The Prices For Life-saving Diabetes Medications Have Increased Again
A Type 1 diabetes patient holds up bottles of insulin. Reuters/Lucy Nicholson Insulin prices have been rising — increases that mean some people are spending as much on monthly diabetes-related expenses as their mortgage payment. It's led some people living with diabetes to turn to the black market, crowdfunding pages, and Facebook pages to get access to the life-saving drug. At the same time, the companies that make insulin have faced pressure from politicians including Senator Bernie Sanders, class-action lawsuits that accuse the companies of price-fixing, and proposed legislation in Nevada. Even in the face of this criticism, two of those drugmakers — Eli Lilly and Novo Nordisk — raised the list price of their insulins again in 2017. Diabetes is a group of conditions in which the body can't properly regulate blood sugar that affects roughly 30 million people in the US. For many people living with diabetes — including the 1.25 million people in the US who have type-1 diabetes — injecting insulin is part of the daily routine. Insulin, a hormone that healthy bodies produce, has been used to treat diabetes for almost a century, though it's gone through some modifications. As of May 2, the list price of Humalog, a short-acting insulin, is $274.70 for a 10 ml bottle, an increase of 7.8% from what the list price had been since July 2016. On May 2, Lilly also took a 7.8% list price increase to Humulin, an older form of insulin. Novo Nordisk, which also makes a short-acting insulin, increased its prices to the drug in 2017. In February, the drugmaker raised its price to $275.58 for a 10 ml bottle, up 7.9% from what the list price had been since July 2016. In December, Novo Nordisk committed to limiting all future drug list price increases from the company to single d Continue reading >>
Why Is Insulin So Expensive?
There have been recent article written just to answer this question. This one time when I approve of what of what the drug companies are doing even although I don’t especially like the prices. When insulin was first discovered and used therapeutically, it was pretty raw stuff. It acted the way that it did, and it was necessary to figure out the way to use it. Later the drug companies, based on their own research, found ways to alter the time course of insulin availability. The new insulins, of course, cost more but they provided new convenience and new improved ability to control blood glucose concentration. By the 1970′s NPH and Regular insulin were available, and these together worked pretty well to provide convenient control blood glucose. There was also a parallel group of insulins referred to as Lente, Semi Lente and Ultra Lente to provide BG control. The NPH and Regular insulins still exist, and because they are now old technology, they are relatively cheap. The drug companies began tinkering with the insulin preparations again, and they created new formulations that had new and exciting capabilities. Some artificial insulins had a very rapid onset of action, others were able to produce a uniform 24 hour long reduction of blood glucose. These insulins were new and even more expensive, but they were potentially easier and possibly safer to use. So, there was always a “new, improved” insulin that was priced as a “new-improved” insulin. The cost of insulin has always represented the newest technology, and it never represented a older, more “mature,” and cheaper product. Remember the NPH and Regular insulin combination. It gives you the best of the 1970’s and works pretty well. It is less convenient to use but much cheaper than the new stuff. I used Continue reading >>
The 10 Most Expensive Liquids In The World
WRITTEN BY: Alexi Melvin *Editor’s Note: since this piece was published in May 2016, insulin prices in the United States have continued to climb. Please visit our Focus on Access page for more information about what we’re doing and how you can help. Type 1 diabetics rely on injections of a certain life-saving liquid called insulin. But have you ever wondered what the exact cost of insulin is? And how does it weigh in (per gallon) against the most expensive liquids in the world? Hint: It’s a heavy weight! Let’s take a look, shall we? 10. Human Blood: $1,500 per gallon The actual acquiring of human blood isn’t all that difficult, considering we all have it! However, the processing of the blood after donation can be very expensive depending on where in the world the buying and selling of it is occurring. Depression, insomnia, and narcolepsy are just three of the disorders that GHB can be used to treat – as it is commonly used as an anesthetic in medicine. It is found in the human central nervous system. GHB is also well known by its nick name when used illegally: the “date rape drug.” No matter the price of your printer itself, the printer’s ink always costs far more, and the manufacturer for each printer and its corresponding ink is the one and the same. Mercury is not as widely used in the production of medical tools (such as thermometers) as it used to be due to its toxicity. However, it remains to be the only liquid metal that remains liquid at room temperature, it can be used to conduct electricity, and in vapor form it is used in street lighting and fluorescent bulbs. Insulin is very expensive to produce in its biosynthetic form. As we know – (or should know!) insulin is a hormone naturally produced by healthy pancreases. According to the Journal Continue reading >>
Why Is Insulin So Expensive In The U.s.?
