I believe we have lost the future of humankind because a relatively few; 400 families or so worldwide, decided, because they could, to rip everyone off by pretending that they are superior.
Humankind; less than a blip in the universe because of self aggrandizement and witless greed. Global Climate Change brought to you by the worst humanity has to offer; greed, stupidity and bloated ego. Disgusting. Degenerate. Deadly.
Registered Republicans: Let them eat cake.
2
And then they’ll need more insulin!
1
Name names.
2
The cost of a Humalog pen from a pharmacy in Kathmandu was $17. Here the cheapest (with coupon) is around $68 and upwards (goodrx.com). Same product, same manufacturer. Gouging doesn't even begin to describe the level of avarice. The suffering of the people in this video is laid fully at the feet of the individuals in the drug companies who make financial decisions about insulin without conscience, decency or compassion. The spirit of Pharma Bro Martin Shkreli lives on.
4
@James It is not just the Pharma. Insurance companies and pharmacies also have a hand in your pocket.
4
@W.A. Spitzer Thank you. Yes, absolutely. And it shows clearly in the price difference. $17 doesn't sound much to us, but it is a price out of reach for the vast majority in Nepal.
2
I feel ashamed and disgusted at the Trump Administration and Mitch McConnell for sitting on their hands while thousands of Americans are suffering, as seen in this video. I feel embarrassed as an American to see this suffering.
1
Greed knows no bounds when it comes to pharmaceutical companies. Let them eat cake and die
2
A occasional trip to Canada for someone buying for a group is not expensive. Maybe they should watch the movie “The Dallas Buyer’s Club” about AIDS drugs.
1
Maybe that’s okay for your cholesterol and ED pills, but access to insulin is not a joke.
Disgusting! How does this happen? Answer! The most powerful lobby in Washington, D.C. is the drug company lobby. They spent $282,724,469 last year to buy the influence of our elected officials. The second most powerful lobby in Washington is the insurance lobby. They gave $158,033,794 for the privilege of influencing our politicians. (OpenSecrets) Both parties take the money and do the bidding of the donors. Do not think for one minute that these diabetics have an voice equal to these special interest groups. They are simply customers. They are line items on a profit/loss ledger.
5
I am a Type 2 diabetic who has maxed out on my non- insulin medical options. God aka Mother nature created invented insulin.
That there are no controls nor price negotiating power over pharmaceutical medications and medical device corrupt crony capitalist corporate plutocrat oligarchs is inherently callous, corrupt, cruel, cynical, evil, immoral, inhumane and hypocritical.
What should embarrass and shame most Americans is what is legal. Access to quality affordable healthcare is a human right in every civilized nation. America is not in that cohort.
3
It's not accurate to say that the price of insulin is rising, any more than it is accurate to say the price of iPhones is rising. Yes, the price of the latest and greatest version keeps going up. But the price of any given iPhone or insulin version tends to stay the same or drop.
Doctors, for various sensible reasons, prescribe the latest and greatest version. But for most people, earlier versions work perfectly well, and cost much less.
Snopes
https://www.snopes.com/fact-check/insulin-walmart-vial/
2
First, I paid $800 more for my insulin in 2018 than in 2017. That’s a price increase.
In many instances, older insulins have side effects that make life more difficult for diabetics. Would you be content to take the first blood pressure pill available with side effects not present in newer drug formulas?
2
Gross profit by gouging patients is gross.
How about creating a nonprofit, pharmaceutical manufacturing co-op.
2
Insulin should have gone generic decades ago. Yet another example of how cruel and corrupt our country is when it comes to pharmaceuticals. This should be an easy one. It's not a new drug. It's the result of recombinant DNA and has been for decades.
2
@M Insulin in many of its forms has been generic for years. The cloned human insulin, Humulin, as been off patent for 19 years.
4
Due to the insulin cash cow, are companies looking into cures? There is a negative financial incentive to finding a cure. My husband is a type 1 diabetic and is involved in a study by Dr. Faustman. I can only hope it leads to a cure or a least results in decreased insulin use. https://www.webmd.com/diabetes/news/20180621/tb-vaccine-tied-to-better-type-1-diabetes-control#1.
1
I saw a new article about this and people come to Canada for their insulin as it’s probably half the cost - America this is shameful
1
@BevTry 1/10th the cost.....
Your money. All of it please.
Or, your life.
If it's your life, please just go and die someplace quietly without bothering or costing us any money. That would be great. Otherwise stop whining, believe our lies, and be grateful. And don't forget to pay.
2
America, what is happening to you? In the UK things are, shall we say, fraught, but we can still give sick people the drugs they need. What is it about your culture that sees a sick person and thinks "I can make a buck on that"?
2
This is one of those cases where the market is not free. The sellers can force the buyers to take what they offer or do without, a classic Hobson’s Choice. It’s easy for the limited number of producers to collude or just follow what each other are doing into exploiting the buyers. That is exactly what has happened. They are pretty cold about the consequences because of the profits. In addition, insurance companies have no incentives to fight the gouging and individual patients have not the means to fight it.
So the only rational reaction is for society to make the sellers be nice and accept modest profits instead of high ones that cost lives. There are a huge proportion of Republicans who suffer from diabetes. They are prepared to face poverty or death rather than support regulations that constrain businesses, it would seem.
1
This video shows the remarkable truth about our dysfunctional medical system. As a family physician I am once again seeing increasing numbers of patients without insurance or with unaffordable deductibles due to congresses attempts to undermine the Affordable Care Act. These patients are exposed to the greed of multiple players throughout the medical delivery system: drug companies, insurance companies, pharmacy benefit managers, hospital systems are all gouging the public because profit is at the center of how they operate. Why should a couple stitches in a finger, which at my office would cost $200 to treat cost $2000 at the ER? This crisis with insulin is replicated throughout pharmaceutical categories for patients with many many disease states. We need our political system to respond to the needs of average citizens, our politicians are currently oriented toward lining the pockets of their corporate sponsors.
212
@MichaelDG The system will not change until the current GOP roadblocks are voted out of office and replaced with politicians who do not worship money. That goes for all democrats who stand in the way of change. GREED is killing our citizens and our country.
26
@MichaelDG This should be a NYT pick. It's not just Big Pharma, but a lot of players who stand to benefit from the current system. But to extort someone for something that is lifesaving is criminal.
14
@MichaelDG
$ 200 for a couple of stitches means $ 100 per stitch…
Hence $1000 per stitch at the ER is more than a steal, it's a con.
I'm not saying that GPs don't have high expenses that tells why the bill is so high, I'm just saying I'm happy I have full coverage for almost(*) free in France !…
At any rate basic stitches at the ER are almost(*) "free", ie. not more than $ 25 + expenses for needle and thread at the GP's.
USA are going backwards on many issues : health care is the more tangible.
What's quite troublesome is that many Americans still support the "private system" as they hold to the very puritan and individualist notion that each man should be "rewarded" what he pays for.
America has still a long way to go before being a modern country as it claims to be.
_____
(*) "Almost" because contrary to what many believe French Social Security is not a single payer system : 1/3 of the bill is paid either by the patient or by his / her personal insurance.
However life threatening illnesses such as strokes, cardiac issues, cancers, etc… (among which diabetes !) are covered 100% by Social Security.
6
The United States is a revolting land of exploitation. Walmart cheats its workers, Uber manipulates its drivers, Facebook steals its customers data and sells it, and Big Pharma impoverishes the sick and vulnerable. What a pathetic country you have become.
4
America. Broken.
3
Although nearly half of Americans (and plenty of non-Americans) receive govt. health care via Medicare, Medicaid and Pentagon Inc., the major flaw in ACA/ObamaCare was not that it left 9% of the nation unable to afford their suddenly higher premiums, it was that it did nothing to address the problem of higher medical costs that have made health care unaffordable: Big Pharma and Big Medicine - gold plated hospitals and country club doctors.
2
I'm so tired of hearing about "voting" to effect change in our country. Both sides of the aisle are inept and corrupt. Every stinking one of them avoids the issue of reasonable health care for our citizens. I do not know how they sleep at night. For shame.
Its time to hit the streets and raise hell.
2
The government should take over the production and pricing of this drug. Not all drugs, mind you. Just one class of drugs to set an example and put the fear of God, and government, into one of the most craven industries known to man.
Trump can get the job done, after all the hemming and hawing, but then he'll cave in, and we will be back where we started. Better to elect a pit-bull, like Warren.
2
America is garbage people. Just admit it
3
There is not a deep enough pit in hell for these board members and politicians who profit from these companies.
1
Everyone in, no one out, no co-pays, no POS fees.
Universal Medical Care for All, PERIOD.
Every other industrial country has already figured this out, it's time for the US to as well.
4
I'm a Type 1 diabetic since I was pregnant 32 years ago; I'm now 63 years old. I take Toujeo for my basal control and short-acting Humulog for my meals. The cost of Toujeo can range from $10 when they have a promotion to insurance-covered $453 when it's not. HOW CAN THAT BE?
Drug companies: Stop using promotions short term when we need these medications for the rest of our lives! I have an illness that is dependent on you to provide medication that allows me to control my blood sugars, but you are the real blood suckers! How many executives at your company are Type I? Understand this problem from our perspective.
64
@ActualScience Executives are earning a salary that lets them be blind to the cost for normal people. Greed by the pharmaceutical companies is unethical and intolerable. And actually murderous.
10
@ActualScience
The executives are rewarded for the money that they make and the appreciations of corporate stock prices. They rationalize the exploitation of patients with drivel about fiduciary responsibility, jargon for, "never give a sucker an even break".
8
I hope Insulin and this video move to the top of the drug debate list. Government controlled by special interests groups will be the death of our democracy and economy. We are running out of people to squeeze for profit.
The future is not as bright as Trump and company would like you to think!
1
According to a CBC report, the retail price of a vial of Humalog in the U.S. is $300. In Canada, the same vial costs $32.
Why are so many Americans so dead set against what they keep calling "socialized medicine"?
5
@Rob...Is $300 the copay if you have insurance, or is that what the list price is if you don't have insurance? The list price and the copay price with insurance are often very different.
1
This is obscene. We as a nation are being hijacked by pharmaceutical extortionists.
I am not a diabetic, but it is unconscionable that any person has to endure this blatant thievery. The structure of our current healthcare system disgusts me.
5
This is monstrous. Insulin is free to people with diabetes in the UK and the NIH bargains with the drug companies. When is the US going to stop treating its citizens as disposable?
5
Didn't a Republican Congressman say: "Why don't they just die", I think referring to the poor. Maybe that's the Republican strategy, kill all the diabetics and we can eliminate health care for the 99%. Ah, the Cruelty Party never stops.
2
This is how the "magic of the market" kills people. Remember, the GOP has as a goal turning ALL of the medical "industry" over to the "magic of the market". Of course the corporate management and the members of OUR congress already have great health care so why wouldn't they see the average citizen as a cash cow?
1
A much discussed topic in economics is how consumers' or investors' "animal spirits" can be loosed with a herd instinct driving "irrationally exuberant" consumption or investment decisions. The current obesity epidemic driving increased cases of diabetes 2 has shifted the demand curve for insulin far to the right, and, if the supply curve of insulin does not markedly increase, and too, shift rightward, the new equilibrium price will simply be much higher, with little change in the quantity supplied. The "animal spirits" arising here are those of the producers of insulin and their investors, who like many other Big Pharma firms of late, are enjoying windfall profits from large, patent-protected, product price increases.
A NY Times article titled: "The Toll of America's Obesity" by Drs. David S. Ludwig and Kenneth S. Rogoff (Aug 10, 2018), states: "Beyond the toll of human suffering, obesity and diet-related diseases impose massive and rapidly growing economic costs." Per the American Diabetes Assoc., "the annual cost of diabetes in 2017 was $327 billion, including $237 billion in direct medical expenses and $90 billion in reduced worker productivity." The article adds: "More than 90 percent of diabetes cases are Type 2, which is strongly associated with obesity."
This article closes with a proposed five-pronged federal program for attacking the obesity epidemic, and its huge collateral damage, as with these increasing rates of diabetes.
[6/13 Th 12:28p Greenville NC]
1
@John Joseph Laffiteau MS in Econ: most Type 2 diabetics never use insulin.
They use oral meds, like Metformin -- still pretty cheap at $4 a bottle.
Also: real diabetic endocrinologists (not "economists on the internet) know that Type 2 diabetes often causes obesity -- not vice versa. You have it BACKWARDS.
Sadly, nearly every forum about diabetes turns into a "fatty-hate fest" by smug people who think they can NEVER get this disease. You are wrong -- most Type 2 diabetics are OLD...not fat.
Anyways, this is about insulin and most users of daily insulin are Type 1 (or Type 1.5) and not Type 2 -- blameless, slender people with an auto immune disease.
1
What ya got for Type 1’s?
1
Ways big phamas hurt Americans.
Big pharma pays generic companies billions not to make cheaper generics of a drug.
Big pharma work with each other to deliberate create shortages.
We give big pharma billions in aid every year.
This is extortion, plain and simple. I guess life is becoming a luxury only the wealthy can afford, like everything else. The torches and pitchforks are coming soon.
3
Well, obviously the drug companies make a pile of money selling to type-ii people due to poor lifestyle choices. And now, the suppy is low. So they jack up the price, because they know it's important medicine.
I agree but just do not place any of your hope on the present administration.
Unimaginable greed.
Incredible. That poor mother who lost her otherwise healthy, happy son after experiencing sticker shock at the pharmacy...so needless. The pharmaceutical companies will deny to high heaven that their prices are high because they feel they deserve to make sky high profits so that its executives and their lawyers can own two homes and a yacht. Oh, and the lobbyists, too. People don't think about these things when they vote for Republicans. The people of Kentucky certainly don't, when they re-elect Mitch McConnell. Pharmaceutical companies need to go back to the days when they maintained ethical business practices, not Wall Street/Goldman Sachs values.
Let the government make it.
Affordable Care Act was a DUD! Why are liberals continuously applauding Pelosi and Obama fort this bill. The two of them had a once in a lifetime opportunity to start America on the road to AFFORDABLE healthcare for ALL Americans, but they blew it. Sold out big time to insurance companies, pharmaceuticals for MONEY! Or did they just have no guts?!
2
What can I say? VOTE for Sanders and-or Warren. That's it.
Maybe some of the multiple anti abortion-right to life groups could direct some of their efforts to helping with this problem. Their goal is saving lives, right???
2
This is ridiculous. There needs to be a ton more competition in this market to get these costs down and some level of regulation. This is highly unethical. Type 1's cannot help what happened to them. I do question the diet and lifestyle of some type 2 because I know people that have fully come off their drugs. It's a hard diet and lifestyle change but it's possible. Type 1's need help. This is unethical.
Dr's Banting, Best, Collip and MacLeod must be rolling over in their graves at how pharma's greed has endangered and allowed diabetics to die. Banting and Best had compassion, where is that today "big pharma" and Congress?
I'm a retired employee from one of the major suppliers of insulin. We were told that the company makes only 1/2 cent on every insulin pen. This line was repeated so many times and with such emphasis, it was clearly a lie. When I asked to see supporting evidence for the 1/2 cent profit, I was told that information was "confidential." The "1/2 cent" line was clearly an attempt by company management to get their employees to (unknowingly) lie to the larger public if the cost of insulin were to come up in conversation. Don't believe these guys...they are making plenty $$$ off other people's heath problems.
79
Step One is to start importing g more insulin from Europe and other civilized countries. I get my insulin from the VA and it is a product of Norway.
Insulin is not the only drug being grossly overpriced. We need to realize that most imported drugs are safe and equal in effectiveness - and are cheaper.
There is no patriotic reason to support the drug maker's price gouging.
@Ken: thank you for noting that insulin at the VA is reasonable in cost.
I believe it is either free or costs the minimum $8 for a one month supply.
The VA can bargain on drugs unlike MEDICARE.
However, only a tiny fraction of Americans, mostly men, can benefit from the VA.
I would also like to bring up another point that never seems to get the appropriate attention; and that is the psychological effects of this disease on individuals.
I have had Type 1 diabetes (T1DM) for nearly 46 years, and was diagnosed at 17 months old. I also attended and worked at a summer camp for T1DM kids 25-30 years ago. When I worked there, there were about 25-30 people on staff, with 20-25 being T1DMs. We had hundreds of kids come through that camp each summer.
Since this time, 7 of us staff members (that I know of) have died from complications due to T1DM. Two died from complications due to high blood-sugars; 2 died from a severe low blood sugar episode; but the really awful thing is that the highest number of deaths (x3) occurred due to suicide from depression.
T1DM is a huge burden on a person. We have to put in a whole lot of time, effort and money into something that everyone else gets for free. And this burden also takes away from other aspects of our lives (income, family needs, mental health). This increase in cost of insulin over the years has further increased our burden. I would not doubt if we see more T1DMs decide that this burden is too much to live with.
To my friends and all others with with T1DM - both those who have died and those who are still with us - I will always remember you and be your advocate!
7
Part of the problem is that type 1 diabetes isn't viewed as the serious illness it is. People think that all diabetics made bad lifestyle choices just as they think that all people with certain types of cancer or heart disease made bad choices. Here's the reality: insulin is a lifesaving medication no matter one came to need it. Diabetes doesn't take holidays. Nor do other chronic illnesses. There is no reason for diabetics to die from lack of medication except the stupidity of insurance companies and the greed of the pharmaceutical industry, period.
It's not just diabetics who are suffering. People with asthma, people who require thyroid medications, etc., are running up against the same set of issues. People who need to see a doctor every couple of months are bounced from doctor to doctor because of how the wealth insurance industry refuses to allow patients to see physicians outside their exceedingly narrow networks. In other words what most patients are getting isn't good medical care. It's the cheapest kind which, if one happens to have a serious illness, isn't the best or the most cost effective.
7
@hen3ry: LOL, they must be ice skating in Hades today, as we are in agreement.
I know a neighbor whose 10 year old daughter developed Type 1 diabetes -- which you and I know is blameless, an auto immune disease. The child was very slender. Fortunately they finally diagnosed it, got her help and an insulin pump. She is doing fantastic today at age 20!
HOWEVER....all through school, she was taunted and bullied by other children as "you gave yourself diabetes because you were FAT" (when she is THIN) or "you ate too many sweets and candy!". If there was any treat at school, even if this child properly counted her carbs and modified her insulin to account for it .... the other children ruthlessly weighed "oh Suzy isn't allowed to EAT THAT! she can't have any candy! she's DIABETIC!" -- it was awful and cruel.
Here is even MORE info: no real diabetic endocrinologist believes "fat people GAVE themselves diabetes through poor lifestyle choices". Science and research has established the likely cause of obesity in Type 2 diabetes goes just the opposite way -- the failure of the insulin system (before it is diagnosed or even detectable) CAUSES massive hunger, weight gain and appetite. Not vice versa. The haters have gotten it exactly backwards.
All diabetics do not require insulin (though all Type 1's certainly do) and it is a life-sustaining necessary drug. To let it be manipulated this way to profit PURE EVIL PHARMA COMPANIES is intolerable.
3
@Concerned Citizen, yes they must be. But the fact remains that diabetes is a serious illness and skipping medication is not an option. For type 1 diabetics it can be fatal.
The same applies to other illnesses that require medication. It's not a matter of living the right lifestyle that can help a person completely avoid a chronic illness. I know of someone who has type 2 diabetes and he was not overweight, didn't stuff himself with sweets or carbs. He had to go off his vegetarian diet and count calories too. I think he became insulin dependent.
There are people who will tell a person on anti-depressants that their illness isn't real. Or act like someone who has a heart condition can just "get over it". Ask anyone who has to take some of these sorts of medications and they will tell you that they make a difference. Is medication overprescribed? Some are, antibiotics in particular. But insulin is not.
2
I use insulin, and follow this closely.
One American pharmacy sells insulin for 15% of the rest. I don't mean to be an ad for it, just to say its possible. They have it made for them.
These prices are robbery. They are abuse of monopoly power to commit robbery.
Even when insurance picks up the tab, it is robbery of everyone who pays for that health insurance. The money comes from premiums.
This is just one example of a huge abuse. It is the abuse that the TPP tried to impose on other countries, instead of fixing it in our own country.
Our own government has been on the wrong side of this, on the side of monopoly pricing. Yes, that includes the Democratic Party. Nobody has stood up to the drug companies, except Elizabeth Warren.
4
@Mark Thomason: dude! for cripes sake! tell us who that pharmacy is!!!!
That is critical, life-saving information!!!!
@Concerned Citizen -- Walmart. You'll need to talk to your doctor about how to use it, since it is slightly different.
When type 1 diabetics are deprived of adequate insulin, they get DKA (diabetic ketoacidosis). DKA is life threatening. The cost to the insurance companies of one case of DKA almost certainly exceeds a lifetime supply of insulin. Insurance companies should want T1D’s to get adequate insulin. It is not only humane, it makes cost sense too.
7
Regular and NPH are workable solutions and regular insulin can be used in the older pumps. With adjustments to the active insulin time/insulin on board, regular insulin might even be usable in newer semi-automatic/automatic pumps. When pumps were developed in the 70s, regular insulin was the only fairly rapid insulin available that was suitable for use in insulin pumps.
One problem is that fewer of the younger generations of health care providers and patients/patients’ caretakers understand the pharmacokinetics of and know how to dose those non-amino acid modified insulin analogs. However, they can learn these aspects of insulin use. When enough of them start using NPH and regular insulin instead of the outrageously expensive insulin analogs, the pharmaceutical industry’s control over analog insulin pricing in this country will be weakened and they might have to lower the prices of analog insulin to be competitive with regular and NPH insulin. The vicious trend of increasing dependence on insulin analogs leading to higher prices charged by the insulin analog makers will then be halted.
Of course, insulin types should not be changed without a prescription and advice from a licensed medical provider.
2
With life before birth being so sacred to Republicans why isn’t life ones entire life just as sacred. Republicans continuously sacrifice Americans quality of living to the “free market whims” of their corporate masters.
One can hope Americans recognize this tragic behavior for what it is and vote out of office those who care only about profits and not about the entire span of human life.
7
Thank you so much for focusing attention on this issue, it has really been concerning me lately. I recently had an encounter with a diabetic woman that really saddened me. I was on the subway, coming home at night, when a young woman passed out in her seat on the train. Her fellow riders watched over her until she woke up, and tried to get her to seek medical attention at the next stop. She still seemed very dazed but said she was fine and didn't want an ambulance. The other riders dispersed and I ended up sitting next to her and offered her a piece of chocolate to help her feel better. She gladly accepted, and proceeded to tell me that she was diabetic, but lately could not afford medication because "it's just draining me, I can't...". The exorbitant cost of her medicine had forced her to risk her health and just go without. We parted ways and I hope she made it home safe, but who knows how well she will fare without her medicine. It makes me so angry and sad that things like life-saving medication and healthcare, which should be human rights, are not available to the people who need them most.
7
The rise in the price of insulin as well as other living room drugs has several concauses. The main ones are that there are few manufacturers of the drug (I believe that the big ones are only three) and diabetics are on the rise. Therefore, it is the great laws of the economy that determine the price: scarce competition and demand higher than supply. So, to lower the price you need to act and on the supply side by increasing competition - and centralized (public?) management of drugs is an indirect form of this leverage; think about it for a moment, the one who wants to sell his drug to 300 million Americans must be the one who will offer it at the lowest price for a period more or less long - and on the demand side by aiming to reduce the sick. But here many factors come into play, not least a healthy dietary education since school and a serious fight against the consumption of junk food. But are you Americans ready for this Copernican revolution? Best regards from Padua (EU)
1
@Flavius
You don't understand, type 1 diabetics has nothing to do with healthy food consumption. That's Type 2 diabetes. Did you even pay attention to the video?
4
@Brodie
Type 1 diabetes is "only" around 10%
@Flavius: insulin is not even a drug. It is a HORMONE. And an old one. It can be made for pennies, literally.
It is not because so many are on insulin today.
Most Type 2 diabetics NEVER take insulin -- they use drugs like Metformin or Januvia.
A lot of the discussion over diabetes, very sadly, turns into a "anti-fatty hate fest" with no acknowledgement of the difference between Type 1 and Type 2 or that this is a disease -- and not caused by any food.
Dialysis has been the sacred cow of coverage by the government since the sixties. No other treatment is covered in that way. Instead, the program should cover insulin which will help keep diabetics healthy and reduce kidney disease in the future. Diabetics risk their lives every day they cannot use enough to keep their glucose levels under control.
Insulin has been improved since it was first discovered by making yeasts and bacteria produce human insulin. The timing of use by the body has also been improved, but how much profit do the three companies that make it have to make. It is clear they are price-fixing.
This is a life and death situation with very immediate consequences. It is also short-sighted not to fix the problem of cost now before the very expensive conditions caused by high blood sugar ends up being covered by Medicare and Medicaid in the future. Insulin cost is an immediate problem which needs to be addressed now and it is not that hard to fix. Instead of worrying about breaking up Google and Amazon, they should be fixing the exorbitant cost of drugs in the US.
3
Come on, Americans.
Start daily protests in front of pharmaceutical companies.
Tell companies like Lilly that it would be far more charitable of them to cut prices rather than emphasize their local philanthropic work.
The REAL community service would be to lower your drug prices significantly. But they won’t. They’ll scream research and development costs and never mention their profit margins.
Let’s go, America. Daily protests.
6
@SCZ Protests are a good idea and it worked for saving Obamacare when all the disabled folks showed up in the capitol and were pulled from their wheelchairs.
1
The same thing is happening with Epi Pens which have been around for ages and now cost $600.00 for a refill. People should not be dying from an allergic reaction because they cannot afford their Epi Pen.
Many senior citizens now go to food banks or skip meals so they can pay for their drugs. It's time for Congress to act! At least Colorado is helping some residents though not those who do not have health insurance.
3
Thank you for making this video. It explains what's going on succinctly and powerfully,
Sadly, Type 1 diabetics are born with the disease. I could only imagine what it's like to be in that position. 90-95% of diabetics have Type 2. Type 2 diabetes on the other hand, is earned through years of poor nutrition and/or fitness habits. If more "health care professionals" were trained in proper nutrition diabetes would slowly fade away from our society.
These drugs are only getting people hooked and slaves to the numerous side effects that eventually lead to more medications to "cure" the side effects...smh.
Unfortunately, insurance and pharmaceutical corporations will continue to rake in trillions of $ as people get sicker due to ignorance. Why else would they keep spending so much $ on relentless television ad campaigns?
1
@Tim Black
I have Type 1, and am an MD. What you have stated above is not entirely correct. Type 1's are not born with this disease. They acquire it after the immune system builds anti-bodies towards the insulin producing beta-cells in the pancreas. These anti-bodies destroy the beta-cells. This can occur at anytime during a patient's life, but most often occurs in mid to late childhood (pre-teen).
Type 2 has a genetic component, and may be acquired from heredity. Some people will gain it regardless of their dietary and fitness habits. It is also a progressive disease. This means that it will get worse over time. Diet and exercise may slow down this progression, but it will not cure Type 2. And it should be expected that the longer one has Type 2, the more likely they will require drugs to help.
In regards to the statement, "If more "health care professionals" were trained in proper nutrition diabetes would slowly fade away from our society,"...this is false. This is also a myth. While diet and exercise may decrease the progression, T2DM will always be around.
4
@Tim Black Your opinion about type 2 diabetes is uninformed. If you don’t have the genetic markers for the disease, you simply would not get it.
You can’t get hooked on the medication. You don’t get side effects that causes you to take more medication. This is just plain nonsense.
2
My 15 year old son has been a type 1 diabetic for seven years. I want Congress to do something about this issue SOON.
Thank you for the opinion piece—this is an important issue.
2
When Canadian doctor Frederick Banting developed the first injectable insulin in 1923, he refused to put his name on the patent. He said it was "unethical" for a doctor to profit from a discovery that would save lives. Banting's co-inventors, James Collip and Charles Best, sold the insulin patent to the University of Toronto for $1. One dollar. Today in the U.S, Eli Lilly charges $300. For one vial. Incredible. Insane. Immoral.
11
@cee-dog: and until we MAKE IT ILLEGAL and put the Big Pharma execs IN JAIL….
they won't do anything different.
They are laughing at us on their way to the bank!
JAIL THEM.
One or two execs in jail will have a remarkable effect on the others.
1
Heartbreaking! I have been hearing about the affordability of insulin for a long time and the price just seems to keep increasing. We must do better!
1
How much does it cost to treat the complications of uncontrolled diabetes? Heart disease, leg ulcers, amputations, blindness, cost billions of dollars, let alone the suffering.
5
@Spucky50: I agree, but Big Pharma does not pay those costs.
They know most diabetics are desperate and will do without food or rent or other rings to buy their insulin.
So they are now exploiting that.
And our government, our courts sit and do nothing.
Do you see any "million person" marches for lower drug prices?
>> crickets >>
1
American Healthcare is being used as an economic sector that absorbs lack or slowing of growth in other sectors in addition to helping expand GDP relative to other countries. Republican Party will never support a functional affordable healthcare because of these factors. Healthcare has been the main factor that has been taking the slack since the last depression known as the "Great Recession"
2
Unregulated capitalism will destroy America. The very rich can never get enough money. They will do literally anything for that drug.
10
The price of insulins has nothing to do with the costs of producing the insulin. All one needs to do to confirm this fact is to compare the price of insulin in the US (e.g. $450 for a 10 mL vial) vs Canada (e.g. the same 10 mL vial sells for $21) ... more than a 20-fold difference (!).
Pharma companies are capitalizing on their patent protection and ability to develop market exclusivity to maximize profits regardless of the impact on patient health. An ethical company would charge a reasonable mark-up for their product and not take advantage of their de facto monopoly advantage.
How can we, as a country, justify pricing that forces its citizens to make life-and-death decisions because of their finances? If this is capitalism run amok, give me democratic socialism and government price caps for products developed with knowledge from federally funded studies. Require price caps for any drugs that were developed and patented with government support at any stage of the discovery process.
7
Only fetuses, no matter how non-viable have a right to life. Once born, you have the right to drop dead...after paying every penny you ever made to big pharma.
The utter hypocrisy and depravity of the anti-abortion, evangelical, pro-billionaire big pharma-backed -GOP led by profits over people president Trump is on full display.
6
Affordable healthcare is a human right.
4
For the honor of living in the greatest country in the world (America?) you get to pay 10 times more than other countries for a life saving drug. Until the republicans, the great protectors of big Pharma get sent home once and for all, and the democrats have free reign, things will not change. We can be the greatest country in the world, and we should be, the only thing holding us back is pure unfiltered greed. If greed made you sick the same way sugar did, this world would be a much better and saner place.
4
@Lonnie this is why as I near retirement age, I'm seriously considering retiring abroad. That and I'm fed up with the land of my first generation American birth and lifelong allegiance having become for all intents and purposes a fascist regime.
1
If you want lower drug prices, don't expect it from President Biden.
His cancer charities were formed with money from drug companies.
He's prevented foreign countries from compulsory licensing of expensive cancer drugs, and prevented the NIH from requiring drug companies to lower their prices on drugs developed from NIH research.
His son Hunter is a pharmaceutical company lobbyist.
https://www.statnews.com/2017/11/30/joe-biden-drug-pricing/
5
Capitalism at its finest!
2
This is scandalous. We in the rest of the western world have agreed to make health care affordable for all.
In the US, god help you if you get sick, because your government won't, and, shockingly, a lot of your fellow citizens don't care.
2
This situation is a prime example of the glaring incompatibility between the maximizing profit mission of health care focused corporations and serving the health care needs of their customers. It is nothing less than a national disgrace.
I recently tried to obtain the reduced price insulin marketed by Eli Lilly and found it difficult to get. A major drug chain in my community did not have it in stock. Unless I had a prescription for the drug, they were not allowed to tell me what it would cost. They did tell me that the co-pay would be higher than the usual generic drug co-pay. Although I have been using this drug for 30 years, and depend on it to control my diabetes, I would have to ask my doctor to provide a justification for my continued use. A ridiculous barrier. Other obstacles to easily obtaining this needed drug were also in place. In Canada, a prescription for insulin is not even required. Why is this not the case in the US?
Eli Lilly, by introducing a reduced price insulin but making it difficult to get, has apparently decided to engage in a PR effort rather than trying to effectively deal with a major health issue.
5
Thank you NYT and activist/writers for bringing this issue to the forefront. Mother of a Type 1 since he was 18 and a freshman in college. I have been encouraging my hard-working son to prepare himself career-wise to emigrate to a civilized country where he can live fully and use his education to make a contribution to society without fear of running out of the drug that keeps him alive. When I am near death after a long life, I want to know that my son will get the drug he needs to live on. Other wealthy countries give their citizens that peace of mind. Ours doesn't and judging from the political debate over healthcare, it will not anytime soon. Republicans call it "socialism" to scare voters and it seems to work with enough of them to keep Republicans in control of the national government and most states. When your life is threatened by the actions and inaction of your government, as it is literally by government's healthcare policies, you have to consider whether the country you love loves you. I want my son to live as long a life as Type 1 diabetes, well-managed by insulin and his own efforts, will allow. I would see him move far away from me if that is what it takes although his absence would hurt my heart.
4
There is no excuse, none, to price gouge basic medicine that people need to stay alive. Disgusting and outrageous that it is allowed.
4
Living in a civilized country called France this problem is inexistent. Americans need to learn that socialism isn't a dirty word and that the greed and destructive power of unbridled capitalism is detrimental to human survival.
6
We have plenty of spare aircraft carriers and bombers to send to the Persian Gulf to provoke Iran. But managing to pay for insulin for Type 1 sufferers, well, that's outside our capabilities!
The American people need to wake up.
11
Dermatologist here and I just laugh whenever people tell me pharm co’s need to charge so much for “research.” Every week we get in numerous drug reps trying to buy the entire staff expensive lunches to come in and educate us on new medications. Outside of a few immumodulators (psoriasis) none of the medications have changed in 30 years! Meanwhile all the “research” is just slightly tweaking the same medications (making it long-acting, different vehicle, etc) or just taking 2 and mixing them together! Then they pass out coupons that covers the drug until the patients deductible is full! It is naive to expect pharmaceutical companies to reign themselves in when they are fighting each other in this capitalist system for profits and stock prices. Congress has to stop this abuse robbery of the American people. Health care is just not-suited for capitalism.
9
As a T1D living in a European country (Denmark) with free health care (yes, taxes are higher, but it’s still cheaper than the US system on all levels), I don’t agree with the root of the problem. Indeed, companies like Novo Nordisk have patents on insulin. Take Tresiba as an example. It’s a lot better than some of the older types of long-acting insulin, and cost of developing a new type of insulin is probably more than 1 billion dollars in R&D plus more. If they couldn’t patent it no companies would have an incentive to develop new types of insulin.
I’ve had T1D for more than 20 years, and have never paid more than approx. 500 USD a year for insulin. In my country the system is set up so all health care is free, and any type of medicine for chronic illnesses is paid for the state, after the first 500 USD (approximately) that you pay yourself. Going to the doctor? Free. Got cancer? Free.
I can (and have tried) get an insulin pump if I so wish, and I have the dexcom G6, without paying one cent, and all supplies are free from the start and forever.
On a broader basis, I also find it w that in a developed country, your quality of healthcare is based on your economical status. I am proud to live in a country where everybody can get first class healthcare, regardless if your parents are rich or poor.
And yes, I pay more in taxes, but it is actually cheaper anyway, because we provide just as good healthcare, if not better, for half the cost, compared to the US. (Source: OECD)
7
It's unfathomable to me that our politicians can't seem to make a clear moral argument against profiting off the sick and desperate and formulate simple policies, likevregulating pharma pricing like utilities.
3
My cousin in Spain pays 54 cents (that’s right) for his insulin. My European relatives think US for profit health care is “barbaric”.
4
America has lost its way. Just read Kushner's co. accepted $90MM in shadow money from some offshore entity. The guy works in the administration and handles top secrets. And now this news. Constantly depressing. What happened?
4
So...how many Republicans need insulin?
Many of the respondents lack the empathy gene. Diabetes and HBP are so prevalent you'd think this would be a bipartisan issue.
4
I’m surprised that more people aren’t talking about the low cost alternative to the expensive insulins. In California, you can buy a vial of Novolin N and Novolin R for $25 without a prescription at Wal-Mart (ReliOn brand Novolin N & R). They aren’t ideal, but better than giving up food to be able to afford insulin.
4
@Eddie: some people cannot take those types of insulin.
Some people need very specialized insulin.
i have a friend who is insulin dependent, and she has to take long-acting insulin at night, or it "runs out" before she wakes up and she can go into a coma with the wrong insulin or dosage.
The Walmart stuff is fine for some people, and it is cheap, but it is not a solution by itself.
Generic drug manufacturing should be nationalized and the contribution of research by government funded universities should be taken into account. Few drugs are the creation by a company alone. We need another purging of the greedy rich to let them know we will only accept so much influence on politicians by the wealthy. The rich should be living in fear.
2
Now lets see an article with what Congress is (or isn't doing) to fix this issue. With NAMES of those who are introducing bills to correct this nightmare, and NAMES of those who are not on board with changing the process. Too many drug companies lining legislators pockets. And someone was right - why aren't we holding protests in Washington on this issue - it's life or death for these poor folks!
2
From where I stand, that woman's son was murdered by the pharmaceutical and insurance industry. She should press charges!
This, and all the other outrages currently underway in the US, beg the question - why haven't people taken to the streets and stopped all business as usual until this nightmare/Republican mania for money and power has ended? But now I understand better. People are scrambling, not just ahead of homelessness or unemployment (although that too, for sure) but ahead of death. Who has time or energy under those circumstances?
The Republicans have gutted education, made health care for the wealthy only, destroyed job security AND and the government safety net to catch those who are impacted by their actions, are actively ruining the environment - water, soil, air - and ensuring that poor people (the 99%) eat food that is nutritionally dead. How could anyone rise up and demand different when they are a product of that?
The world watches in horror.
3
They just had a story on this in MN $1300 a month for insulin. They talked about caravans of people that drive to Canada and get it for 1/10 the price and bring it home. Sad when the citizens of the self proclaimed greatest nation on earth have to drive to a country that according to Trump is a national security threat to buy the medicine they need to keep them alive.
4
This is madness. Apparently a vial of insulin in Canada costs C$30, which is about $22 in U.S. currency.
Congress must act to end this horrible situation.
3
the benefits of "socialistic" medicine living in a country where we care about all our people
"There are some startling differences in price between the U.S. and Canada. According to one report, the retail price of a vial of Humalog in the U.S. is $300. In Canada, the same vial costs $32.Jan 28, 2019" cbc radio
3
This editorial is totally misleading with its talk of Big Pharma killing Diabetics. It trades in invective rather than facts.
The list or retail price of insulin has gone up over the years, but few people pay that. Almost everyone has insurance that negotiates much lower prices. PBP rebates are even being curtailed by HHS regulations. And with Obamacare insurance subsidies and Medicaid expansion, almost everyone can get affordable insurance coverage.
You intentionally mislead about the patent situation. Animal insulin is a century old. Modern recombinant insulin is a few decade old. The patents on several of the most popular modern insulins have expired and bio-similar competitors exist. You don’t produce generics with biologics, it’s bio-similars. So what exact patent abuse are you railing about?
And what exactly is Congress going to do? Hauling drug companies CEOs before committees to be flogged is getting old. If bio-similar competition isn’t lowering prices to your satisfaction, you’re free to band together and create your own non-profit insulin maker. I’m tiring of the complaints of greed and profiteering. If you think insulin can be made for pennies per dose, hire the scientists, doctors, and engineers and give it a try yourselves.
1
@H, you have a constitutional right to your opinion, but there is nothing in the constitution granting you the knowledge or absolute truth.
IN MY OPINION the article is spot-on. Since diabetes is common in older Americans, a lot of insulin is provided through Medicare. Note that Medicare has been prevented from negotiating drug prices by congress.
IN MY OPINION greedy drug company officials who are responsible for unconscionable unrealistic drug prices should be found guilty of profiteering and sent to prison. Yes, that's what congress should do.
IN MY OPINION we don't need to band together to create non-profit insulin manufacturing plants. All we need to do is allow health care businesses to import cheaper drugs from other countries without artificial government interference.
2
@H
I think that the argument is less about greed and profiteering and more about life and death. For a Type 1 diabetic, not having insulin feels like your blood is thick and cant move through your veins, your brain is foggy all the time and the dehydration is terrible. Imagine knowing that there is a very easy solution - one that has been around for centuries - and not being able to access it.
also to your last point - people are doing just that http://blogs.discovermagazine.com/crux/2018/09/13/diy-insulin-make/#.XQJ1plxKjmE
1
@H We can't!!! Patents are the problem.
I have $5000 retail cost of insulin in my fridge. If I sold it, I would be breaking the law, but the pharma companies are the criminals.
5
Congress is Investigating why the prices is so high! Wow. No need for investigations. Spend the money on getting insulin to people who need it. The answer is GREED. The CEOs who make these decisions that put lives at risk should be prosecuted for depraved heart murder every time another insulin deprived American dies! It’s time to make a stand. Profits over people is a business plan that puts lives at risk and has actually killed and will continue to kill until actual criminal prosecutions are brought. Where are all this “pro life” Republicans on this issue? Taking in the big checks and smiling.
2
Too bad Ivanka isn't type 1 diabetic. Trumpy would have made it free by now.
1
This is a travesty. An overreach by capitalism, a failure of government to protect the vulnerable. And it's sad that awareness has not risen. Thank you to those created this content and to the NY Times for publishing it
2
This article is both totemic and a savage indictment of US capitalism. Our UK NHS is hugely mismanaged by the government but I sincerely believe the NHS would never allow this to happen; simply on the basis of morality, ethics and public taxpayer’s accountability.Yes we have problems and rationing, but nothing like this. Evil is the correct word for this.
2
I’m shocked to discover the number of commenters who don’t seem to understand the difference between type I and type II diabetes and think that you can treat type I diabetes by changing your diet.
4
@Rebecca: I know CHILDREN with Type 1 who are mocked at school by other kids and sometimes even by TEACHERS and adults, for being "fat" or "eating too many sweets" or that "you gave yourself diabetes and you are at fault!"
They are tormented every time they eat a snack of any kind, and their every bit of food consumption is scrutinized by others -- not to help -- but as mockery and derision.
They are laughed at as fat, when most are thin or average weight.
This is what "fatty hating" comes to in the end.
This is rank piracy. The intellectual property exclusivity of pharmaceuticals and medical devices should be extremely limited. I tend toward libertarian positions and am a frequent defender of capitalism. There is no defense for this. Big Pharma marketing budgets dwarf R&D budgets. Our govt could directly fund competitive, open-source medical research for far less money than it currently pays these thieves, these scoundrels for their IPR each year. It would cost government less AND drastically reduce patient-paid costs, which are unimaginably high. Bipartisans must act.
1
It would be interesting to find out who in Congress is diabetic, and what their taxpayer medical benefits are. Do they pay zero while all others are gouged.
2
Many people understand the problem and also the solution. However the real problem is that American society has for a long time been so easily manipulated by simple one word demonization of ‘new’ ideas I.e. communist - now socialist. Until the US electorate can see beyond such facile manipulation I fear there is no hope for change. Can’t you just picture the discussion at a debate? YOU have the government that YOU deserve.
I’ll check back in 20 years....
1
If a user dies because free insulin is not available for all who need it, those restricting the supply need to be charged with murder!
2
@Mark in Western Colorado: it does not need to be free.
It's about $30 a vial in Canada, which I think is a fair price.
The prices in the US are pure, unadulterated gouging and price fixing.
This is disgusting. The pharmaceutical companies are totally out of control. I knew an executive from a pharmaceutical company who flew all over in a small private plane supplied by the company he worked for (whom I shall not name for fear of being sued.).....Big business contributes to the so-called leaders of our country who count on big business to finance their campaigns so they can continue to raise prices and continue to finance their campaigns and on and on and on......and we pay the price for this.
2
The feds will do nothing - it is owned by Big Pharma. States should declare an emergency - more people are threatened by insulin shorage than hurricaines. They should take over the supply chain for critical drugs and distribute them.
1
You are making me feel guilty when I buy insulin for my dog.
1
@Rich Murphy: I buy insulin for a diabetic cat.
I buy it at Walmart for $24 a vial. A cat uses very little, and I never use up a whole vial -- I have to throw it out when it expires.
The needles are about 20 cents each. The needles cost more than the insulin -- for a CAT.
However, i know that humans are complex and need a variety of insulins, and the cheap Walmart stuff isn't good enough.
Frankly, it is not even ideal for a cat. It's just all there is, and all i can afford.
Let me hear again how the “free” market fixes all things.
5
@Wise12 "Free market" It's amazing right? If we had a free market AIG wouldn't exist anymore because they counted on the tax payers to bail them out during the 07/08 collapse.
2
This is totally wrong. The US must institute a healthcare system which covers all medications necessary for life. No one should have to do without insulin or cheat their daily needs. Healthcare for all!!!! Vote for candidates who support this policy.
1
I'm voting for Republicans as a way of punishing Wall Street and diabetics (and future Social Security recipients).
1
I'm a Spanish GP. We have another problems in our country, but no problems with medical drugs.
Diabetic products are "Black point", this is, products that people need to live. Every drug for diabetes: insulin or oral medicines is 1,5 euros /box or free in people with low pension.
2
Both sides care more about drug lobby $ than really helping with drug prices. The sad part is some additives in our foods helps to create long term diabetes. Trump solution on fixing drug prices is to allow drug companies to increase their cost.
I suggest we average other nations cost of drugs and drug companies can charge no more than 20% more.
1
In 1972 congress extended Medicare benefits to most people suffering from end stage kidney disease because of the tremendous cost and people will die without dialysis. Why in the world do they not either pay for the insulin for diabetics or force the drug companies to provide it for a nominal fee? If you prevent the long term health effects of uncontrolled diabetes you will save lives and money.
2
My mail-order drug company which I am required to use, sent me an e-mail asking why I hadn't refilled 1 of 4 diabetic medicines that I am supposed to use. I e-mailed them back and said I couldn't afford it. They re-emailed and asked me to call them and speak to one of their pharmacists since their pharmacists don't respond to e-mails. So I called. I told the pharmacist I couldn't afford the co-pay for all of my diabetic medicines plus 12 other prescription drugs I take for other chronic problems. Did the pharmacist say, "I'm sorry" or "Let me investigate an alternative solution?" No, she incredibly just said, "Is there anything else I can do to help you?" Who is the stupid one here? This low-income, sick, senior citizen or the supposedly highly educated pharmacist?
120
@george
Did you call the company and ask for help? I wouldn't accept this answer if it involves your day-to-day life. Ask, ask, and ask again someone can help you! Start a compaign for your medical needs! This is unacceptable to be dependent on a medication and not be able to afford it.
7
@george I had this experience with a gynecologist who was part of a very well known group in Westchester County. I had lost my job and couldn't afford a check up. When I called to cancel the appointment and told them why they said the same thing to me. There was absolutely no concern for me as patient, nada, none, zilch. So much for the "hypocritical oath".
9
This is afwul, I knew things were bad, but not this bad. This country is so off-base; truly sickening.. Change is needed, and now. Thanks, for sharing your story.
7
This is a clear violation of price fixing in violation of anti trust laws. The Trump administration should have the Attorney general file appropriate action. Instead they allow unconscionable profits and resulting deaths. Manslaughter charges should be brought by Federal authorities and states can files such charges. Top company officials should be in prison!
3
And to think that the discoverers of insulin, Banting and Best, gave their discovery to the world free of charge and free of patent.
5
Yet another clear example of the distorted health care system as practiced in an unregulated capitalist system. It's wrong. It's bad. It's a matter of life and death. Big pharma doesn't care. Congress doesn't care. Fat profits and election day payoffs are the only things that matter to them.
2
There was a hearing held in April.
https://energycommerce.house.gov/committee-activity/hearings/hearing-on-priced-out-of-a-lifesaving-drug-the-human-impact-of-rising
But with McConnell in office, nothing will be accomplished. I remember when people in wheelchairs were outside of his office protesting his determination to abolish healthcare reform, and he just had them removed from their wheelchairs, dragged on the floor and carried off to a van that threw them in jail.
We know who really belongs there, and it's not those citizens.
Also, Trump appointed the former Eli Lilly Executive to head the Dept. of Health and Human Services.
Also, if you are a citizen in the United States, it's deemed "illegal" to purchase your prescribed insulin from Canada.
This is what a real national crisis looks like.
And it's the Trump and administration along with his toadies who have caused it.
Please get out the vote.
4
I am a Type 2 diabetic. My body still produces some insulin, but does not use it effectively. In addition, I exercise regularly and control my diet, which are helpful, but I still need oral medication and insulin. Even so, while those of us diagnosed with Type 2 diabetes are generally not at the same risk of dying in the short term due to a lack of insulin as those with Type 1 diabetes, we remain at risk for a number of other “side effects,” (as are Type 1 diabetics), such as neuropathy, infection, blindness, and organ failure, among others — along with the health ripple effects from those conditions. In any case, while my dependence on insulin is different than many with diabetes, my sensitivity to — not to mention my incredulity and disgust over — the ridiculously high prices are the same.
5
Canadians Frederick Banting and Charles Best released their discovery of insulin on March 22, 1921. They sold the patent for $1 so everyone would have inexpensive access to the drug. What has happened to the price is extortion.
3
@Rick Taves...After 20 years patents expire and become public property.
1
How can we have rent control and not have LIFE SAVING MEDICATIONS CONTROL?
This is heart breaking.
And to allow publicly traded companies to profit off illness is shameful.
The monopolies of the drug companies prohibit true competition.
Last Fall, there was a huge outcry about drug prices. The quote is from Healio.com.
“The Infectious Diseases Society of America and HIV Medicine Association strongly criticized Nostrum Laboratories Inc. today for quadrupling the price of the antibiotic nitrofurantoin from approximately $500 to more than $2,300 per bottle, saying it was unethical, irresponsible and unnecessary”
The drug costs pennies to make and saves lives throughout the world.
So where is the outrage? Why no protests? People who are sick can not care for themselves, their families are also busy just involved in caring. So who will fight?
Because the trillion dollar pharmaceutical industry spends millions on Public Relations and Lobbying. A very powerful group to convince the public they provide miracles, or perhaps just distract us so we March for One Illness at best, or at worst just think of our own health and not our neighbors, and so we don't stand Together to Demand Health.
“Life, Liberty and the Pursuit of Happiness”
Doesn’t that cover “having Insulin?”
Or “not dying from an untreated bladder infection that leads to sepsis?”
2
Its a real shame when Trump tries to push these bills to UK when it has NIH needs to be dismantled etc and make way for US pharma companies and other providers!
I am not for universal medicare but I am for restricting price of Life Saving Drugs ( not the rich kids push to get high though ) and life saving procedure bills !
Lets see ,if the rest of OECD world is surviving without the Big US pharma , so be it we will survive in USA too.
The pharma industry is out of control. The insurance industry is out of control. Corporate medical and hospital groups are out of control.
People suffer and die because of it. But,hey, those stock prices are soaring!!
1
i guess the obvious response is USA USA USA.
better to have people going broke and/or dying than give in to the horrors of socialized medicine with everybody covered at a much lower per capita income--like other western democracies have.
longer life expectancy, lower infant mortality rates....what rational person would trade his/her freedom for that?
2
@brupic
should've read....much lower per capita COST, not income
“Patent laws and existing regulations allow the top three manufacturers to continuously increase prices without consequences.”
And then:
“...Congres is actively investigating why the price of insulin is so high.”
If the first part is true, then this shouldn’t require much of an investigation.
There's this notion that somehow capitalism must extend into health and welfare. When a hurricane hits and gas stations double the cost of fuel its called gouging and illegal. When a corporate pirate like a Shkreli or a generic maker like Teva buys up old drug patents and increases the price 1000% its called good business and perfectly legal. It shouldn't be. Its akin to murder by torture and our republican friends in congress and the white house throw down every roadblock possible to make sure it does not change. We need change. As DocMark pointed out take your typical asthma regiment Albuterol for emergencies: $150. Inhaled steroid to avoid emergencies: $475. That's a month's worth of medication for treatments that have been on the market for decades. There is no R&D to recover. There is no extraordinary cost for production. Its profit.
1
@RT1 capitalism is not the problem. Government is not doing its job to protect competition here. It is granting exclusive copyright protection on insulin (!?!?). The solution is allowing more capitalists to make insulin at a very cost, which will result in low prices. The government is failing to do that, probably because of government / legislative corruption. Corruption is a serious issue that must be exposed and fought. Or else.
@RT1
In the civilized world they have health services. In America we have a health industry. Just like the auto industry, chicken industry, fast food industry. Even our so called tax exempt no profits are swimming in cash. Cash they used to tighten their grip on our health delivery industry.
2
When the worship of money exceeds the practice of saving lives we have to stop and ask ourselves...who or what have we become?
2
We need the insurance companies out of the medical decisions. Utilization review has killed the practice of medicine. Physicians should be the ones making the decision what type of care the patient gets, not the insurance companies.
And, insulin should be free. Plain and simple. This coming from someone who happened to go visit her Type 1 friend after 2 days only to find her on the floor unconscious because she couldn't afford insulin. We all paid for that emergency room visit and hospital stay, so we should all be willing to pay up front for her insulin.
3
Under Capitalism, there is a need to maximize profits and not leave “money on the table”. During a Trade, as all students of economics have learnt, the buyer decides how much money to exchange to use a given product. At some point he balks - as we did with flat screen TVs a decade and a half ago. WIth insulin, he cannot. Therefore the price must be high.
These are the reasons for which the movement for ‘medicare-for-all’ is increasing currency. This is why the pendulum is going to swing towards democratic socialism.
1
This is so frustrating!! I can't find answers to the questions I have on this issue. (1) What is the newest kind of insulin that you can find as a generic? (Walmart apparently sells insulin at reasonable prices - but it looks like the same kind that was introduced in 1946. Do I have that right?) (2) How long are pharma patents supposed to last? How does the US compare with other first-world countries? (4) What's your egregious example of an insulin that should be out of patent that mysteriously stays in patent, in terms of "it was introduced in 19XX"? (5) What's the best, most universal insulin that should be a generic by now? How much is it?
2
Good video and coverage of the insulin availability issue. As others have posted here, it's a problem that is endemic in private enterprise: If production cannot, or will not, be increased, then only those with adequate financial resources can get the insulin.
A private enterprise system ensures the inconvenient truth that there will be a statistical population that cannot obtain some resources. As this penetrating video shows, it is unacceptable to restrict healthcare due to cost. The unavailability of insulin to a portion of our population is a poignant reality that notifies us of the horrible inadequacy of out healthcare system.
In Canada, a vial of Humulog costs aroun $32, whereas in the U.S. it goes for $300, according to this informative CBC article:
https://www.cbc.ca/radio/whitecoat/blog/the-soaring-cost-of-insulin-1.4995290
The original goal of the insulin patent was to make it available to all those in need.
It is outrageous that this nation does not provide insulin in order to maintain a capitalist supply-and-demand relation for producers that ensures uncontrolled gain in profit for them. The nasty truth about business in the U.S. is that it is based on having a large number of disadvantaged citizens, and it is also based on an irrational fear of socialism.
1
I'm a Type 2 & have been on insulin about 10 yrs. I now use Basaglar - my insurance pays half of $300/mo & I got a manufacturer's discount card online so my portion is only $11/mon. These cards can't be used if you have govt. insurance such as Medicare & Medicaid, so when I retire soon I'll keep my insurance, which I can do as a govt employee. These same benefits should be available for Type I meds.
2
If you'd like an informative, fairly accurate, humorous discussion of this topic I'd suggest checking out Hasan Minhaj's netflix special, Patriot Act, and finding the episode on drug pricing.
2
How much does insulin cost in the European and Nordic, etcetera countries cost?
I am a scientist working for big pharma and I am tell you that insulin prices have sky rocketed in the US only to increase profit. The not-so-secret secret about pharma is that the high prices payed in the US are acting to subsidizes the low costs paid by everyone else and to pay for the R&D not being done elsewhere. The party line is that if pricing collapses in the US then companies would be forced to raise prices for medicines to all other countries and would be unable to perform the financially risky research needed for new drug development. However, since pharma doesn’t disclose it’s costs vs income at any granular level, it is impossible to know if that is true.
I do know that it is VERY hard to create new medicines and that scientists can work their entire lives without ever producing something that becomes an effective therapy.
3
Thank you, scientist who works at big Pharma and for Janet above you in the comment section: I would like to know comparative things like what does a kilo of butter (or pound if you like) costs in other countries , Scandinavia Nordic, And also Southern Global, and compare them with the cost of butter or insulin for that matter in this country… The US.
@Umm..excuse me
You must also know that we could be using generic insulin if there wasn't so much bilking going on by the pharmaceutical companies holding the patents.
Why are you claiming it's "very hard" to create Humilin insulin (also known as Recubinant Human Insulin) when it's been around since 1978' the cell that replicates the DNA divides thus producing tons of replicas, and Indiana produces it in a vat that's 4 stories high.
Please.
Give me a break.
I mean that as a Type 1 Diabetic. Gimme a break. Honestly.
1
@Capt. Pisqua
?
I am not a young man and I love this country, but health care is so completely messed up that I know I will have to move to Canada within the next 5-10 years so I can afford the medication I need for chronic medical issues. I never smoked, don't drink alcohol, I eat mostly fruits and veggies and lean protein, I run, swim, bike and lift 6-7 days a week but that doesn't cure other stuff that's genetic and which I have nothing to do with. I'm sorry...like NYC, where I couldn't afford to live after 26 years, I cannot afford my own medical care and am unwilling to euthanize myself...yet.
3
@ZellicksonThat's not a good enough reason to get in....
There are no practical reasons for the outlandish prices of drugs in the USA. It's all about greed. OK, we're a capitalistic nation, where making your business profitable is the primary goal.
However, congress has been crawling into bed with the drug industry for years, rather than standing as an advocate for citizens. Would anyone be shocked to learn that a majority of elected congressmen are accepting campaign funds from those in the drug industry, or that they are invested in drug stocks and pulling in profits?
Drug overpricing is so rampant and unconscionable that congress should have acted long ago to protect the health of American citizens. That's another reason for term limits on senators, and time limits on senators revolving between government and private employment.
Perhaps it's time for some agency of the US government to declare public health emergencies and provide essential drugs to citizens at no charge--including insulin. If the government were paying the cost, perhaps congress could figure out a way to reduce drug prices--negotiation, anyone?
Or, maybe states should set up minimum security prisons for the millions of citizens who have to commit crimes to get their drugs provided.
Would you rather go to prison and get free insulin, or stay home and die from hyperglycemia? Or, do you need to relocate to Canada or Cuba to get necessary medical care?
2
@Bentspoke: you cannot just "move to Canada".
Canada has very strict immigration law and cuts off immigration at age 45 (50 if you are a physician or highly skilled tech worker).
Canada is not insane, and does not wish to give full medical care to Americans who never worked nor paid taxes into their single payer system!
Some of the cost of insulin is being misunderstood. Say for example the pharama that makes the insulin lists the cost of a certain unit at $400. If you have prescription insurance, the insurance company buys (in one form or another) the insulin for $400 dollars and then the pharma rebates the insurance company (in one form or another) $380. The insurance company than makes the $400 of insulin available to their insured customers for a copay of $30. One reason the cost of insulin keeps going up is that the insurance companies keep wanting to get bigger rebates. The bottom line is the real cost of insulin to the patient is often not what it might appear to be. It is much like what hospitals charge but almost never receive. This should not be read as a defense of the system, but rather to suggest that we need to eliminate the middle man from process wherever possible.
2
I may be a little fuzzy on this, but don't I recall reading once that the researchers who developed insulin for Type I diabetics literally gave away their patent and refused to take any money for it so it could be provided a no cost / low cost to the people who needed it to simply exist? So the drug companies didn't pay a single cent for the patent, and are now raking in beaucoup bucks for the product? How much does it actually cost to manufacture? THAT should be the only cost to an insulin dependent diabetic. To do otherwise is criminal.
4
@Alice...The use of insulin to treat diabetes is one patent. The isolation and purification of insulin from pork pancreas is another patent. Cloned human insulin and cloned modified human insulin are other patents.
1
A modern day "Merchant of Venice".
This has reached crisis levels and the drug companies have lost their moral compass. Emergency actions would not be inappropriate.
Do we charge them with extortion, murder, or some flavor of conspiracy to commit the same?
1
I was out of work in the latter half of 2017. As a result, I lost my employer-provided health insurance. COBRA wanted $2100 per month to cover myself, my pregnant wife and 2 kids or about 800/month for just myself. With idea of when my next paycheck would come, I had to rely on my savings and insulin was one way I thought I could cut back.
Though the exact price escapes me now, paying for a month of Lantus Solostar was simply beyond my means if I still wanted to keep food on the table, pay my mortgage, credit cards, utilities, etc. As a result I rationed my insulin, stretching a 6-week supply to 4 months.
The result? My blood sugars shot up after a few weeks and never went below the 300s. The stress of a frantic job search and worrying when my next paycheck would come compromised my immune system, so I got utterly hammered by the flu in October. I developed fungal infections on my neck and body that I'd never had before. I'm pretty sure I aged a few years in those months.
The fact that health insurance is tied to your employer in this country is farcical! I've worked (almost) continuously since I was 18, working my way through college and grad school (when that was still possible). I pay my taxes every year, and pay for insurance out of every paycheck.
I've never asked to anything that I did not earn. But I would like some assurance that losing my job does not also put my life at risk because I can't afford to pay $2100 a month to line insurance and pharma execs' pockets.
13
It should be noted that health insurance companies profit more from high prices, since they are simply a middleman, passing along the costs to the consumer with a percentage profit. Higher prices for us means higher profits for them.
3
The issue of insulin reflects a much larger health care problem. Our goal must be to help people who have a treatable condition achieve long term control. Otherwise, we are looking at enormous costs from heart disease, strokes and subsequent long term care, kidney failure and dialysis, vision loss, loss of limbs. Low cost insulin is so important and diabetes so prevalent that we are in a nearly invisible national crisis. The profit motive is too powerful when production capacity of controlled by a few.
The NIH, several major universities, and the American Diabetes Association certainly can raise the capital to build a research facility for diabetes and to include a production facility to compete in the market place.
We the people should fund research, development, and production that is beneficial to us, the people. This is another crisis that brings to light the limitations of capitalism at its worst. Since it is competition that the capitalists love, let the competition begin!
5
The people responsible for these insane price hikes should be treated as criminals. Who knows how many people have had life-altering diabetic complications because they were forced to ration their medicine?
This is exactly why we should not leave healthcare in the realm of free-market capitalism. The fundamental goal of medical professionals is to improve health outcomes, but the entire healthcare infrastructure is concerned about profits- these concerns are directly at odds with one another, and we can't deliver on both at the same time. I choose ethical medical care over corporate profit, and I think any moral person would agree with me.
2
Democracy has been reduced to the idea that eventually we can vote when we are asked to do so.
The REAL democracy is instead the possibility to access healthcare as a RIGHT, not a privilege.
2
In 1920, being diagnosed diabetic was a death sentence. In 1923 the use of insulin from pig and cow started to save some lives. Insulin was improved again in the fifties and was the first protein sequenced in the 1960's. That eventually led to the creation of Human Insulin, a synthetic insulin, in the 1980s.
The cost of manufacturing insulin should have plummeted, but with the help of Republicans three companies have held this treatment hostage for a huge ransom. People are dying because of their greed.
The Federal Government should declare this a national emergency and start manufacturing insulin to be given away free. Or, withhold any future research grants or tax breaks to companies that do not produce this at a much more reasonable price. Otherwise, for too many people, we are back a century and the diagnosis of diabetes is death.
5
@Joe Barnett..."The cost of manufacturing insulin should have plummeted,"....Correct, because insulin, Humulin for instance, has been off patent for 19 years. If you wanted to undercut the three big pharmas, all you would have to do is form a company and go into business - they don't have patent protection that could stop you. So why hasn't it happened?
2
In Australia the cost of most types and brands of insulin are locked in at A$39 a month (US$27)for most people although for seniors , unemployed and disadvantaged the cost is about A$9 (US$6) for the poor and those dependent on complete Government support, the cost is free)
We also have safety nets if families spend more than about $1000 a year on Prescription drugs any extra costs are refunded.
This pricing applies for most Prescription drugs including the Hepetitis C 12 week Drug offerings costing from US$60,000-90,000 for a 12 week supply. For uys the price is A$39 , A$9 or Free.
Australia is aiming to be Hepititis C free by 2021 with no one suffering the disease.
In most of the developed World , the pricing and support is broadly similar to the above...only in America does profit and Greed take precedence over people's health and even their lives.
Ask your elected representatives why this has to be the case, because it certainly shouldn't be.
4
@Loomy
Apparently you've never tried to reach an elected representative. They are out raising funds from pharmaceutical companies to fund their next campaign. They are not going to talk to peons like us. Their staffer will say "he/she's very concerned about this issue and will look in to it." And they never do. But they sure as heck do show up at the pharmaceutical lobbyist meeting in their office or at an undisclosed location off-shore for "fact finding". Democrats, Republicans - makes no difference. Crooks and prostitutes is what they are.
3
In 1921,Sir Frederick Banting, a Canadian physician, and his colleague, Charles Best discovered insulin. They were awarded the Nobel prize for their work in 1923.
Banting wanted everyone who needed insulin to have it available. He could have become very wealthy but he chose to give his patent away for free, so price would not be an issue for patients.
Is there a lesson to be learned here?
5
When I read articles like this--and I am in the medical field--I know we need Bernie's "political revolution." Because if the drug companies and their bought-and-paid-for politicians keep things going the way they have been, they will force us to fight for our lives a la 1789 France.
6
As a type 2 but insulin dependent diabetic for more than 25 years, I have long wonder why a drug that has been available and only tweeted not re-imangined for the last 70 years should be so expensive. In most first world countries it available to anyone who wants it for a low price and without a prescription. The same insulin in America must be prescribed and cost 10x the average of other 1st world countries. This is greed at its ugliest. The government puts a cap on electricity and phone prices in the days of monopolies, so why is it so reluctant to do the same for medication. I am lucky that I have insurance that takes care of most of the cost but this is not true for a lot of individuals. Medication for chronic illness should be available and unprohibatively inexpensive for those who need it. Period.
6
The usual excuses that pharmaceutical companies give for high drug prices are 1) "We have to recoup our research and development costs for this new drug," and 2) "This condition is so rare that only a few hundred people in the country need this drug."
Neither is true in the case of insulin. It has been in common use for over 90 years, and literally millions of Americans depend on it to stay alive.
It's pure, callous corporate greed, nothing more.
I wish someone would do a study of how the attitudes of corporate executives as a whole have changed since the 1980s, when major corporations stopped hiring humanities and social science majors for management career tracks and began hiring only graduates whose sole focus in college had been on learning ways to improve the sacred bottom line.
9
If you are lucky enough to live close to Canada you can get insulin from pharmacies there much less expensively than USA. I've heard two different stories about whether they will mail to the US because it needs to be refrigerated-one person said yes, another said no,
2
This country choses to ignore the fact that we have had sugar in our diets for 300 years and while sugar is a poor food it was after the invention of HFCS that the current epidemic of obesity and diabetes began.
Other countries keep the use of HFCS to a minimum but here in the USA our well intentioned but corrupt government is devoted to put the cheapest food available in our bodies. The lies do us a real disservice. In this case the lie is that HFCS is identical to sugar. This is simply not true.
Things are so bad that Wikipedia has a whole page on the mistakes of the FDA.
3
@Allan
Diabetes is a problem with carbohydrates. You could completely eliminate sugar but still have a problem with carbs in many plant based foods-rice, potatoes, corn, peas,fruits, flour, lots of beans
5
@rlmullaney
For the last 10,000 years people have revered wheat as a perfect food. Now we have destroyed it.
All that is required is to buy organic wheat berries, grind it, and make bread that totally eliminates the cravings we have for junk food.
@Allan
Hey Allan, Type 1 Diabetes is an auto-immune desises - meaning your immune system attacks your insulin cells causing your body to stop producing insulin. Without insulin a person can not survive no matter how many wheat berries you eat. Your body produces a hormone called glucagon, this makes your blood sugar rise. If a type 1 diabetic does not have insulin the glucagon will continue to be created and you will have high blood sugars that will lead to DKA and then death. So while junk food is a problem in the country I don't think it is the crux of this problem.
The major cost related to diabetes care used to be hospitalization related to uncontrolled glucoses/high blood sugars and complications like amputation, heart attacks, strokes and dialysis for kidney failure. We have dramatically improved diabetes care and the need for acute hospitalization. But now the cost of insulin and other diabetes.medications far exceeds the cost of hospitalization. This is a result of the unregulated pharmaceutical industry and their shameless pursuit of maximum profits for shareholders and themselves. The answer is regulation and price controls not just copay limits. This applies to all drugs and the governments failure to take action is costing lives and preventable deaths and complications.
5
Keep this topic front and center.
Two nights ago I was listening to Canadian radio ("As It Happens"), and they did a long segment on the Canadian government's efforts to reduce and control the increasingly high prices of prescription drugs--the high cost of drugs, the uneven pricing of the same drug in different locations, what to do about life-saving new drugs for children that are far too expensive for most parents, and the conflict between private vs. public control of drug pricing.
We don't do anything effective in this country to address this widespread problem--the price gouging epi-pen scandal should have been a wakeup call.
But with most of our attention focused on the latest Trump political stunt and antics, plus Citizens United and our legalized bribery campaign finance "laws," Republican politicians, in particular, do nothing but obstruct, block, and stonewall any efforts to control Trump or drug pricing and the availability of expensive drugs for sick Americans and their children.
Talk to doctors--most of them still manage to care and are very frustrated for their patients.
But now that our hospitals and the health care system are mostly run by large powerful corporations and business people where it is all about money, market share, and image, it will take a revolution to make our American health care system great again (US is THE most expensive but ranked #37 in health care in the world). Let's find out why. Don't count on the GOP, however.
7
I have not had the misfortune to confront this problem directly in my life. However, I am astonished. Insulin has been around for decades; I thought it was the equivalent of a generic drug, almost a commodity, certainly not something that should (or could) be price-gouged. What happened?
5
@Wine Country Dude...Insulin to which we refer is not one single thing. Initially insulin from pork pancreas was used. It has several problems as it is not the same as human insulin and there are religious prohibitions for Jewish people and Muslims. Cloned human insulin is somewhat different, and human insulin has been modified in some cases to be more effective. All of these things are called insulin but they are somewhat different in chemical composition.
What really galls me, as a person with type 1 diabetes, is that insulin is now worse than it used to be. It’s filled with higher levels of preservatives (phenol; metacresol), to which I and many others have become allergic. There are no alternatives without these preservatives. So in addition to paying these high prices, I now have to take frequently debilitating amounts of antihistamine. I suspect the preservatives are the main “innovation” to allow use in insulin pumps and to support longer-acting insulins. Was there any other innovation for insulin in the past 20 years?
1
We should all do our research and not vote for any candidate that takes money from pharm or insurance companies. Congress will never take ethical action on health care while dependent on their dollars.
1
Thank you, Governor Polis, for taking this essential action. Big Pharma is another example of 'socializing the losses and privatizing the gains.' Taxpayers help fund the drug industry through bailouts and Congressional donations. While taxpayers continue to pay for their products through financial ruin or their lives. First quarter earnings for 2019: Pfizer $13.12 billion, Eli Lilly $5.09 billion (insulin producer), Merck $10.81 billion.
@PC
The good news is that Big Pharma are very liberal and donate up to 99% of their earnings to the needy and charity, but keep only 1% to pay taxes, bank loans, and corporate needs.
It's not their fault if people do not learn how to reap the benefits of their largesse.
FP
@Fernando Pagán Hmmmm. Thanks for the un-reality check.
One thing I'll will note is that these people are holding up insulin pens. While convenient they are expensive to manufacture (I used to work in the industry) because they each have to be calibrated. But they provide the companies with a marketing tool (fast, easy, convenient). They also create a lot of waste. A vials of insulin and a syringe is probably cheaper. I buy insulin in Thailand, it's around $80 a vial, syringes are $4 for a box of 50. The cost here is shocking and it is disgusting that drug companies get away with this. To hear that a woman lost her son to diabetes in 2019 is just simply shocking, my heart goes out to her. This should not be happening 100 years after this drug was develop. It is a testament to greed in America.
1
I worked in a pharmacy a little town in California in the early 70's. We kept the insulin in a little fridge in the back room. I don't remember how much we charged for it, but not much. Buying it was no big deal for anyone 45 years ago. It's inconceivable that it's now unaffordable to so many diabetics. Actually, the way things are, it is conceivable. sigh.
5
@Zeca/...The "insulin" then and the "insulin" now are not the same thing in chemical composition.
Surely universal medicare and universal pharma care are hallmarks of a just and compassionate society. Is it possible that citizens have been conditioned since birth to confuse the social democratic principles which would prioritize such basic human needs with the tyranny of communism. Surely medical care in a first world democratic country that describes itself as "great" is an item that could be government regulated as "not for profit".... I understand that it may appear sanctimonious or interfering for a foreigner to make such suggestions, and still, it is all a bit incomprehensible from here.
3
There is a third alternative to ‘We Either Buy Insulin (at high US costs) or We Die’, especially if dying is a serious threat: move to a country, say, Canada, where insulin is more affordable. The latter is doable, e.g., millions of us, Americans, were born in another country.
3
It’s not that easy
One way to reduce the costs and dependence on insulin is to need less of it, by drastically reducing carbohydrate intake. This has been shown to be effective for Type 2 diabetics and also impactful for Type 1 diabetics as well. Dr. Sarah Hallberg, a bariatric physician, has been advocating for this approach for years. Her TED Talk from 2015 is straightforward and her work since has shown the safety and efficacy of this approach. Well worth researching and trying.
I think you may have missed the point of this article. Our last insulin purchase, with prescription coverage, was $632.00. And note, I did say WITH PRESCRIPTION COVERAGE. Low carb consumption would not have reduced the cost.
9
@AK What a callous way to look at a lifelong illness, and I suggest you take Ted Talks with a grain of salt and a lot of further research. Type 1 diabetes is a very different story from Type 2, and going low-carb is not going to eliminate the need for insulin for these patients. The answer is a complete overhaul of the despicable US healthcare system.
2
@Kate, I have a PhD in a biomedical science and understand the differences between Type 1 and 2 very well. The forefront of nutritional research is gauging individual variations in metabolic response, and the era of "one size fits all" nutritional advice--yes, even for people with diabetes--is coming to an end. The impact of very low carb diets is an area of active research and debate. In the absence of well-defined clinical biomarkers guiding treatment plans, which will take literally decades to develop, the only option open to patients is to do the experiment themselves. If it is impactful, this is a way for people get out from under the burden of illness and the need for the healthcare system in the process, with virtually no additional expense. TED Talks are approachable for nontechnical audiences to be introduced to the topic. Of course further investigation is merited. Bottom line is, it's worth doing the experiment to see if it works for you.
I didn't know that the drug companies have jacked up their prices so much that diabetics in need of insulin are paying prices as if they were buying heroin. That says the system is broken.
6
@Anon Heroin is cheaper.
1
Healthcare is a right. We, as a global society, must develop a system to disperse related costs to as many people as possible, and remove the extreme profit motive from the equation. In addition, the level of bureaucratic administration at the office level is archaic and ridiculous. Furthermore, I don’t want to have to fill out a new form (pen on paper) every time I am sent to a specialist. Electronic health records should be universal (by now, with our technology). Ideally, in large metropolitan areas, we should only have to visit one building—a proactive wellness center—for exam, diagnosis, treatment, and, most importantly, prevention.
4
I know that these comments are monitored for civility.
We are constantly told to be polite, civil and patient when dealing with those that govern us and control essential services.
(by the way...The original discovery of insulin was given away free to the people of the world)
I am very much afraid that people in power have forgotten the many lessons of history. At some point a limit is reached and things get ugly for everyone including the rich and powerful.
I am 70 years old with tears in my eyes. I never thought I would have to write something like this in the United States of America.
12
Gee, I don't understand. According to Joe Biden, Americans are "satisfied" with their current health insurance and health coverage. Or maybe, Joe Biden is just out of touch with the financial struggle of average Americans to keep themselves alive and healthy.
4
You are generalizing and pointing fingers and not being objective about the problem
Please tell me when Biden said this?! I’ve never heard him say such an idiotic thing....sounds more like Donald!
In France ,5 Novorapid Flexpens (3 ml) cost 35,23 euros, which is roughly 39,50 dollars. Of this, 65% is reimbursed by the national health service.Perhaps this is "socialism", but it keeps people alive.
9
@Alexandra Chapman I'll never understand the American knee-jerk reaction to "socialism". I was lucky to live in the UK for 8 years and found the NHS to be fantastic (better coverage than my platinum PPO that I pay $250 a month for AFTER massive subsidies by my US employer). Americans, wake up! Healthcare coverage and drug costs should NOT be a constant worry, and it simply isn't for most people in the developed world.
3
Pharmaceutical companies, like any company in general, exist to make money, so it is a tad naive to expect them to be completely altruistic and making products which are not profitable. The problem, I believe, lies in the society that we want, and which type of government is in place. A society that accepts that health is something to be managed by corporations is bound to create this kind of situations, in which the health insurance (corporation) negotiates with the pharmaceutical company (another corporation) the price of, say, insulin, for which they agree to pay, say $50 per vial; to make it look amazing for the insurance company, the pharmaceutical company lists the price of insulin at $800/vial and then all the insured people at that company feel that their insurance is great because it covers their insulin for a small $50 copay! The pharma company wins, the insurance company wins (they spend nothing), and the losers are the people who cannot afford the premiums of the health insurance corporation.
5
What is crazy about this is that without insulin, type 1 diabetics are not only subject to unnecessary death, but also are subject to catastrophic complications and medical emergencies.
Whatever insulin costs, a health plan will pay far more for emergency medicine, intensive care stays, amputations, blindness, and a host of other complications.
Any health plan with the big picture in mind should go out of its way to ensure that all type 1 plan members have absolutely no impediments to obtaining adequate insulin.
6
Wrong. You are enabling manufactures to scalp us. We regulate the cost of water and electricity we should do the same for health care.
In Europe no one has to worry about this. When you explain to Italians or French citizens that this is how health care works in the USA, they are incredulous. Health care in our country has nothing to do with caring for health. It is solely constructed, managed, and regulated to produce profits for shareholders.
19
This is pharma blackmail. Your money or your life. Insulin should and could easily be free in USA, like other countries with universal health care. But our legislative representatives are paid indirect bribes.. special interests by lobbyists to promote this travesty upon the American public. Our legislative representatives are indirectly coconspirators supporting this system of extortion. They happily take the money that flows through the system from diabetics pockets, to pharm, to lobbies who give some of their profits into the American legislative process to protect and support the cost of insulin to diabetics.
12
@paulu
Nothing of value is free. You pay or someone else pays.
1
The problem isn't a few "evil' people in industry. The problem is that under the competitive private industry system we have created _only_ health care providers, insurance companies and drug manufacturers that prioritize profits above human lives can stay in business. A CEO that prioritizes lives above profits would immediately be fired by his board for not maximizing their incomes.
As a physician for 38 years I find myself aghast that so many of my fellow professionals reject Medicare for All as an existential evil when the current system of private industry control of the health care system has resulted in such a disaster for our patients.
13
Thank you for your comment! They reject Medicare for all because of....greed.
An answer to this craziness is for this country to use eminent domain to own all pharmaceutical resources collectively. It's clear by now; we need protecting from this evil that has lasted far too long with no end in sight. Full control over the for-profit scoundrels is an area of social welfare that the Declaration of Independence was talking about if a document could speak. We can't thrive; the opportunity is robbed from millions by the misfortune of their bodies. It's life for God's sake. Eminent Domain. We take it all.
6
Agreed. My mother's Humira is thousands of dollars a month. Thankfully she has coverage. The medications i need for my condition are hundreds of dollars, which i cannot afford - so i experiment with alternatives...
4
@James Mason
Physicians income should be capped at $75000. Great savings for the patients.
2
The CDC reports that 100 million U.S. citizens have diabetes or pre-diabetes. In 1958, less than 1% U.S. citizens had diabetes, now 7.4% have diabetes. Something is horribly wrong with the American diet, mainly refined carbohydrates and sugar. Simply eliminating carbohydrates from you diet will significantly bring down your glucose levels!
5
@John You are making a common error about diabetes. People with Type 1 diabetes are dependent on insulin to live. They have an autoimmune disease which has no connection to their diet. Their pancreas is attacked by their immune system and they produce no insulin. We do not know why the immune system destroys the cells that produce insulin. A carbohydrate-free diet is not a treatment for Type 1 diabetes. It will actually lead to more complex metabolic concerns.
15
@John what you are saying has NO relevance to Type 1 diabetics — the individuals whom the article and video address. A Type 1 diabetic suffers from an auto-immune disease that is neither caused nor can be cured by diet or exercise. Insulin is required to live. Type 1 diabetes (unlike ppl diagnosed with Type 2 which is a totally unrelated disease), are reliant on insulin to live.
10
@John Intermittent fasting is also very dangerous for diabetics.
The fact that no generic is allowed to step in and undercut the obvious price fixing being done by Eli Lilly and other big Pharma is a big part of what is wrong in our health system. Competition is not allowed, in fact its illegal. This isn't free-market capitalism, its not socialism either...in the US we live in this weird highly-regulated hybrid where we've managed to cherry pick the worst of all worlds.
8
There are “generic” competitors. With biologics like insulin, they’re called bio-similars. Most of the patents have lapsed. Some prices have come down. US list prices are not what most people actually pay. They’re just initial numbers that get cut down substantially after negotiations between insurers and drug companies. So Sanofi’s Lantus took a big hit when bio-similars hit the market.
The difference with European nations is they negotiate nationwide discount prices. The US doesn’t. And the business model of most drug companies is to charge Europe less and make up their profits in the US. This even happens with Novo and Sanofi, who are European insulin makers. Higher US prices offset lower prices everywhere else.
2
For-profit health care is an oxymoron. The price of insulin for American diabetics is a cold slap in the face. Our daughter is Type 1, and after finally saying enough is enough we found a Canadian source for insulin, the exact same insulin, for 20% of the American pharmacy price. We are saving $500/mo. You should too. It's not hard, it's legit. Help yourself because the US gov't has shown it will not. VOTE
11
Many Americans believe - religiously - that government is always the problem, never the solution. Health Care in general and Type 1 Diabetes in particular are Exhibit A, why this is not true.
There are things that don't work, if you leave them to a for-profit industry. However you do want to have competition. In Germany we have had affordable and excellent health care for everybody since the 1880s, but it is not a single-payer system.
6
I keep suggesting the German model as a viable fix for the American healthcare disaster. Unfortunately, our dialogue seems stuck between the for-profit model and single payer “Medicare for all.” The not for-profit, highly regulated German model seems the perfect compromise for us. Unfortunately, no one here is looking for a middle ground.
4
Our daughter has no insurance benefits from her job. She is type 1 diabetic and needs insulin to live. When are US lawmakers going to put us (the people they serve) above the huge profits they make from lobbyists?
7
@Sarah Stone
When we vote them out, they will listen. Unfortunately, until a problem becomes personal or they understand that not all illnesses are from lack of personal responsibility, they will continue to view these people critically.
If you look at the posts here, many people think that you can put a 3 year-old on a special diet to prevent type I diabetes. This is not realistic. A large section of Americans are willfully ignorant and selfish to the point of voting against their own self-interests.
It is unfortunate that Democrats, in order to get Obamacare passed, needed the support of the drug companies that contribute to their political campaigns. As a result, Democrats dismissed Republican support for regulating drug prices. Democrats probably correctly, believed that if drug prices were regulated, the opposition from their powerful friends in the pharmaceutical business, would kill any chance of Obamacare becoming law.
5
@Robert Bosch, excellent (new) FOX talking point, but this: "Democrats dismissed Republican support for regulating drug prices." is a complete lie.
You can't find any evidence for this, and that's because it's false. There are over 100 republican amendments in the ACA, and it was Louisiana Republican Rep. Billy Tauzin that opened the door wide for pharma to get an outsize seat at the table. Republicans sacrificed hospitals, rural clinics and a lot more, in order to keep their promises to lobbyists. When the drug industry and the republicans locked arms, with republicans in the majority, what should Dems have done? You weren't listening at the time, and you still aren't, so stop sniffing that the ACA is flawed.
Look it up, and get back to us when you've got some non-revised history to discuss. Sheesh.
1
Until people wake up and start voting this sort of the will continue non stop.
or have universal, public insurance...
3
Congress investigating? I’m sure the problem will be solved in no time.
3
Didn't Trump campaign on a promise that he would do something about high drug costs? Maybe he meant that Mexico would pay for the cost of drugs.
6
Canadian and T1D + 25 years. I am so glad to be a Canadian where I don't have to worry about getting insulin to keep me alive. I'd be dead by now in the US. It's the same insulin by the way, much cheaper here because we have implemented a system that big pharma cannot avoid if they want to do business here. But I do understand that US senators and congresspersons are pretty much indentured to their highest bidder....sorry, I meant campaign contributors. Greatest country in the world, the US? Actually, more of a bright and shining example of how a society can go wrong.
12
I am a retired physician. The cost of insulin has ballooned immensely since my retirement, unbelievably, even. It makes no practical sense. Is Greed practical?
Lewis Carroll said it well, long ago:
"There's no use trying," she said: "one can't believe impossible things." "I daresay you haven't had much practice," said the Queen. "When I was your age, I always did it for half-an-hour a day. Why, sometimes I've believed as many as six impossible things before breakfast."
I read the NYTimes before breakfast, so the context is OK. Who's in charge around here?
4
The health care industry fears single payer while doing everything it can to bring it about.
4
Frankly, this is price gauging plain and simple. It is occurring because drug manufacturers can do it. It will continue until government intervened and scares the bejeezus out of some execs by introducing price controls and mandated manufacturing or else.
Where is Trump and his art of the deal when it comes to fulfill his promises of cheaper drugs?
5
This story makes me want to cry. What is the role of congress. Why is money taking over the country? A failing country the USA. I am not happy to call myself an American any more and I don't see an end
6
This can only be described as evil. Using a monopoly to price gouge cheap (on every other affluent country on the planet) drugs.
As long as corruption in congress (coyly called lobbying) is legal, our representatives will not represent their electorates interest over their paymasters.
The USA is the only Western health system where the main focus is profit, not health. It's long overdue for a change.
6
The bigger point: Republicans and centrist Democrats are fine with people dying. This is their chosen policy. In this country you die if you can't pay the toll that only we, here in the greatest country in the world, have to pay, to live. If you lived a few hours north, in Canada, you could live. But here, you die.
I can't believe this is allowed to continue, that this is not the #1 issue. Republicans should be polling so low that they can't manipulate the vote to win. That's one of the ways they keep this going. Electing spineless careerist Democrats who accommodate Republicans (Biden and, really, Obama) is another reason this continues.
Citizens are to blame only in that we haven't protested enough to force politicians to change this. In France they would have marched in the streets long ago. This would never fly.
Here in the "greatest country in the world", people die so that other people can profit and our politicians and many of our voters have directly enabled this. I agree with Bernie Sanders: it's past time for the middle ground. The American middle ground is this.
4
This is outrageous. The medical system has gone completely out of control.
4
The public and Congress needs to know how insulin is manufactured today. Then we can talk about how Big Pharma is profiting and hurting the diabetic community.
4
This is the reason we vote for our Congress people: to support and help.
1
Welcome to the greatness of Capitalism. The bottom line for Conservative voters is that lower insulin prices will lead directly to USSR style Communism. Higher prices for insulin is the price we "all" pay for Freedom. There is no other choice. Ask any GOP Congressmen, ask any Red State voter, and we see how important it is to have higher and higher prices for such medicine.
2
Amazing - only one post offering specious dietary advice ("do this and you won't need insulin anymore") and only one post blaming diabetics for their medical condition. The day is young, however . . .
2
If someone held a gun to a person and extorted money from them, most would see that as a crime. I fail to see the difference in what big pharma is doing with insulin.
8
The question is, what is Congress, particularly the Republican Senate, doing about this?
2
What does insulin cost in other countries?
2
My cousin in Spain pays 54 cents (that’s right) for his insulin.
3
I am sorry to read about things like this and for those who have minimal pharmaceutical coverage this must be a nightmare. When you are young and healthy, it is hard to imagine that one day you will have pre-existing conditions or that many of us will have these sorts of needs.
People, if we want change, you might have to boot even the nice republicans out of office. If they voted for 20% tax cuts, they are not going to turn around and vote to regulate prescription drug costs or to allow universal health coverage.
1
My sister died of Diabetes 1 at 58 in 2011. She had had the disease since age nine. Diabetes is anything but “perfectly manageable.” Even with daily insulin, my sister endured every pain and indignity known to man, though she tried to work until the last three years. Insulin availability had even then become unreliable, especially in the appalling Florida network of private insurance entities that my sister, who had lost “real” insurance, depended on. One time, there was a lapse of one day between two “insurances,” meaning that a single dose cost over $500. Although 58 is pretty long-lived for a diabetic type 1, I feel my sister would have had several more years if only she could have maintained full insurance.
8
Thank you to everyone who has added their knowledgeable comments on this tragedy. Please continue investigating. No one should be accepting that someone should die because they could not afford treatment of any kind. What kind of society would that be? A cruel society. My condolences to the families who have lost loved ones in this surreal battle of dollars vs life.
7
I know it is a total fantasy, but I think the drug companies should be taken over and run by the government. They prove over and over that they cannot do right. We could at least demand payback for government investments in the development of drugs that could be used to subsidize drug costs.
5
Why is it a total fantasy? What is delusional is to think this sick murderous system actually "works." The most rational thing would be precisely to nationalize the entire medical industry. It would actually serve the sick, as opposed to parasitical investors. There is almost no significant innovation except for "profitable" drugs catering to the wealthy few. Meanwhile, there is virtually no innovation of new lines of desperately needed antibiotics for billions. It's a myth that nationalization would stiffle innovation. Most basic research is performed by the government who then hands it off to the profiteers.
1
@rawebb1 Take a look at the current government and honestly tell me you think they would put your best interests above personal profit.
@SDC Big flaw in my fantasy.
I'm a diabetic in CA. My test strips, with the highest level health insurance they offer, jumped from free, to $75 for a 20 day supply (for the prescribed # of tests per day). One of the insulin products went from zero co-pay, to $75/month. All this for the bargain price of about $1000 /month in insurance premium ($800 that my employer picks up, and $82/week that I pay for the upgrade). I haven't seen what the insurance company covers on the insulin or test strips.
6
What kind of a country makes a necessary ingredient to staying alive so expensive all to increase the profits of corporate share holders and CEO's? There is something majorly wrong with that.
Profits, yes. Wealth, maybe yes. LIFE absolutely yes.
Our country has lost its hold on what is moral and decent. No wonder Trump is president.
10
There are many necessities of life that are too important to be controlled by the greed and self-serving imperatives inherent in the capitalist system. Healthcare is just one of many. Others include housing and shelter, nutrition and access to safe and healthy food, a safe, sanitary and affordable water supply and an environment and quality of air that is free of harmful chemicals. In addition individuals and corporations should not be enabled to mortgage the health and safety of future generations at risk of the dire effects of human influenced climate change for the benefits short term financial gain for a relative few. Until we realize these facts and to cease from allowing ourselves to be frightened by labels such as "socialism" we will continue to sacrifice our collective future to continued exploitation by corporate interests and their political allies. Remember that government programs such as Social Security, Medicare, Medicaid and Supplemental nutrition were all disparaged as "socialism" by their opponents at one time or another.
7
What are they teaching business students at university?
2
Unless there is a compelling reason for Insulin to be ever more expensive, one must conclude that greed is the 'reason'; and if so, drastic measures to cut Big Pharma's gouging must be taken to stop the abuse. It's O.K. for corporations to make a profit but the primary aim ought to be that of service to their communities...of which they are, or should be, part of. This is what happens with capitalism gone wild, for lack of regulation and public supervision, a perverse selfishness for lack of ethics...and, ironically, shooting it's own foot in the long run. A shameful practice indeed.
5
There is at least one excellent bill in Congress that would stop insulin price spiking, along with the practices applied to EpiPen and, well, most pharmaceutical products across corporations' entire portfolios. That is Sen. Sherrod Brown's (D-Ohio) Stop Price Gouging Act, which imposes an excise tax on price spikes, quickly large enough to deter such conduct, and serious penalties for non-compliance. This is not the whole solution to pharma prices -- just a piece -- but it may well be an essential piece, and it needs support.
1
Have been a type 1 since 1989. Getting ready to retire but I can not. 3 month supply of insulin will cost me $4500. It is a shame that an old drug that is needed by millions of American people cost this much.
216
@R Clemmons FYI: In Canada I have Type 2 & take 18 units per day. The cost for 5 X 3ml SoloStar injection pens is about $145. Manufactured by Lantus in Laval, QC.
16
@R Clemmons
Im in Minnesota. Google "Insulin Caravan". A group of folks left the twin cities to road trip to Canada and purchase insulin. Their story is pretty well documented online, along with a few twitter pictures.
I'm betting you could find an alternative country to Canada, particularly if you have friends or relatives living abroad.
Stay safe.
6
@R Clemmons : Unconscionable. Criminal. Immoral. So much more than "a shame." When will our politicians see beyond their next Big Pharma campaign donation?
14
NYT, please tell us the total compensation (salary, bonuses and other benefits) of the executives of these companies over the past 10 years. .
It is a little ironic that Dr. Frederick Banting gave the original patent to the company that became novo nordisk for 1 Canadian dollar.
8
How do the shareholders of these companies live with themselves? They profit while patients cannot get the lifesaving drugs they need. And, the CEOs of these companies are paid millions while men, women and children are rationing their insulin in order to survive. This is capitalism at it's worst and most despicable.
7
Oh they sleep very well. They’re making money. What else matters in the USA?
2
This is another evil from the Citizens United decision. If one representative does take on Big Pharma, Big Pharma will bestow truckloads of contributions on their opponent in the next election.
It’s not just the reactionaries that Big Pharma supports to keep in office; it’s also the opposition money they can dump to kill any upstart.
3
Only in America where GREED comes first before NEED.
The richest country in the world with the largest defence budget than the next 10 countries combined , yet it cannot protect or defend its Citizens from a condition whose treatment has become too expensive for some despite being almost 100 years old and cheap to produce.
What value freedom in such a country where some of its people die from lack of a basic remedy due to profit mongering whilst those in many poorer countries will never see a single person ever go without or left to suffer due to cost.
Not America the Brave...which it can't really be, when it's leaders are such cowards who fail so many over others wish for greater gain as their actions or lack thereof rob some of their people of the life, liberty and happiness that is there to have but theirs to deny .
6
I am an Insulin dependent diabetic (30 Years), and thus travel with Insulin. It requires refrigeration and thus presents a potential problem as one travels for long periods of time (more than 2 weeks). I was in Lucca, Italy for a month
I am thinking about coming back to Lucca next year and decide to check with a pharmacy what I need to get insulin here and its cost.
I use a product called Humalog 100 unit Quick pens. They come 5 pens to the package in the states. The pharmacist showed me the identical product and indicated I did not need a prescription as I already had a pen. I asked the cost. It was 49E ( $55).
I called my US pharmacy to find out what it would cost from them without insurance (comparing marbles to marbles) . Once we got past coupons and no insurance, the cost was $624. There are no typos here . A pen in Italy is $11, and in the US $131. Direct comparison for the identical product and manufacturer.
14
Could the report provide the stats?
How many are paying list?
How many have the insurance and employer picking up the cost? Doesn't seem to be a concern around me as the employer is picking up the cost and reimbursing the deductible...but not everyone has that generous an employer.
1
It is just shameful that Big Pharma is allowed to continue to repackage insulins and maintain patents to milk more money into their pockets, while Americans with diabetes die because of it.
Having to drive to Mexico or barter and trade to get life saving medicine is appalling.
The other aspect of this is that most of the people with Type 1 diabetes are children and or young adults who typically don't have much cash in their pockets.
Time for Congress to close the loopholes that allow Big Pharma to get away with murder!
5
America: where nobody has a right to health care, but everyone has the right to a gun.
11
The greatest, richest country in the history of civilization doesn't have universal health care is a joke! The USA needs to wake up and stop thinking they have it all. We have nothing compared to Europe when it come to medicine. Time to wake up. This story is a mockery to every tax paying American. Shame on us as a society.
7
It is immoral for companies to jack up the price of medication that turns a common devastating disease into one that is easily managed in order to boost their profits. It is also immoral for politicians to side with the greedy industry and its greedier investors against the interests of the people who elected them.
5
I couldn’t even watch the video it was so painful. Greed kills, silence=death. Diabetics need an activist as brilliant as Larry Kramer who started Act Up and GMHC at the beginning of the AIDS crises. The system of American medicine is clearly failing us and needs radical reform. It’s past due time for Congress for stop using health care as a “wedge issue” for votes and start presenting a plan for reform. I’m not smart enough to know if medicare for all is the solution, but I do know that when diabetics are dying from lack of insulin the system is very broken. Congress - wake up!!!
2
Slowly, much too slowly of course, the American people are coming to know that what they thought about their government, is pure fiction.
As every day goes by, reports such as this are removing the blinders from their eyes, and exposing the truth, the reality that our American so called Democratic republic is a farcical thing carefully designed to prevent the masses from knowing that our government is a wholly owned division or arm of corporate America, with all agencies staffed with former high level corporate executives, nearly all of whom return to their corporate masters after a stint in government to create rules, regulation, and law, that will increase corporate control and profit.
Trump, his Republican partners, and indeed the Democratic Party and it's partners, are together engaged in keeping the American people deaf, dumb, blind, and stupid, when it comes to who and what is governing them.
Most of the mainstream media operates as a willing partner in this decades long sham, and except for Warren and Sanders in the current crop of Democratic candidates, the self-serving Democratic Party is nearly entirely co-opted by corporate America.
It may be too late to redeem America.
4
Another reason to hate and distrust drug companies. CEOs make million while patients suffer and die.
1
One particularly enraging aspect of this issue doesn't seem to get much coverage. That is the development of cloned insulin. Prior to the availability of gene cloning, insulin had to be extracted from pancreases provided by slaughterhouses. Human insulin was, of course, not producible in this manner.
Genetic technology developed in the '70s and '80s permitted the gene for human insulin to be placed into bacteria, and produced in virtually limitless quantities from bacterial cultures. All you need is a culture system to grow the bacteria and the mechanisms to purify the insulin from these cultures on a large scale. This should be a process equivalent to, say, brewing beer. The price of insulin should have plummeted.
Instead, we have drug companies holding this drug hostage, along with he lives of type I diabetics. Why???
And don't say R&D costs. The R&D was pretty much done by 1985, most of it NIH-funded. This technology belongs to all of us. Insulin should be free to all who need it.
475
Then go ahead and make it if it’s as easy and cheap as brewing beer. And don’t say patents because the most popular insulins have been off patent for years. That includes Humulin and Lantus.
Nothing is holding you and others from producing free insulin. Everyone here ranting about greedy Big Pharma should join your efforts to produce insulin for the masses. No one is stopping you from competing against Novo, Sanofi, and Eli Lilly.
5
@H Thank you! If it's so easy and so cheap, everyone would be doing it. It isn't. And the insulin being produced now is not the insulin that was produced 100 years ago. People want advances in drugs but they are enraged when they have to pay for them. It's only going to be "free" in the sense that the patient doesn't pay for it -- somebody else does. In the case of countries with government health insurance -- the taxpayer. Which may be fine, but this rage that pharmaceutical companies don't provide "free" products is absurd.
3
@RDJ
The problem with insulin from bacteria, is even if it has the proper human sequence it would likely NOT be compatible or as effective. Modifications and processing by bacteria, as much lower creatures, are not the same for higher organisms. There would also be toxicity to consider.
There are many, many challenges to what you re proposing. Let us not be like the Trump folks and over simplify both problem and solution, just because we want it to be so.
9
Ironically, it’s also a regulated marketplace that enables this kind of price gouging to begin with— i.e. laws that prohibit generic drug makers from offering alternatives if drugs are ever-so-slightly reformulated. In a truly open market that wouldn’t happen.
There is a compelling political argument to be made for “opening the marketplace,” “allowing competition,” or actually “DE-regulating,” which might take this conversation beyond the current political battle lines.
As a T1D myself (and as a human being), this whole situation is appalling; only those with good insurance or disposable income can afford to be healthy. Equally important to insulin however, are testing technologies which are also very expensive, and frequently not covered by insurance. I was diagnosed two years ago in my mid 30’s, and relied on frequent testing/a CGM to learn the disease and my insulin dosages. That these treatments aren’t available to everyone, particularly young kids whose bodies are changing constantly, is a travesty.
2
Get one thing straight, if you are not rich enough to make sizable contributions to politicians, you have very little voice in US government. The rich should be living in fear, it’s time we accomplish that.
1
I don't understand this train of thought: "But this is not enough: Insulin must be affordable and accessible to prevent more unnecessary deaths."
No, insulin should be free and accessible to anyone who needs it. What is with this weak response of "making it affordable"? There is absolutely no reason a diabetic, let alone a diabetic with type 1 diabetes, should have to pay anything to receive insulin. American society has become so conditioned to believe we must pay for everything ourselves that even the idea of providing life-saving medicine to our fellow citizens is somehow seen as a moral failing.
423
@Tom
It still needs to be produced. Someone has to build the processing facility, employ the workers who make the drug. It is a crime to price gauge the folks who need it, but the drug doesn't come out of the sky. I assume you work for a living. Someone pays you for production of some sort. Your employer needs to sell a product or service in order to pay you a salary. And they don't take the risk of building a business out of the goodness of their heart. They expect to make a profit off of it. That profit comes from customers being charged a premium for the product.
The point of the article (and the crime here) is that these companies are enjoying a quasi-monopoly on the right to produce the product and are price gouging people who need it to survive. That certainly is wrong and I agree some sort of counter-weight here needs to be applied to the supply and demand equation because the consumer, in this case, is at the total mercy of the supplier. Free market competiton doesn't apply here.
We certainly need protection from this practice because for those with this condition, the good or service is not optional. But making it free isn't something that can be done with the wave of a magic wand. I would direct you to Venezuela for an example of how that can go wrong. Thru socialized medicine, or thru regulation - this product will always have a cost to produce.
4
@Tom I completely agree with you and more. We have become a nation of ruthless, mean, stupid people who would quite willingly let people die for lack of insulin, asthma medication etc because they are poor and can’t afford it. Their illness is not a moral failing, yet we treat it as such. We make it very difficult for everyone who is not lucky enough to work for a company that provides insurance to get healthcare, much less pay for it. I truly despise who we are and what we will not do for our fellow man.
14
@Tom
Now you're sounding like Bernie Sanders.
There is a huge difference between type I and type II diabetes.
Type I diabetics MUST have insulin or they will die. This US pharmachemical industry like the carbon energy industry is controlled by management who's only interest is the bottom line.
This is the same strategy as they use on the opiate trade except in this case they have a naturally occurring captive market. It is why they research therapies and eschew research that have the potential to lead to cures.
Like all drug dealers including the tobacco industry and the vaping industry and illegal drug dealer they want their customers hooked.
This is unregulated capitalism run amuck. Wall Street better regulate themselves or see their system regulated by a democratic socialist government in the very near future.
193
@Honeybee
A lower carb diet will partially reduce the amount of insulin that a Type I would need but they will still need some insulin even during fasting (a horrible idea for a type I diabetic). For example, about 40% of my daily insulin is independent of what I eat (called Basal) and the other 60% (called Bolus) is taken during meals and snacks. Type I diabetics can eat slow acting carbs since injected insulin is slow acting but have to be careful about taking fasting acting (high glycemic index) carbs because they will produce a very fast rise in blood glucose levels. The total amount of insulin needed in a day depends on body weight, amount of exercise, and insulin sensitivity (which is greater for people with more muscle mass, or people who do high intensity exercise.)
13
@Al Please present all citations and the medical degree that led you to this dangerous conclusion. Type I patients died before insulin was available. There IS NOT ANY TREATMENT OTHER THAN INSULIN.
8
@Honeybee - I have Type 1 diabetes, and have had it for almost 46 years. I am also an MD. I realize that the question you posed is one of curiosity, so I am going to try and be as polite as possible when I answer it, but there is a level of insensitivity towards Type 1's with posing this question.
Let me start with explaining the difference between Type 1 and Type 2. The more common is Type 2, and is a disease of insulin-insensitivity. So the person makes the insulin, but it is not used in an efficient manner. Type 1's do not make insulin because the cells that produces it have been destroyed. Therefore they are required to take insulin injections to stay alive.
As a Type I diabetic, I have to pay for and put in a lot of time and effort to get what non-Type 1's get for free. It is a very difficult life with many burdens. Insulin is a requirement to stay alive. But the disease also requires balancing carbohydrate intake with exercise with insulin dosing. To ask a Type 1 to have a stricter diet in order to lessen the amount of insulin is similar to asking a paraplegic to crawl up a stairwell using their arms because building an elevator (for a wheelchair) is too expensive. The burden put on the individual is so high that it ends up being cruel.
I have a couple of other important points to make about this disease, but it will require a new post...
16
It's such a racket. When insurance pays the cost, drug companies think they can charge anything they want and get away with it, and for the most part they can. It's when people don't have insurance or they can't pay out of pocket because the only insurance plan they can afford to pay the monthly premium on has such a high deductible that they can't afford to pay out of pocket for health care while they rack up enough bills to actually get coverage. Health care is not a commodity that works in the capitalistic system. And, greed is everywhere throughout the US "healthcare" system. You can't wear your own socks pre surgery, you hAve to pay for hospital socks --- but then you're can walk across the floor to the bathroom in them and pretend they are sterile so the hospital can charge your for those socks! The whole system is fraught with money-making as its core business model. I feel for type 1 diabetics who have no choice to forgo taking insulin. And, if one more person says change you r diet type 1 diabetics, I am going to scream!!!!!
147
@Nmtm - I am a type II diabetic but it took my doctors 3 years to determine that. I inject insulin twice a day to control my sugar levels, plus metformin and glypizide. I was an athlete before I developed diabetes, so exercise does not prevent diabetes. I have been on a low-carb diet successfully for years and my diabetes hasn't gone away. Most of the information I got from my local doctors was flat wrong and their diabetic training was appalling. And nobody wants to talk about a cure. It's too lucrative in a money talks culture like ours.
3
@Nmtm I think your last sentence is key to the mentality surrounding this issue. People think Type 1 and Type 2 diabetis are the same. They are not. While diet has a positive effect on Type 2, the only effects Type 1 diabetics get from diet are bad -hypoglycemia or coma.
And this mix-up is costing lives.
2
Faulty regulation. Pure and simple. Either regulate the price or open the way for generic competitors to join in. We have a crazy balance right now that allows pharm cos to set their own price.
While looking at insulin, take a look at inhaled steroids for asthmatics. Also necessary for life and incredibly unaffordable.
146
@DocMark the ingredients of the older inhaled steroids have been generic for years - but the delivery methods are almost impossible to duplicate - hence they are not "interchanagble" in many cases. That is where the change needs to be made. I believe in patent protection and that companies should be able to recoup their initial investments, but 100 years of price protection is insane, in the case of insulin.
18
Is there any regulation at all price wise now?
2
@DocMark As an asthmatic this was the first thing I thought of! Some of the inhaled steroids have been without a generic equivalent (and my insurance makes them Tier 4 drugs) for ages. It's absurd to expect someone to use only a rescue inhaler and not take the basic daily steps necessary to remain out of the exorbitantly expensive emergency room. It feels like they set you up for failure one way or another...either your health or your wallet!
6
To an Australian, it's inconceivable that a country as wealthy as the US would allow its citizens to suffer - never mind die - from a treatable illness such as diabetes. Here, the maximum cost of insulin under our pharmaceutical benefits scheme is around A$40, and many patients, such as age pensioners or recipients of certain kinds of government welfare, pay far less.
Health care in an industrialised country is quite simply a human right that should be free or heavily subsidised, supported by everyone through the tax system for the wellbeing of the whole of society. It's not a slippery slide towards socialism - it's just common sense!
315
@paperbackwritoer - It isn't really suffering. Our system is designed to find people with money, good jobs or savings and figure out how to rip them off, steal from them.
In the old days, banks and pharmaceutical companies worked to help you, then MBA's came along and simply by monopolizing supply you could control the price. We have less pharmaceutical companies and banks (the Great Recession was a great shake-out mechanism and when it was over there were a lot less banks).
15
@paperbackwriteraaq
"Health Care" is not some will defined item that a government can declare to be a right and be done with it. It is complex, ever advancing system of technology and techniques. Those advances are incredibly expensive, and most of that expense is payed for by the American market. All the rest of the industrialized world - France, Britain, Germany, even the charming land of Oz - benefits from America's willingness to leave healthcare to the free(ish) market.
Ten years ago, people of your frame of mind were complaining that America was not doing enough to help those of its citizens who were suffering from hepatitis C. Healthcare, we were told, was a right. Now there is a drug that can cure hepatitis C, a drug that could only have been developed because the American market was willing to pay $100,000 for patient for it.
Today you are complaining that America is not doing enough to make insulin affordable for its diabetics. But as we speak researchers are working on beta cell replacement, more effective insulin pumps, and advanced immunological interventions. In other words they are working on a cure. If you want to delay that cure by a few extra decades, by all means cut off the flow of American money. I'm sure diabetes sufferers will be comforted to know that healthcare is a right.
1
@paperbackwriter
Heavily subsidized?
No way!, according to Messrs. Graham and Trump.
Complete waste of taxpayer's money.
FP
2
I found out one year ago I am a Type 2 diabetic. The first question I asked my doctors was: is it possible to manage it without insulin? My doctors laid out a regimen that at the time seemed draconian and impossible to achieve, but I was determined. It required that I eliminate sugar from my diet, control carbs, become more active and lose weight. The way I overcame the difficulty of accomplishing this was by tracking every metric I could. I use a number of apps to track diet, fitness, glucose, blood pressure, weight, and nutrition. This patient generated data is aggregated using the health app on my iPhone, and my doctors at MGH and Leahey can see it because I make it available to them on their apps. The results? I lost 70 lbs, dropped my glucose from an average of 500 to 110, A1C from 15 to 6.2, BP from astronomical to acceptable, and excessive to daily. I did this at the age of 60. It was not easy, but it can be done. I am convinced Type 2 diabetes is preventable and unnecessary for the majority of Americans. The place to start is with sugar. There is so much added sugar and corn syrup in our food supply it’s criminal. We allow this because sugar and corn producers have lobbied to convince us that fat is the enemy, not sugar. Then we have big Pharma sell us drugs to control a disease that for most of us, is man made. We can change this. For Type 1 diabetics, insulin is not optional, and should be heavily subsidized, if not free.
4
@Jeffrey Schantz And the crime is the ADA knows this, but they don't make it their #1 priority because it will decimate the profits of Eli Lilly and others, which donate millions for the ADA's "search for a cure" (HAH!)
2
@Erik
What about Coke and Pepsi?
11 tablespoonfulls of sugar in every bottle?
Not bad.
I only drink 4 bottles/cans/cups of coke a day!
I really don't like the taste of plain and tasteless water. I also miss the burping if I don't drink soda.
Once you are hooked on soda pop, you can't escape. No amount of education or doctor's warnings can break the habit. Long live Coke!
FP
FP
1
The US has the best medical system in the world, for rich people. If you are poor and sick, kindly die as soon as possible without making too much of a fuss.
Cuba probably has one of the best medical systems in the world if you are poor. They are not too good at providing ridiculously expensive treatments for rare disorders. Or even the latest and greatest overpriced medicines for common diseases. But look at their life expectancy, maternal and infant mortality rates, doctor population ratio or any other health statistic. Then remind youself that their per capita expenditure on health care is vastly lower than the US and most other rich countries.
When it comes to healthcare, capitalism has clearly failed. The presence of a profit motive in healthcare leads to nothing but mass suffering and unnecessary deaths. The primary goal of medicine is to heal the sick and save lives. The primary goal of the American healthcare industry is to extort as much money out of the sick as possible. These two goals are mutually incompatible.
336
@A Cynic. I agree with everything you said, with the exception of your first sentence, that “The US has the best healthcare system in the world, if you are rich.” My sister has been Type 1 since age 5. She is now 51. She is a Physician married to an attorney. They are not “poor” but quite financially comfortable. Notwithstanding, the amount of money she has to spend out of pocket on her diabetes medication and supplies (INSULIN and devices such as her glucose monitoring system and test strips and pump supplies) is staggering and is unaffordable even for them. Their lifestyle and spending decisions are driven by these medical costs. If my sister faces these hurdles, the situation for people less financially comfortable is that much worse. The costs of drugs such as insulin in the US is inexcusable. Pharma companies need to be reigned in.
43
@A Cynic
You need to squeeze the orange, as long as there is any juice in there. The heck with the rest!
FP
1
@A Cynic
The goal of the American healthcare industry is to extort as much money out of the rest of the economy as possible. It is one of free enterprise's biggest success stories.
Like any sector of the economy, it competes with all other sectors of the economy to increase its share of the national pie and decrease the share of other sectors. In their own self-interest, the other sectors of the economy should get together to limit health care's share. People who must buy high-priced drugs to survive will do without nice vacations, new cars, or granite countertops. But if the purveyors of vacations, cars, and countertops got together and pressured governments to limit health care extortion, they would threaten the foundations of the free enterprise system. So for the sake of free enterprise, they let the health care sector steal their customers.
2
I am an American with Type 1 diabetes living in France. I use Lilly Humalog in a Minimed pump. The state health plan pays for the insulin and the pump (as well as my Freestyle Libre glucose analyzer sensors).
But I still get to see the prices paid by the health plan. A 10 ml bottle of U-100 Humalog costs 17,59 € (or about $20.70). Again, I pay nothing. I looked at what was billed in the year 2000 – it was 21,80 €. (My cost was, again, zero.) So in France, the price paid by the health plan for insulin has *dropped* in the last 20 years and remains, even without assistance from the health plan, eminently affordable. No one need suffer in France from lack of insulin.
What's going on in the U.S. is scandalous and is enabled by ignorance of what's common practice elsewhere. France has negotiated a $20/bottle price for Humalog. Hey, Americans, show us up and get an even better price.
323
@Andy
Congratulations on your candor and I appreciate your advice for Americans to show France up. However, you have merely reported France's outcome in the current marketplace.
It is not a free market, it has components of ownership interests through patent law which extends far beyond the drug itself to delivery systems into the body, as well as constraints on free marketplace inherit in the laws and regulations of negotiations in the US marketplace.
If those are removed, it is not just a ripple effect in the pond but a huge bolder. The effect to France in the case of American consumers "showing up France" more likely than not will change the price in France and perhaps even the supply critical to your own well being and economic circumstance.
I believe that is as simple as possible but not simpler. The ticket prices on an airline flight have a wide range, for now, France is in the cheap seats.
1
@Andy
I was in Paris in April, and stopped into a pharmacie to see if I could get some Humalog (in case I had underestimated for my trip)... no prescription needed, they handed me 5 Quik-pens for $35!! I travel there annually and plan to stock up next year. Thankfully I have decent insurance through ACA in CA (high premiums but not bad prescription co-pays) but moving to France is a possibility in the future, esp. if our fears come true in 2020. Then we are doomed!
15
@Andy "What's going on in the U.S. is scandalous and is enabled by ignorance of what's common practice elsewhere."
Even when Americans are made aware of common practices elsewhere, they make arguments about why such things couldn't work in the US. They're beyond hope.
24
Here in Australia insulin is heavily subsidised by the government. Almost unthinkable that any diabetic could not afford it.
6
I'm a Type 1 since I was 5 years old and until I moved to Germany in 2001 I had decent insurance through my work so insulin wasn't expensive, as I recall. Here I pay a very small co-pay and my test strips are always free (other prescriptions are also very reasonable). I cannot believe what my fellow diabetics are going through and I'm embarrassed that my home country has become a place where such power is in the hands of big business interests, even concerning matters of life and death. As much as I sometimes get homesick, I hope that I don't ever have to come back to stay (which I theoretically would were my husband to predecease me, since my adult children are in the US), because as a senior on Medicare I have no idea how it would work with my medical costs. It's inconceivable to me that we can't figure out how to do health insurance, surrounded as I am by insured Europeans.
337
@Cynthia Grant, you might want to consider carefully before leaving your home for the US if your spouse should die before you. Moving to be near the kids is pretty common, but I have seen sad cases where elders did that, only to find their children have busy lives, the grandkids scant interest in socializing with them--these are, despite good enough intentions, ongoing lives in which the elder doesn't well fit. And regrets about having left their homes for a lonelier life elsewhere follow. This is something I've seen more than once, so do take care about it.
19
@Cynthia Grant Our healthcare system quite simply is all about greed. Period. Full stop. (I have worked in healthcare for twenty years and cannot believe the prices we pay for the medical supplies we use.)
18
@Cynthia Grant
My husband, also a type 1 since he was 5, is now on Medicare. He’s been on an insulin pump for 25+ years. Before retiring, he had excellent insurance through his employer. He has the latest Medtronic 670g pump and the CGM that creates a closed loop system. Now that he’s on Medicare, his insulin co-pay is about $250/mo and his CGM sensors are $345/box (month). Medicare will now pay for the sensors as a reimbursement, but only after his endocrinologist wrote a note that indicated the patient’s possible ‘death’ without the CGM sensors.
His test strips are covered by Medicare.
So, all of this is available to you should you decide to return to the States.....
10
A major flaw of capitalism is that it allows the seller to name the price; this works fine when actual competition exists, so that Smith's "invisible hand" keeps the price down. When Smith wrote "Wealth of Nations" the manufacturing community consisted of many, many small units so that no one unit could determine price--no units big enough to affect what was charged. But with time "trusts" took over and were able to charge whatever brought in the most profit because competition had been eliminated.
At that point, the system required regulation. To stand up to the very wealthy like the railroad magnate who announced fares would be set by "whatever the market will bear"--regulation, anti-trust legislation was necessary.
Today we have fewer manufacturing units .
In the drug industry this is especially prevalent because of patents. Without regulation--as we do with public utilities where government regulators help set the price---drug sellers can sell at any price the market will bear, regardless of their own cost.
But will Republicans agree to interfere with business? The chance that they will consider regulating the drug industry is low. There would be a much better chance for needed regulation of this life-preserving industry were the Democrats in power.
Also keep in mind that even if insurance covers these outrageous price increases--unmatched in other countries around the world--we still end up paying them by increased premiums.
1
@shimr when the demand curve for a life saving drug is nearly completely inelastic this is what happens without common sense regulation. Utterly shameful.
@jrig
You are right , of course. But I have read that there are many who forego medications because of expense and simply die. To gauge the degree of inelasticity it would be necessary to know what percentage do not buy the med.
But there is no doubt that government regulation is needed. Greed has no limit.
For Type 1 diabetics, this can be solved by 50% of the people who are Type II diabetics to get a better handle on their health through serious focus on nutrition and exercise.
Here's the reality of what we face as a nation.
For every person who crosses the bridge from PreDiabetes (pre-disposed..do you know your risk?) to Diabetes, it will cost our health care system an additional $327,000 over that person's lifetime.
35% of America is 'obese' according to NIH statistics. That's nearly 80,000,000 Americans who are predisposed to diabetes.
If you think insulin access is a risk now, just wait until the bill comes due for America.
That's $26,160,000,000,000.
That's right. Over $26 Trillion..just because we like our pizza and beer and caramel macchiatto skim latte's with 5 extra pumps of caramel while taking the Uber to work.
If the nation collectively lost 10% of our BMI, the cost of insulin for those Type 1 Diabetics would come crashing down.
There is simply too much demand for insulin and not nearly enough supply.
I believe that's what's technically known as Econ 101 and price elasticity.
Or, we could just order up insulin from Cuba and Venezuela. I'm sure they have more than adequate supplies...on the black market.
4
@Erica Smythe If reducing demand for a drug led to lower prices, drugs for rare diseases woul be cheap. Drug makers charge so much for insulin because they know people wity Type 1 diabetes literally can't live without it.
And type 1 diabetes is not related to weight or diet. No amount of marijuana, essential oils, "clean" eating, or vegan diets will prevent someone with Type 1 diabetes from needing insulin.
12
@Erica Smythe
This is not an answer. We cannot tie the health and well-being of Type I diabetics to the presumed lifestyles of Type II diabetics, and add to this error by using flimflam economics as the justification.
11
@Erika Smythe there is no Supply/Demand issue driving the insulin price situation. No Insulin manufacturer has ever even attempted to suggest that. What is driving the price hikes is the increased PROFIT insulin manufactures want to achieve and the of government regulatory environment that enables them to do so by falsely tweaking packaging or dosing to fraudulently maintain patents indefinitely.
6
It is very sad that medicines like insulin are un-affordable in the richest and most powerful country in the world! How we put up with such nonsense and elect politicians who care nothing for the welfare of the people is something I cannot understand. Big pharma needs to have a line of medicines that are offered at really affordable rates to patients or the US needs to completely rehaul its prescription medication plans and get the big/black money out of all this!
10
Shameful. Pharmaceutical companies care more about profits than people.
5
@Nick
That's the law of unfettered capitalism, known as the profit motive.
There is no escape from the system. It's like the NASA space station: you just can't get off!
FP
1
This is the poster child of what is wrong with the U.S. Medical Industrial Complex. Is there Anti-Trust Violations? Nope. Price Fixing? Nope. The gross inhumanity of the suppliers is is mind boggling, the complacency of the federal regulators is beyond corrupt.
13
@motoman2525
The mission and purpose of regulators is to facilitate, enable, accommodate users to the needs of the job creators, i.e., Big Pharma, et als.
Regulators are culprits that all they do is restrain trade.
FP
The real shame is that T2 diabetes (which are something like 95% of all diabetics) is largely caused by behaviors, and can be stopped before it starts, minimized, or placed into remission by a simple diet change and a daily 20-minute fast walk.
But Eli Lilly does not want you to know that, nor does the American Diabetes Association, which reaps millions of dollars every year from Eli Lilly through donations and advertisements in the magazines and periodicals.
Oh, and the diet? Simply avoid all grains, starches and sugars because they spike blood sugar. Eat animal protein and greens because they don't spike blood sugar. It is not rocket science.
6
@Erik Did you know the op/ed is about Type 1 diabetes, an autoimmune disorder that has nothing to do with diet or exercise?
4
While what you say may be true, that is absolutely not the real shame. The behavior of the insulin manufacturers is the REAL shame.
1
Just one more thing . I became aware that Diabetes was becoming an epidemic in the mid to late 1990,s and since that time up until today the biggest problem in managing the disease ( " Americans are dying from a perfectly manageable
autoimmune disease " ) is not access to insulin but the dietary and other restrictions that need to be perfectly done that are problematic for most humans who are not perfect .
What first drew my attention was a case where a doctor explained that most of the people he was treating in a particular hospital were there because of a complication from diabetes . So , while doctors tell patients they can manage it ( easily ) the reality is it has been difficult for most to do these so called simple things each day .
This is the biggest problem not access to insulin .
2
You are wrong. Type 1 diabetes is controlled by insulin. If you can’t afford insulin you die
1
This is not just a manufacturers issue but also the insane plan designs that healthplans are pushing onto patients. Why do they create such high out of pocket costs for Type 1 Diabetics when regular use of Insulin keeps patients out of hospital saving the healthplans more money than the cost of Insulin? It makes no sense other than keeping profits high to Heathplans, PBMs and Rx Manufacturers.
7
There is absolutely no justifiable reason for insulin -- or any drug for that matter -- to be priced higher here than in Europe or Canada. Those who claim otherwise are either lying or deceived. How do I know? I worked in the industry, internationally, for 30 years. I saw the books.
19
@Penseur
If the president can lie, the industry has a right to lie, too.
Nobody possesses something called the truth.
Truth does not exist anymore.
Nietzsche said that many times you find truth standing on its head. These days truth always stands on its head.
.
FP
1
Diabetes is one of many autoimmune disorders that gob smack the patient, the family, and the very economic existence. It is as noted in the preceding comments one that can be managed with the drug of course but also a personal care plan.
However, that personal care plan entails additional attendant costs as to diet, living environment, a support system, and the ability to exercise. It all can be achieved by a person with a socioeconomic status but absent that some people don't make it through.
My cousin's wife passed even with all factors in her favor. Chronic illness syndromes due to autoimmune disorders range from multiple sclerosis, ALS, scleroderma, lupus, rhueumatoid arthritis, myasthenia gravis are just a few cases where the immune system attacks the body by mistake.
How does society apportion the costs between and among its members? In some cases the apportionment outcome determines who lives and who dies.
4
@Dale C Korpi
Excellent!
FP
Strategies that may help from a Health Insurance Planner :
In the more than 25 years I have been helping hundreds of clients with benefits I have not been told by most who are Type 2 ( 95% of diabetics are this type ) that there is a crisis that prevents them from getting this vital drug , and I hope the alarms that investigative reporters mistakenly promote in areas that research will fail to comprehend what requires years of immersion and work , nevertheless I hope these strategies might be applicable to your individual circumstances and help :
1- Run a Benefits Checkup on the National Council On Aging website that will research hundreds of private and government programs .
2- Go to PHARMA the Pharmaceutical Manufacturers website to find discount and free programs and or google and or call the makers of your drug directly .
3- See if Special Medicaid Programs ( programs that people would not qualify because of higher income ) in your State will pay for some or all of your health care costs not being covered , or set a Spend Down limit that will kick in and pay once you have paid a certain amount .
4- Search for Community Based Programs ( community based hospitals are one good source ) that may provide the drug for free , or at a discount . At a hospital system this may involve seeing a doctor there at least once .
5- Look to reduce waste or unnecessary spending elsewhere .
No more space for more. Hope these help .
5
I appreciate your helpful suggestions. But, are these really helpful? Spend down, reduce waste, look to community based programs? I'm sorry but these are insane. There are many of use who actually are type 1. No insulin = death. Except for the insurance and pharmaceutical companies never ending quest for limitless profits, this would not, and frankly should not be an issue! I have a "platinum" insurance plan and in addition to my not insignificant premiums, my yearly out of pocket costs comes to over $10,000 per year. I can afford it...barely, but there are many who cannot. Your very good intentions, while somewhat helpful just play into paradigm of greed that has been engineered by those who stand to profit by our illness.
11
@marcwex
I have posted real and reliable things I have helped many dozens of clients and other with for about 20 years and it's unfortunate that you are questioning them before trying any of them. i can only hope someone who needs the help will try and not be dissuaded by your disbelief for no good reason .
@marcwex
Unbelievable ! I post real strategies that have helped and will continue to work for people and someone who has not tried any has actually gotten likes from people .
I don't blame people for not knowing about benefits , and methods that will help because the marketplace is full of sellers with little information on what can be done " if this then ? " and advisors like me , or non profits are little known , and even Government resources are usually manned with clerks with little expertise , or responsibility beyond the defined tasks of their jobs .
But, since my job is helping people I am disheartened that someone who doesn't know can get agreement from others who also don't know.
You can keep complaining about things you can't change , or you can decide to do something about it .
This is beyond an outrage. I struggle to understand how anybody can continue to justify unbridled capitalism to provide for our medical needs.
35
@Philip This is not capitalism, it's corruption. Companies are buying government protection for their criminal malfeasance.
1
Capitalism works fine when it's about cars, clothing, computers, cable. But not health care (or education).
57
@Kathleen
There comes a point when capitalism encourages and enables its entrepreneurs to become monopolies, which is the ideal or goal of any business operating under the profit motive. If left unchecked and unregulated, monopolies reach the stage of Boeing and others, dominant and abusive.
FP
1
This is just another example of a long list of obscene events caused by one thing...greed!
Having health issues myself that might require drugs costing 25K/year, I am heartbroken for anyone who is not wealthy and living in such a heartless system.
By sheer luck, I live in a country that is a little less heartless—I will pay a small fraction of the cost of the drug, whether I am employed or not. I am soooo thankful for that.
This US style predatory capitalism is destroying people's health, and so much more: the environment (and not just for US folks), democracy in the US (however imperfect it was, it is now much worse and openly for sale), belief in facts and science, tolerance, social justice, women's right, human rights, etc.
The neglect of public education and a disdain for social services—tolerated because of the "big government = socialism = communism = evil" message so successfully repeated since the cold war by the rich and powerful—have kept so many in ignorance, that they don't even know this is happening, or won't believe it. Only a messiah can improve their lives. Sad.
35
@Claudia Don't you know? The Messiah is here - and his name is Trump. (sarcasm)
1
In 1922, insulin was given for the first time to a boy dying of diabetes. In the 1950s, if was sequenced. Later, synthetic insulin, insulin pumps, islet cell transplantation, and a bionic pancreas were developed. With science, the whole approach to diabetes has changed.
In 2019, nearly a century later, people are dying from diabetes because they can't afford insulin. This is a stark example of how the country is going backward.
For this, I served my country?
130
When Banting and Best perfected the purification of insulin and went to sell it they charged a price that covered the costs to deliver insulin. Considered it to important to make a "profit "!
14
Animal insulin, which works, has been off-patent (if it ever was patented) for more than 75 years. Why aren't generic drug companies making and selling it? It's a big market, unlike the obscure generic drugs whose prices were multiplied ten- and hundred-fold.
16
I'm not sure if I should say I am fortunate, or a ticking time bomb.
I am not a diabetic-yet, however, with the prescription coverage I have that coverage would pick up a good percentage of the tab in one instance, or the other would pay full freight and provide me with disability income on top of the diabetic supplies.
However, all of that aside, I am astounded that we, a country of largesse, well some, allow many to suffer an indignant death due to the high cost of life-saving medicines.
I find it alarming that many resort to on-line purchases of insulin, some of which could be questionable, to keep themselves supplied, or, travel to our neighbor to the north.
But, when I see the endless advertisements on the television or in print it is easy to see why the costs are so high-we the consumer pay the cost of that slick advertising.
14
The government must take over the drug companies and the entire medical industry. We need Medicare for all and truly national healthcare. Greed and profit need to be removed from the equation.
35
When Medicare Part D, the Prescription Drug Benefit, was passed, the GOP immediately attached a bill that forbade Medicare from negotiating prices with the drug companies. Why? Wikipedia provides the answer:
"Former Congressman Billy Tauzin, R–La., who steered the bill through the House, retired soon after and took a $2 million a year job as president of Pharmaceutical Research and Manufacturers of America (PhRMA), the main industry lobbying group. Medicare boss Thomas Scully, who threatened to fire Medicare Chief Actuary Richard Foster if he reported how much the bill would actually cost, was negotiating for a new job as a pharmaceutical lobbyist as the bill was working through Congress. 14 congressional aides quit their jobs to work for related lobbies immediately after the bill's passage."
THIS is the problem we Americans face when trying to deal with Big Pharma price gouging.
92
@Jonathan
I remember reading at the time that GW Bush and the Bush family were major stockholders and on the boards of some of the big Pharma companies. I doubt if GW would have signed the bill if it called for negotiating prices with big Pharma.
4
This is a completely forseeable result of allowing entities (corporations) which are incapable of experiencing empathy (which would act as a check on greed) run our healthcare system.
It's far past time to try something new.
25
What happened to true competition? And when will pharma be required to compete for Medicare's business? The businesses layered between people and drugs are greedy and obviously colluding. Look, competition must be work (forced to work,) or we turn to socialized medicine.
13
@Mary
competition is bad for business. Profits are maximized when a company has a monopoly or at worst a duopoly. The purpose of a business is to maximize profits.
1
We need to bombard all the Democratic candidates with messages urging them to make reforming the prescription drug business a major issue. Even those of us who can afford to buy our meds suffer from changes made to them , rendering them less effective, just to preserve patents. One example is steroid inhalers for asthma—exorbitantly priced. Also there needs to be more regulation of generics imported from other countries. One is Valsartan, in widespread use for hypertension, that was found by Europe to be carcinogenic and finally recalled in the U S. We need more proactive functioning of the FDA, which needs more funding, staff overhaul, or less political oversight— or all three. Most of all, as others have said, stop allowing Big Pharma to pay off the pols.
11
In a normal industry, prices go up and businesses rush in to cash in which reduces prices. Is there a commentator that could explain why that does not happen here? Is it liability fears? Is it the generic application process? Or something else? Understanding this would help craft the solution. Replies appreciated.
7
@Robert
On the legal side, two things work together to keep competition at bay, patents and the FDA approval process. If another company try to sell the same formulation for insulin as Lily does, they will be sued by Lily for patent infringement. If that company makes enough of a change to the drug to win any suit brought by Lily, that “new” drug has to go through a long and costly process of approval by the FDA. That process includes small trials to prove safety and effectiveness, followed by large trials to make sure the small trial did not have a selection flaw and to further prove safety and effectiveness.
This process is much reduced for the big three insulin makers as they tweak their formula, not requiring as large an effort to prove safety and effectiveness, and this resets the timer on when their patent expires. Separately, the two parts (patents and trials) work to protect consumers from ineffective or dangerous medicines and protect the initial investment for R & D of the company getting the patent.
However, the big three producers are manipulating the system to rake in massive profits which they then claim are necessary for research and trials for other medicines.
2
@AS Pruyn...You are partly right and mostly wrong. The Lilly patent for Humulin expired in 2000. That means with limited FDA approval (approval of equivalency) anybody can make and sell Humulin and have been able to do so for 19 years. While it is true that they tweak the formula (the Humalog patent expires this year) the tweaking does nothing to prevent someone else from selling the insulin Humulin as it was in the year 2000. I repeat, the, patent on Humulin expired in 2000. Lilly hasn't been able to prevent anyone from making Humulin for 19 years. The more important question is why hasn't this happened to a greater degree.
@Robert
In the case of insulin it's the patent system at fault. For decades insulin has been manufactured by genetically modified e.coli bacteria. The bacteria secrete insulin. The patent on insulin expired decades ago but the Pharma companies have been able to keep the process of making insulin proprietary (with help from the FDA) and so no generic manufacturers are allowed.
I've seen the price of a vial of insulin increase from about $25 in the early 90's to over $550 today. It's despicable; it's morally bankrupt; and our government representatives are so bought off they don't care.
This story explains all we need to know about the immoral big pharma in our country. We need health care reform now.
25
I am a type 2 diabetic and having spent over 40 years selling major systems to large hospitals, I know our healthcare system. Prior to selling to healthcare, I sold process chemicals to many different industries. One of those process chemicals was activated carbon which was used to purify everything from vodka to antibiotics. I found that Eli Lilly was a major user of activated carbon in their process of making antibiotics. I was calling on the division that made antibiotics for people and was told that they were small users compared to their animal division located near the Purdue campus in West Lafayette, IN. They chose this site because of the availability of inexpensive land and a great supply of water used in their huge fermentation tanks.
The USA is the only nation in the free world that does not permit insurance companies or major medical institutions to make their major Pharma companies bid for their business. David Ricks, CEO of Eli Lilly heads up the lobbying group that fights any attempt to kill this law that rips off millions of USA citizens. Maybe our next president will see the light.
29
Finding low cost insulin is a real issue when talking to diabetic inmates being released from prison.
Managing diabetes is more than insulin. Management includes disease process education,diet, exercise, and employment that enables time for self care. Good luck finding all that without a felony record let alone without a felony record.
The cost on managing DM 1 or DM2 isn’t covered for most but the true irony is that if you don’t die Medicaid will pay for dialysis.
14
And we’ve got a whole contingent of lobbyists fighting to save embryos who might develop type-1 diabetes. So much for right to life in this country.
25
I literally cannot believe that I sit in the United States and read this about our country. I've read about this many times before and it's still shocking and staggering, that we've come to this.
29
As a Type 1 diabetic for 47 years, I recall when the cost of a vial of insulin was $8. Now, here in the US, it ranges from $160- $400. While in Canada for a trip, I had a diabetes problem and bought a vial of Novorapid (Novolog) for $38, OTC. To Canadians, it's free. I returned to the US with a cooler and 8 more bottles, because $38 is less than the co-pay I have for my Novolog. And we pay 12k per year for our health insurance.
This issue illustrates "crony capitalism" at it's worst. If elected officials reject financial contributions by "big pharma" then they are not beholden to them. People are dying and law-makers, who are "investigating" (e.g. a code word in government, for doing nothing) are the direct financial recipients of our misery and human heart-break. How can a person live with themselves knowing this? How can persons elected to take care of us only care for themselves? Where did human empathy and decency go? When did it cease to become a part of America?
64
@Lisa
My son is a type 1 diabetic. With his insurance he pays close to 1000.00 dollars a month for insulin. He makes a trip twice a year to Canada to buy insulin, sold over the counter. 495.00Can for a six month supply. Same stuff........1/10th price!
24
@MGH That's because although Canada does not universally cover medicaitons under its provincial health plans it has price controls for pharmaceuticals.
3
This is heartbreaking and horrifying.,
2
I think that we should take a look at common drugs across the board, see which ones that tax dollars played a large role in developing. If tax dollar funded research played a role, we take back the patent.
Then just start a government run manufacturing facility (you can probably use the university system to set this up) and start producing drugs that are then available at cost to patients.
We as taxpayers fund a lot of medical research in this country, I read that the NIH 2019 budget was nearly $40 billion. Of that $1 billion goes into diabetes research, which I assume does benefit drug companies. Again, this is "our" money, and we should see some form of a return at some point. IMO, a "return" is not spiraling drug prices. I'd think it would either be much better drugs or less costly drugs.
19
@MC...The patent for Humulin expired 19 years ago. You or the government could make and sell it today if you wanted to. The cost of insulin is not a patent issue.
@W.A. Spitzer However it would require FDA approval of equivalency, and the FDA is funded not by taxes (heaven forbid!) but by "user fees" paid by the very industry it regulates. There is no effective competition.
@W.A. Spitzer
So at some point, maybe it's time to look at what taxpayers spend on these drugs in terms of payments to drug companies (insured/uninsured/medicare/medicaid), and see how much it would cost to produce the drugs (set up the manufacturing, get approvals) and sell the drugs. We spend $1 billion a year on diabetes research. I have to imagine that would make a good dent in setting up a manufacturing facility for an already proven drug.
A perfect example for those that believe health care should be organised by the market.
Health care is a human right. It needs to be organised by the government, for its people. It needs to be paid via taxes and anyone that says it is too expensive only needs to look at the most successful heath care solutions outside the USA to realise that this problem can be solved.
The GOP is literally killing Americans with its continuous attacks on health care on behalf of their billionaire donors.
65
@Dutchie. It’s important to keep in mind that ‘government’ in the form of Congress passed a law that prohibited Medicare, and other health institutions, from negotiating drug prices.
Unlike others in my social group, I reject ‘Medicare for All’ (in it’s present form) because I see it as a free for all that, despite being called “socialist” and ‘administered’ by the ‘government’ will only exacerbate the corruption in the medical industrial complex.
There is no reason to assume that Congress or the people involved in ‘administering ‘ our healthcare are motivated by good intentions. Nor is there any reason to believe socialism will be a panacea for those of us currently being oppressed by the high cost of medical care, including drugs.
2
@Gabbyboy So why does in work in Canada, the UK, Scandanavia, France, Australia, etc....
1
What is the role of government in this crisis? With any other product, the high cost would invite competition offering the same product at a lower cost. It seems that government regulation of generic drugs makes it cost prohibitive for generic drug makers to enter this market.
Education and health care, the two industries with large government involvement, are also the two industries with well above inflation cost increases. I don't think that's merely a coincidence.
12
The free marketers think we live in a bubble or vacuum. They fail to see that socialized medicine and socialized education in every other first world country has affordable healthcare, affordable insulin, and affordable education. The cycle of one party tearing down the entire government while the other party strengthens it is a recipe for disaster or our current government. The government can work if we close up loopholes to big business. But as long as we have free marketers wanting to tear it down everything we will have a broken system.
12
There are a lot of insane things that we do in America that no other industrialized nation on earth does, the very worst of which is leaving medicine and health care to capitalists. When tourists from other countries arrive in America, when they fly over this land of plenty and beauty, when they see how our country has every advantage they must wonder how it is possible that in the year 2019, many generations after they gave their citizens free health care as a matter of human right, that we are so far behind in this. We have handed over two of the most vital enterprises a nation can hold dear over to capitalists, those two industries are the health care industry and the food industry. The food industry which seems designed to lie to you, makes you sick with foods that lead to obesity, which leads to medical problems which lead to doctors, round and round it goes.
Lets get smart, lets stop living like Rats, lets take control of our lives and health, and the first thing is to eat right and understand what we put in our bodies. Stop eating processed foods ( fast food ) or at least limit it to a few days a week. The second step is to elect people in 2020 that will bring our entire nation into the 21st century and give us universal health coverage, so stories like this become a thing of the past. The future begins by voting for democrats in November 2020, lets make the republican party and their greed over people a thing of the past. Lives depend on it.
36
@Lonnie
Although I now support a universal health care system I remind myself that when living in Europe I experienced the taxes paid by all with a major chunk designated for health care. Medical care is not free. Another part of health care costs relates to our Tort Laws. In Europe there are virtually no malpractice law suits and huge monetary awards for treatments that go wrong. The state continues to pay for injured folk lessening the motivation to sue. Whatever system we install will require a fundamental change in our expectations of services provided. Central Government provides the service, malpractice suits must be filed against the government. No juries, administrative judges working for the Government settle claims. Many lawyers will no longer have jobs.
4
@Lonnie
I am a long-time type-2 diabetic, 76 years old, resident of San Juan PR. On May 30th, I went to a nearby Walgreens pharmacy to pick up a vial of Lantus Insulin. Cost:$320.99; co-pay - $28.00; "your insurance saved you $292.99", according to the label.
I am not working, and depend on Social security and a small private pension, to pay for rent, utilities, car loan, appliances credit, plus food and medicines.
Guess where I need to make cuts or stretch the dollar as if it is made of rubber? The last two items, of course.
PR is a territory of Congress bought from Spain by President McKinley in 1898 for $20 million. Some want the Island to become a state of the Union.
Is this the American Dream come true?
FP
2
Narcan is as available as air to breathe to save people who made bad choices, but insulin is very costly (most of those who need did not cause this need) where is the outcry to save the type 1 diabetics like there was to save the addicted?
32
@stan:
when you say: "most of those who need did not cause this need" I think you are confusing (as many people do) Type 1 Diabetes with Type 2 diabetes.
Type 1 can strike anyone at any age, including very young kids. Their pancreas simply quits making insulin.
Type 2 insulin is often seen as "lifestyle" related, in that it can be prevented or reversed with weight loss, change of diet, exercise and so on. Most Type 2 diabetics don NOT require insulin, but take pills.
Bottom line is: we NEED some form of "Medicare for All".....every single other developed nation in the world takes providing health care for citizens as a right.
4
@stan also narcan is used to revive people in medical distress due to overdose. It can't be compared to insulin - it's better compared to a defibrulator which revives someone in cardiac arrest.
2
@RLiss Have a little empathy for people with type 2 DM....In my family, at least eight maternal relatives in two generations, developed type 2 DM, most were NOT overweight or sedentary. There is a genetic component to this disease as well.
BTW my co-pay on a new med prescribed for me recently is over $300/month. This is with good, expensive insurance. Retail, cash price of the new drug is over $800/month. There are frequent advertisements on TV promoting the drug.
I agree with you bottom line.
Yes, why IS the cost of insulin so high here in America that other countries selling the same bottle at 1/4th of the cost are also asking that question.
Another good question is this Senate run by a majority "leader" who want to destroy healthcare reform.
And another good question is why is healthcare reform being referred to as socialism when even Winston Churchill advocated universal healthcare.
Could it be that the Republican party consists of corrupt self-serving people who are better suited to a jail cell instead of public office?
Anyway, as a Type 1 Diabetic, that is my answer to all three of those questions.
77
@Jbugko 1/4 th cost? Try 1/10th the cost.
1
It’s not only the Republican party
This crisis makes it apparent that there is no health care system in the US. There's a health-care market place increasingly dominated by a rentier class that has no particular interest in helping the sick. This "industry" should be nationalized and run with the needs of people as its only goal.
37
Case in point why the 'invisible hand' of capitalism is a myth foisted upon the public to rationalize calculated greed. This is yet another case in point why unfettered markets do not automatically yield the most efficient solution or support the common good. What the medical industrial complex is doing is no secret and yet the federal government continues to fail to act and looks the other way. This is nothing short of government sanctioned extortion.
32
Wondering why US citizens are not in the streets protesting.
Here in Europe everyone could afford Insulin as production costs are low (old products), mainly produced in e.Coli or yeast compared to real biologics. Being a pharma insider the COGS is not even near 20% of the insulin price and profits for a low tech product are enormous.
No one dies because of Diabetis in Europe. How can this be allowed to happen in the biggest economy of the world ?
81
As a person with T1, I regard it as a kind of PSA to point out three things when this topic comes up. 1) You can get cheaper R and NPH insulins OTC at Walmart. 2) This stuff behaves very differently from what most of us are used to, NPH particularly is much riskier to deal with than modern basal insulins like Lantus. They are NOT a simple substitute for analog insulins like Novolog or Lantus, which people fortunate enough not to live in the US can get for a fraction of what they cost here. But: 3) they are an improvement over risking death by Diabetic Keto-Acidosis (DKA).
For the general public it's also important to know that just because there is an inferior alternative like this, it's not an easy choice or a real solution. I lived on the R/N regime for twenty years before there was an alternative, and the fear of unpredictable, potentially life-threatening hypoglycemias was ever-present during every moment of those two decades, a trap-door that could--and all too often DID--open under you at any time, virtually without warning. The analogs reduced that anxiety considerably--truly life changing for me, even more than switching to an insulin pump. So there are many reasons people are reluctant to resort to them even if they are aware they exist, versus insulin rationing, letting yourself run "a little high" while you figure out a way to get your hands on the insulin you're used to and know how to use. That Hobson's choice is what is putting all too many of us into ERs.
55
@WilliamB
Many of the people surviving off that over-the-counter insulin available at Walmart do not have health insurance and dose themselves by guess. This is truly Russian roulette. A path to an early grave, but does America care?
7
This is a terrific comment. Thanks for explaining so clearly. @WilliamB
2
Nothing illustrates the inequity and inefficiency of the US healthcare system better than this issue.
Wealthy companies pay high insurance premiums for their employees which subsidise inflated drug and treatment prices of the healthcare system. While all of the corporate players profit big time. All are complicit, including elected representatives paid off by said corporates.
Those that fall between the cracks in the system run by the corporate capitalists die.
Basic healthcare (such as access to insulin) should be a right in a modern Western democracy, not a privilege.
50
We need government intervention and control. What my medical profession used to call "socialized medicine"-- in the tone of a curse.
Using health problems to make inordinate profits has no place in health care and is counter to every ethical tenet held by the professionals in the healing arts.
This would not exist in the form it does except for the very successful lobbying (as in, money) lavished on Congress and the body politic by the industries in question. If it takes "socialized medicine" to solve this mess, then bring it on.
24
As a pharma insider, I can say that pharma is not only out of control pricing-wise, but also behind in operational efficiency. It accepts far too much disorganization and suffers from a lack of automation in mundane physical and cognitive tasks throughout most of its hierarchy that should be laughable to any modern businessperson.
Why innovate operations if you can overcharge your customers? If you do choose to innovate, the innovators will invoice you heavily knowing that you can overcharge your customers. And even after you've realized these cost-cutting efficiencies, why not just pocket the new margin or reinvest it into new products and repeat the cycle? This is the result of natural business logic when critical medicines are considered no more critical than any other routine commodity being brought to market.
The generalized debt of the well-educated that biopharma attracts doesn't help. But I can also say that there's a budding generation of enlightened executives whose hope is to maintain their moral compass as we ascend within the machine. We're in there trying, but markets and shareholders have different priorities, so our efforts must combine with outside pressures if they are to produce effective change.
Eventually, the biotech industry's genetic therapies will bottom out pharma. Prices will drop once development costs are recovered and initial egregious profits achieved. But time will claim its victims, unfortunately. I struggle with these means every day.
18
We have our problems with our universal health care up here in Canada but something like this is unheard of. In our country, we all agree - everyone deserves free health care. We all take care of each other and take part in the cost.
130
@Catherine
HOW FORTUNATE!
We envy you.
FP
San Juan PR
1
The obvious answer is that the government needs to use its power of eminent domain to nationalize certain insulin patents and either produce it itself or license it out to companies to agree not to sell for a price above $X.
If it is constitutional and in the public interest to forcibly take someone's house to give the land to a developer to build a mall (see Kelo v. New London) certainly this would also be legal.
Congress needs to stop investigating and act. This is a major public health issue that has been going on for a long time that has several obvious answers. (Another option is importing foreign insulin, of course.)
32
@Big Cow
The American Government is becoming more and more irrelevant. It continues to sleep at the wheel, while the train heads for the precipice at the end of the curve ahead.
Healthcare? Public Education? Infrastructure?
Who needs it?
FP
San Juan
3
Frederick Banting, who discovered insulin in 1923, gave his patent away for 1$ because he realized how many lives it could save.
Of course US corporations somehow found a way to extort an increasing amount of money from people who would otherwise die anyway.
Can we move on already from our raw capitalism to regulated, EU style markets? This version of the US isn’t working for 95+% of the population.
68
@LizPeople are driving to Ontario towns close to the border to get their needs for 1/10th the cost in the US, but that may have to stop for they are voiding local inventories. This happened before when so many pharmatour buses showed up at border towns voiding inventories a bill forbidding filling of any more foreign 'scripts was introduced.
15
@Liz It is perhaps emblematic of this issue that Banting was Canadian.
3
@Liz
Capitalists, as we all know, are the most generous persons in the country. They constantly donate 99% of their wealth and earnings to the needy or charity; and keep only 1% to pay taxes and their Bank/bondbuyers and cover Family necessities.
Do you really want to destroy this marvelous setup?
FP San Juan
2
I don’t think government should be regulating prices on anything but only the most urgent of medicine, this clearly is one of them
3
@There:
Disagree strongly.
As a retired RN with 30+ years in Hospitals, and as a health care consumer myself, it is ridiculous that we Americans are the ONLY developed nation in the world to not provide health care as a right to all citizens....we need some form of "medicare for all" now!
2
Do you understand that the cost of all medicine and all medical procedures will rise to take every last penny from your pocket and ensure that your rightful heirs receive nothing so that some money hoarder (billionaire) can brag about having still more? To prevent out of control theft is exactly part of the social contract holding us together as a nation.
When someone collects too much of anything it is an OCD condition: hoarding. Why do we applaud hoarding money?
1
@There
Yeah, Capitalist discovered and invented America and every wonderful thing that we have today.
We should worship at their feet, kiss their hand, and lick their boots. That's how much we owe them, how grateful we should be.
the ingrates! Huh!
FP
1
How is it that the same drug by the same manufacturer is sold in other countries at a fraction of the price charged in the US? What are those countries doing right that we are doing wrong? It seems unlikely that the US consumer is really "subsidizing" the world.
If the federal government is unable to act either through formal legislation or through President Trump's declaration of a national "emergency" (though he stopped short of this with the opioid crisis), could the states (or at least the largest among the 50 to start with) enter into a compact to use their combined economic muscle (via pension plans, state Medicare or otherwise) to gain price concessions as a condition for selling in their market?
20
@Charlie in NY In those countries the Drug Companies don't own the legislators. The Healthcare Industry is the greatest transfer of wealth at public expense in the world. Hospitals feast on Medicare, surgeries on 85 year old for hip replacement? Medical quackery driven by financial incentives. Our health matters less than how much revenue the visit can generate. Unnecessary tests and referrals.
16
@Charlie in NY
US consumers are the "hen that lays the golden eggs'; a plenteous cow to be milked and remilked again and again BY BIG PHARMA AND OTHER GREEDY AND UNSCRUPULOUS CAPITALISTS. As somebody said, Gather ye rosebuds while ye may for time it is a'fleeting!
The waves and time wait for no man!
Don"t you know that only a billionaire can pass through the eye of a needle?
FP
FP
@Nevdeep Gill
In other words, so-called American healthcare is a farce!
FP
1
Ah yes, the "greatest healthcare system" in the world.
99,000 people die in the U.S. every year from infections they got while in the hospital.
45,000 people die in the U.S. every year because of no access to a Dr.
Infant mortality in the U.S. is 71 percent higher than the comparable country average.
And the list goes on and on...
Enough said.
75
@Raven I don't think anyone says the U.S. has the greatest health care system in the world. Some of the best doctors, certainly, since we're willing to pay doctors here without limit which attracts global talent and the best minds, but I can't remember the last time anyone alleged the *system* was anything better than abysmal.
11
@Big Cow
Um, most Republicans absolutely say that.
"Nearly seven-in-ten Republicans (68%) believe the U.S. health care system is the best in the world, compared to just three in ten (32%) Democrats and four in ten (40%) Independents who feel the same way."
7
Actually, many people say that, Big Cow. I live in Trump country, and it's a common statement, part of a massive number of just such incorrect beliefs in the defenders of predatory capitalism here. Starting with the idea that predatory capitalism is their friend and that Trump is their savior. Sure it's crazy. But don't kid yourself that it doesn't exist; it does, and currently has power to ride roughshod over reason, to our great danger and loss.
4
In Europe, the average price for private purchase of insulin is around $20 per 10mg.
In reality, as a medical necessity it is almost always provided, free or heavily subsidized, by countries' universal health care systems. Were a citizen of any EU country to die because they could not afford insulin it would likely be a front-page national scandal.
The fundamental difference between the US approach to this and the European one is that Europeans generally see basic health-care as a fundamental right. It seems that, finally, a plurality of people in the US agree with this view. Whether that will be enough for your system to change remains to be seen, however.
65
Sorry, there have been several studies on the cost to manufacture insulin, the best guess by the Kaiser foundation is that insulin costs approximately $6 per 10 ml to make. The cost to US consumer is almost $300. Distribution, FDA licensing, marketing, & R&D do not cost $295 per bottle. I’m not asking for free insulin, but in reality, approximately $40 per bottle is a profitable price that includes inflation from its introductory price of $26 in 1996.
We aren’t subsidizing other countries insulin costs. Other countries’ nationalized health systems are not subsidizing the price of insulin. They are negotiating and regulating the tendency of corporations to price gouge consumers to benefit shareholders.
If we want to fix American health economics, regulation of health insurance, pharmaceutical manufacturers, and the stock market are all necessary. The system is completely ruined because we’ve protected everyone but the citizen, the voter.
24
@The
Can you be more specific so we can understand the real cost? Insulin is dosed in units but comes in 10ml vials. Do you mean $20/10 ml?
1
@SDemocrat
Why should there be "marketing costs" at all on prescription pharmaceuticals that people need to stay alive?
Actually, why should there be advertising on ANY prescription drugs? I am sick and tired of seeing TV ads for drugs that cost many thousands of dollars per year. Every notice that the ads for national news and such - the most expensive slots - are mostly for pharmaceuticals?
If it takes a prescription to get it, marketing should be limited to educating physicians on the products.
7
My daughter was diagnosed with T1D at 18 in 2013. Without insurance, her monthly insulin cost is $1500. That doesn't include to cost of pod and CGM supplies. Plus, there's no living off cheap junk food- the only way to control blood sugar, even with insulin, is to eat a varied, healthy (and expensive) diet. When she did a semester abroad at Hebrew University, her insulin cost, WITHOUT insurance, was $37.50. She would love to go to graduate school but she needs her work insurance to cover the diabetes expenses. Her life is constrained in so many ways because of this condition, but not nearly as much as it is by the outrageous greed of the pharmaceutical companies.
190
This is precisely my experience, as well.
19
Just wrong. I’m so sorry.
2
My son has had Type I diabetes for 33 years, first diagnosed at 15 months old.
I have watched with alarm at the rapidly escalating price gauging of the insulin production industry. Our government has done nothing about it.
The FTC is a joke. Insulin MUST be purchased by people with diabetes. As well, devices that help manage blood glucose control are very expensive...in the USA.
This is another snapshot of the SWAMP. Congress works for corporations, not for the people who must purchase insulin and devices to survive. If a person with diabetes wants to achieve excellent control, then it will cost them. Others who cannot afford the best technology to achieve excellent control will have to settle for more health problems that can arise from poorly managed diabetes, at the cost to our already mismanaged health insurance system.
Profits are extreme for the corporations that supply people with diabetes with life-supporting insulin. Corporate explanations about their "cost" relative to the price are smoke and mirrors, camouflage for their blatant thievery.
Where is the FTC hearing about global pricing and USA pricing? No one is at the helm...this administration is an abject failure.
90
This is compelling, and while insulin is wildly overpriced, the issue boils down to government. Are we doomed to have a federal government that cannot regulate anything? The Republicans have undermined and underfunded the regulatory and enforcement ability of our government. Thus, we pay taxes for their salaries, and when they leave government they go and work for the companies they failed to regulate.
125
@BostonGail
Is this the promise of the American Dream?
Bullets, bullets everywhere and every day and no-one left to slay!
FP
1
Thank you NY Times for highlighting this important health issue. I hope this gets much attention in the coming election, as it seems quite ridiculous that U.S. citizens should have to suffer or die because the drug they need is too expensive when in other countries it's a given. Instead of talking Obamacare vs. whatever-health-plan-you-have-or-don't, the debate should be specific. Is Insulin covered for all Americans with Diabetes, why not? Fix it. Are Annual Health Checkups covered for All Americans, why not? Fix it. Is a Broken Foot covered for All Americans, why not? Fix it. Simple, specific, not idealistic.
53
Suboxone to treat opiate addiction is similar to insulin for diabetics.
Both should be over the counter to reduce costs and increase access.
12
Insulin as been around forever. It's practically a commodity item. Its cost should be minimal, like aspirin.
94
@MIKEinNYC It is if you want older formulations which take more aggressive monitoring and administration--$25 a vial and available OTC
1
Very powerful. Big pharma is out of control and needs to be reined in. No one should have to ration necessary medicine to survive.
43
@Mary kay feely
Some people want it that way.
They have the power and the willingness to use it.
Don't rock the boat or we'll throw you overboard!
FP
Some drugs are needed by so many that maybe those drugs should be produced by the government and distributed for free. Insulin is off patent. Millions need it. Insulin costs are affordable in other countries so if Americans companies don’t want to be in this business maybe the government can create a few factories to meet the need?
60
@Deirdre
This is not WWII, when tractor and engine companies made tanks, weapons and other war materiel.
The need to do that was overwhelming and was clearly justified due to the Nazi threat. All the people joined in the war effort.
It was a death-or-life situation.
Where is the urgent need now?
I don't hear Trump and Graham calling for it.
They consider healthcare a waste of money that can be put to better use, like Oil and Gas exploration in the Arctic, reopening Southern coal mines, Fracking in the Midwest, building 5 more $20 billion nuke Aircraft Carriers at Newport News, building a Southern wall to keep out the Brown People, turning North Korea into a tourist and developers' paradise, etc.
The end justifies the means!
FP
Thank you for enlightening us, but what is our call to action here? How can we mobilize and help?
16
Call/write/email your representatives. Volunteer with your local & state races. Run for office. Write Op-Eds, share news stories with friends, march with activists. Vote against Republicans who refuse to regulate because “free market” solves everything....when healthcare is anything but a free market.
The only thing that can change the situation is state & federal government.
2
@Day:
serously? Support some form of "Medicare for All".....
We're the ONLY developed nation in the world not to provide healthcare for its' citizens.....
2
The cost of insulin has risen so dramatically because its makers realize they have a captive market, and they want even more money. The larger problem is that the government continues to allow this, presumably because of the river of money flowing into their pockets from Big Pharma. I'm not surprised that the drug companies do their best to to maximize profits, but I regard the failure of our elected officials to protect vulnerable citizens from their predations as criminal.
87
@Chintermeister
It seems that the desire for money is almost limitless: for the more money you get and have, the more you want.
The rich always want to get richer.
That's the story of Big Pharma, Big Oil, Big Steel, Big Gun, Big Bank, Big Insurance, Big Etc.
Our genes feed on money, not blood.
FP
1
Where is our government on this? Why is there no Executive Order to stop the rise in the price of insulin? Where is Congress with a law that caps all drug prices? People are tired of our government not working for them. It’s time for a radical change.
66
An Executive Order needs an executive who cares. That’s why none.
5
@Mike L:
this administration is clearly run on the basis that what is "good" for multi billionaire CEO's is the "right thing" for the U.S.
4
Hmm, three companies all raising prices when there are no underlying cost increases and profit margins are already high? Sounds like something the FTC should be investigating.
80
I have been a type 1 diabetic for about 4.5 years and have Medicare part D for my prescriptions. I can get my insulin for less than half price from a pharmacy in Vancouver, BC. As I understand it, this is technically illegal, but not enforced.
32
@Edward Meyers..indeed, where is the free trade for the individual people...Mexico is my local pharmacy...
9
@Edward Meyers yes, if you can get a Canadian prescription a Canadian pharmacy will fill it. I worked up in Canada for 3 years this past decade and had a doctor up there (no fees to see her)- after I returned to the States she said I could call anytime for an appointment ($45 Canadian cash TOTAL to see her) and she will write for me - mainly things that are not even available here - FDA and the Canadian regulator sometimes see things differently) That three years was eye opening - I was used to the checkbook system here. Care was great, and no charges at anything. Taxes incrementally higher than here. It's a good system.
13
@E Campbell
In Ontario, diabetic supplies are over the counter.
3
Unreasonably priced insulin is not only dangerous for everyone with diabetes but it is also dumb economics.
About two weeks ago, my nephew (who has been diagnosed with Type 2 diabetes for about ten years) developed an infected cut on his foot. He is very careless about his diabetes, has had no insurance and they kept him in the hospital for two weeks with MRSA and uncontrolled blood sugar. He just learned about the cheap insulin in Walmart (thank you W-Mart!!) and should adjust his diet. I'm optimistic that he can leave junk food behind. With improved diet and exercise, he might be able to stop using insulin.
As a point of contrast, my son (now 30) has been diagnosed with Type I diabetes since he was just shy of his eleventh birthday. His father and I have been fortunate in that our careers have allowed us to move to where we could get good insurance and great care. He has had no problems but he gets exercise, eats very well and incorporates stress reduction into his life. He will always need insulin, no matter what he does.
That we can't find a way for those who need insulin to get it easily and cheaply reflects on all of us as a society. We can send rockets to the moon but we can't find a way to provide life-saving insulin to our neighbors down the street. What is wrong with this picture?
To all politicians everywhere--protect and support your constituencies!!!! Insulin has to be protected in a politics-free zone.
38
@Babs
"our careers have allowed us to move TO WHERE WE COULD GET GOOD INSURANCE "
This tells us about all we need to know about our vaunted "best-in-the-world" health care system.
42
Maybe the real answer is to leave this country. The difficulties we face here get worse every year.
We spend 3 months every year in Mexico and know many people that moved down there permanently.
34
@Allan
YES! we moved north of Merida, Telchac Puerto, Yucatan, on the beach in a little fishing village...4 hours west of Cancun.
Drugs are much much cheaper, a fraction of the cost in the USA. Why is that????
Since most drugs are made in the US.
PS - Many Doctors here have degrees from the US and speak English here. The cost for an visit is equal to the co-pay we used to pay in the USA.
@Allan i am encouraging my 35-yr. old Type 1 to emigrate too. When your own beloved country turns it back on you when your life depends on a single drug, loyalty is not required.
This is not a new problem, but a worsening one. The media owes the public more answers. There is a great similarity between Republican led inaction on critical prescription drugs (like insulin, because diabetics can live only a short while without insulin) and Republican led, regressive economic policies. The reality is that drug companies should be regulated, and they should be required to provide medications as critical as insulin at little or no cost. Why aren't they? What is the reason for this problem? How did this come to be? Which legislators in Washington and State Capitals benefit from high prescription prices? A more thorough analysis is needed in order to truly inform the public. Even right wing media like Fox News should agree about this issue, or will they care, or inform?
52
I hope our Tory politicians who seem so keen to sell off the NHS to their buddies in the private healthcare system will be taking note of this.
There still seems to be a fairly widespread belief on the right in the UK that the US system is 'more efficient' than the underfunded NHS. The fact that it actually costs more than the NHS, and that a lot of Americans are uninsured or underinsured, and being bankrupted by medical costs seems to escape them.
You don't need to be a socialist to believe that affordable healthcare should be a basic human right in the 21st century.
230
Although I'm a fortunate person with diabetes, and never had to ration much - there was a few months of unemployment 20 years ago - I've for decades complained about the pharmaceutical market. Insulin has been around for ~100 years, with no patent, but pharma has tweaked the design and then packaged it in patented delivery systems so they can maintain quasi-monopolies. That they now have gotten even worse and started squeezing people for available, not proprietary life-saving medicine. It's just one more reason to replace American pharma-hospital-doctor-insurer driven healthcare.
114
Universal healthcare, price control, "government overreach" are anathema to American values, to the democratic capitalist system. In fact, if any country now wants to avoid tariffs, they must agree to dismantling any legislation that "take a free ride on the American pharmaceutical industry". Mexicans must withdraw their soda tax and remove any health warning on sugary drinks. The British, if they want to have a trade deal with the US after Brexit, would probably have to open up their health system to American insurers, big pharma and hospital chains. In fact, many of the "promises" that the Chinese government "reneged" on involve the dismantling of safeguards for Chinese citizens that supposedly stifle "free enterprise" and competition from US firms.
Trump is indeed using tariffs to push the agenda of pharma, agricultural, high tech, energy and defence industries.
If Trump has his way, these same stories will play out in China, Europe and Japan. This is the established "international order" they are talking about. The freedom for big corporations to prey on the weak and the desperate.
And the evil, authoritarian Chinese government ? They have enacted laws to prohibit price gouging by pharma companies, insurers and hospitals. This is an affront to American values and must be corrected.
24
@Adrian - Democracy is NOT synonymous with predatory capitalism. In fact it is in direct opposition to democracy and a free population of citizens.
7
@GTM
Indeed. It is therefore arguable whether the US system is a true democracy or an oligarchy controlled by industrialists and financiers. A true democracy would place the welfare of people before the interests of big businesses. Think gun control, access to healthcare, equality in education etc. etc. etc.
While the Western media has demonised the Chinese Communist party, it has done more to alleviate poverty, improve access to healthcare and education, give equal rights to women than any Western government in the past half a century. And ironically, it is an authoritarian, not a democratic, government. Shouldn't Western style democracy be doing better ?
1
@GTM:
tell that to Trump and Mitch!
I remember some years ago when my mother announced that she was divesting from the pharmaceutical stock my broker father had had left her in his investment portfolio. She told us she had read so many shocking things about the way they operated and about the price gouging that she felt it would be immoral to continue to profit from her stock. She was right.
Pricing the financially vulnerable out of normal access to literally life saving drugs like insulin and EpiPens, to name just two, is tantamount to murder in my book.
184
I'll add a third - asthma inhalers. It's unconscionable.
42
@Margaret
Epi pens for anaphylactic reactions another one
That was a hot topic for a while and has somehow gone away
I find astonishing that when someone is arrested they are told if they can not not afford an attorney one will be provided but if someone is ill there is no guarantee of healthcare
Also insulin is only a part of the needs for a type 1 diabetic. Regular follow up by a trained healthcare team, lab work, education and being able to afford a balanced diet, and the equipment to monitor blood sugars, needles, syringes. All a part of the plan of care that a diabetic without “good” insurance can not afford. But Medicaid will pay for dialysis when they develop real failure. Ridiculous
12
@Susan
It is murder.
2
This is immoral and unfortunately a true manifestation of american predatory capitalism.
If I recall correctly insulin was manufactured in a Canadian University laboratory by two scientists in 1920 and the patent was sold for one dollar (!) for humankind to benefit .
It is time to counterattack big Pharma once and for all with legislation protecting citizens not the wolves of Wall Street .
429
You know that isn’t true. The animal insulin isolated a century ago isn’t even remotely the same. In fact, most of the modern recombinant human insulins now on the market lost patent protection years ago. The most popular versions are open to bio-similar competitors. So there’s no legal barrier if you think you can produce modern insulin cheaper.
Governments, nonprofits, and individuals are free to make insulin themselves. You just need to hire the personnel, build the factory, obtain FDA approval, and figure out sales and distribution.
What you can’t do is force private businesses to create the products you want for the price you want. They tried that in Venezuela, and the factories just closed up instead. You end up with no products instead.
3
@H
What should be done is that private businesses may make the products they want and in cases where it involves lifesaving meds, prices are regulated. So if you want the big profits, make another product.
25
@H
Why it is that whenever drug prices are discussed, it is in "all or nothing" rhetoric? I am confident that with the proper economic input and good faith on the part of regulators, a formula that allows companies to make a reasonable return on investment without putting the lives of those who need this medication at risk due to price gouging could be formulated. Medical/pharmaceutical costs are socialized, in one way or another, either directly through public benefits and risk-spreading insurance costs or through the cost of uncompensated care for those who can't take care of themselves and end up in the ER (which is later reflected in higher insurance premiums and hospital costs for the rest of us). Drug prices for live saving medications are not controlled by market forces. Access to and prices for water and power are regulated. What are we waiting for?
22
I am a Type 1 diabetic. I have Medicare and a good supplemental insurance. Yet I worry about the escalating costs as I am now in the doughnut hole with the Medicare prescription plan. The long acting insulin and a short acting insulin are needed by me so that I can live. They are not the only medications that I need at age 68. I worry daily and with each coming year how I will afford my medications as I age. I am not yet at the point of rationing my medication, but if the cost continue to increase I will have to do that. It is such a shame in a country like ours that profits matter more than the lives of people. Oh, I forget. Corporations are people. I guess those people who contribute significant money to politicians can make decisions that negatively affect the lives of those other people. I am among those other people. Thankfully, even when my blood sugar is out of control I can vote unless some state decides to check our blood sugar prior to voting. A new litmus test.
144
We bought an ACA plan to cover the costs of being alive in America with a manageable but deadly chronic disease. We were lucky we could; diabetes, like cancer being the mother of all pre-existing conditions.
The cost of insulin an pump supplies rivals the cost of premiums. If you can't afford an ACA plan, you can't afford medication.
The pharma industry is out of control. The insurance industry is out of control. Corporate medical and hospital groups are out of control.
People suffer and die because of it. But,hey, those stock prices are soaring!!
276
@Cathy
In the state of NY, the cheapest non-subsidized ACA plan without a deductible is $1000/month. The cheapest plan is $500 with a $7500 deductible. Not great choices, and not very affordable.
19
@CA
Wrong. The cheapest ACA individual plan in NYC is about $420 a month. With a $4,000 deductible. And many people qualify for insurance premium advance payments - the well know Obamacare insurance subsidies. People with low incomes often qualify for coverage under Medicaid expansion under the ACA.
10
@H
Wrong.
I chose the cheapest non subsidised plan, from Fidelis, for 2019.
I pay $500 a month with a $7500 deductible.
You are referring to subsidised plans. Many middle class folks do not qualify for subsidised plans and fall through the cracks.
14
To those struggling or unable to pay for insulin, Walmart sells a generic insulin for $25. It’s not a fast acting insulin as it takes about an hour to start working. However, it’s at least something that could maybe tie someone over and prevent them from dying.
29
@Brian Phair thank you, Brian! My husband, a type 1 for 20 years, uses the $25 slow and the only slightly more expensive fast insulin from Walmart. He uses inexpensive needles and the least expensive testers--he also follows an extremely low carb diet at all times, meaning his insulin needs are also low. His AIC is typically 5.2-5.5. He misses being able to eat whatever he wants, but the alternative is the spectre of blindness and loss of limbs. I would like to keep him around as long as possible, TBH.
30
It’s not a long-term solution though. Regular and NPH work in waves that cause cycling between food and insulin management. Still have a much higher risk of hypoglycemia and hyperglycemia (low and high blood sugar) and create a greater risk of complications. Also are not for use with insulin pumps and require training to use: the dosing is VERY different. Please call your dr if you need to switch!!!
14
Regular and NPH are workable solutions and regular insulin can be used in the older pumps. With adjustments to the active insulin time/insulin on board, regular insulin might even be usable in newer semi-automatic/automatic pumps. When pumps were developed in the 70s, regular insulin was the only fairly rapid insulin available that was suitable for use in insulin pumps.
One problem is that fewer of the younger generations of health care providers and patients/patients’ caretakers understand the pharmacokinetics of and know how to dose those non-amino acid modified insulin analogs. However, they can learn these aspects of insulin use. When enough of them start using NPH and regular insulin instead of the outrageously expensive insulin analogs, the pharmaceutical industry’s control over analog insulin pricing in this country will be weakened and they might have to lower the prices of analog insulin to be competitive with regular and NPH insulin. The vicious trend of increasing dependence on insulin analogs leading to higher prices charged by the insulin analog makers will then be halted.
2
This is the US healthcare system in action. A little research shows that the same formulation of insulin from the same company in Canada is 10% of the cost in the US.
441
US companies justify cost increases by claiming to update the formula. While this is true and insulin has been improved, they can’t actually justify the hundreds of percent price increases.
I wish our government would step in and regulate this. I don’t have a choice, I have to buy insulin or I’ll die. Having 2 or 3 companies in the free market isn’t effective in keeping prices down. The companies know I’ll keep buying so they adjust the formulation, blame it on QC costs, or whatever justification they make up. The richest nation in the world yet people die because they can’t afford to purchase a drug their life depends on. It’s disgusting
61
@Gus
Exactly correct. When Americans protest the idea of a civilized, first-world health system such as Canada's, they frequently voice fears of "high taxes." But they end up paying much more for drugs and services, with no upper limit and no protection, that they'd be much better off paying taxes and knowing that they're covered and not being frightened of rapacious prices.
53
@Gus
Health care in the US is a 'failed market.' The insane and immorally high price of insulin, other drugs, and health care in general is purely a failure of insufficient government control over markets.
There are three workable models for financing health care:
1) the National Health Service, like the UK or Veteran's Administration. The UK bases their system on comprehensive primary care, gets the best results, and spends the least, of 21 industrialized countries. The VA, despite a very sick population, has provided good health care to millions at a reasonable price. Both have been hampered by excessive government meddling and inflexibility, and suffer from the ills of large organizations. Still, they provide the best value for money and continually improve.
2) Government paid coverage and regulation, privately provided health care, like Canada, Taiwan, and Australia. These countries have strong primary care, though not as strong as the UK. These produce very good results at good value for money.
3) Private, mostly nonprofit insurance and care with very very strict regulation, like France, Germany and Switzerland. Despite draconian insurance regulation, these have the highest costs outside the US, with less emphasis on primary care, and produce worse results than other systems.
Then there's the US, with weakly regulated, for profit insurance and health care, with the worst health outcomes and double the cost of the Germans.
35
While affordable insulin is obviously important, Americans also need to stop eating like their healthcare is free. The number of fast food chains that have sprouted up over the past decade is insane.
8
@Jake While I completely agree with you sentiment, and would go further and say that we all need to stop eating all animal products, the vast majority of type I diabetics, and some type II, will always need insulin, no matter dietary changes.
51
@Jake I agree that many American should eat better, but Type 1 diabetes often has nothing to do with fast food.
142
@Jake
While you are right about Americans and fast food, that is not a primary factor in Type 1 diabetes. There is a genetic component, and in some families all members have the disease. Blaming the victims is a cruel and cowardly approach to the problem. It includes painting with a broad brush, blaming all diabetics for their disease. Even in the case of Type 2 diabetes, the type associated with obesity and poor eating habits, do the people who profit from selling junk, fast food to people bear any responsibility? For some, eating fast food is an addiction, and the fast food restaurants are like drug dealers. Most importantly, why is our healthcare system allowed to price gouge consumers who will die if they don't pay up?
105
As the parent of an insulin dependent diabetic, I find the continual spiraling of the cost of insulin not only alarming, it is a threat to his life and the lives of millions of others. It is one of the great obscenities of this society that healthcare is a commodity increasingly available only to those who can pay for it. This should be a call for revolution, a complete overthrow of the established order and a dismantling of the drug cartels that keep profits high and citizens sick and dying. The drug companies hold the Sword of Damocles over our heads, threatening to withhold their wonders and research if we do not pay the extortion they demand as a ransom for their goods. America has always been the world's greediest nation, but even the common person has to rise up when these capitalists happily withhold the drugs we need and poison us with opiates to keep us enslaved to their avarice.
297
@Jude Ryan, “Drug Cartel,” I always associated the term with illegal drugs, but you are correct. The Pharma industry is a cartel, and it should be illegal the price fixing, the collusion among themselves.
90
@Jude Ryan
Yes, there should be a revolution. Seriously, there should be...
Yet no one but the people we don't want in power will do it. The left couldn't even make it out the front door before being gunned down. Righties have 70% of the guns and the military and police would likely favor them.
We are locked in stasis, and our only hope is political and deeply cultural change. We will have to use the former to goad the latter.
1
@Jude Ryan. Well, Venezuela recently had a Bolivian revolution. Insulin is free there. And unavailable.
Be careful what you wish for....
Being affordable isn't good enough. Insulin should be free to people with Type 1 diabetes. They need it to LIVE!
189
@Susan
A lovely sentiment, but if you offer no proposal on how to make it free for Type 1 patients, then your suggestion seems nothing more than a wishful dream.
Tax everyone a bit to pay for the drug? Force a company to pay for their staff and employees to make it, but then give it away? What about kidney patients, they need dialysis to live, should that be free?
We all need food to live, maybe that should be free?
"Free!" is not free. Someone has to pay, even if it's society in general. Society paying may be a very legitimate choice, and it's worthy to discuss that option.
But I have to admit that when I hear "Free!", without any plan to pay offered, I tend to not take the speaker as seriously as maybe I could/should.
15
@ImagineMoments In France the cost pathologies such as diabetes are 100% paid by the society. And as there is one entity negociating with the pharma labs for the whole French market, thus which a much higher power in the negociation, the labs sell these types of products at a much lower price than in the US. Individuals are much better covered than the US, and the cost to society as a whole is smaller.
23
There are plenty of countries in this world that provide free insulin to their diabetics. I live in one of them and, even though I'm not diabetic, I don't mind that some of my tax money is used for that purpose. In fact, I prefer the government spends it on that than, to think of a purely hypothetical example, guarding our president while he's out playing golf.
It's not rocket science; many countries have figured out how to provide basic health care to their citizens without going bankrupt.
And, if you must put everything in terms of money, think of it as an investment. You invest in somebody's health, so they live, work, and pay taxes. Keeping your citizens alive is a sound economic policy. Not sure why the US has trouble understanding that.
28