Dr. Jeremy Greene sees a lot of patients with diabetes that's out of control. In fact, he says, sometimes their blood sugar is "so high that you can't even record the number on their glucometer." Greene, a professor of medicine and history of medicine at Johns Hopkins University, started asking patients at his clinic in Baltimore why they had so much trouble keeping their blood sugar stable. He was shocked by their answer: the high cost of insulin. Greene decided to call some local pharmacies, to ask about low-cost options. He was told no such options existed. "Only then did I realize there is no such thing as generic insulin in the United States in the year 2015," he says. Greene wondered why that was the case. Why was a medicine more than 90 years old so expensive? He started looking into the history of insulin, and has published a paper about his findings in this week's issue of the New England Journal of Medicine. The story of insulin, it turns out, starts back in the late 1800s. That's when scientists discovered a link between diabetes and damaged cells in the pancreas — cells that produce insulin. In the early 1920s, researchers in Toronto extracted insulin from cattle pancreases and gave it to people who had diabetes, as part of a clinical trial. The first patient was a 14-year-old boy, who made a dramatic recovery. Most others recovered as well. Soon, insulin from pigs and cattle was being produced and sold on a massive scale around the world. But for some, the early forms of the medicine weren't ideal. Many people required multiple injections every day, and some developed minor allergic reactions. Over the next few decades, scientists figured out how to produce higher-quality insulin, Greene says. They made the drug purer, so recipients had fewer bad reaction Continue reading >>
Why Treating Diabetes Keeps Getting More Expensive
Laura Marston is one of the 1.25 million Americans who suffer from Type 1 diabetes, an autoimmune disorder in which a person's pancreas can't make insulin. She hoards vials of the life-saving medicine in her refrigerator to protect herself from the drug's rising prices. (Jorge Ribas/The Washington Post) At first, the researchers who discovered insulin agonized about whether to patent the drug at all. It was 1921, and the team of biochemists and physicians based in Toronto was troubled by the idea of profiting from a medicine that had such widespread human value, one that could transform diabetes from a death sentence into a manageable disease. Ultimately, they decided to file for a patent — and promptly sold it to the University of Toronto for $3, or $1 for each person listed. It was the best way, they believed, to ensure that no company would have a monopoly and patients would have affordable access to a safe, effective drug. “Above all, these were discoverers who were trying to do a great humanitarian thing,” said historian Michael Bliss, “and they hoped their discovery was a kind of gift to humanity.” But the drug also has become a gift to the pharmaceutical industry. A version of insulin that carried a list price of $17 a vial in 1997 is priced at $138 today. Another that launched two decades ago with a sticker price of $21 a vial has been increased to $255. [This 90-year-old fight over insulin royalties reveals just how much has changed in medicine] Seventy-five years after the original insulin patent expired — a point at which drug prices usually decline — three companies have made incremental improvements to insulin that generate new patents and profits, creating a family of modern insulins worth billions of dollars. The history of insulin captures Continue reading >>
Here's Why Insulin Is So Expensive, And How To Reduce Its Price
She drew the life-saving medication into the syringe, just 10cc of colorless fluid for the everyday low price of, gulp, several hundred dollars. Was that a new chemotherapy, specially designed for her tumor? Was it a “specialty drug,” to treat her multiple sclerosis? Nope. It was insulin, a drug that has been around for decades. The price of many drugs has been on the rise of late, not just new drugs but many that have been in use for many years. Even the price of some generic drugs is on the rise. In some cases, prices are rising because the number of companies making specific drugs has declined, until there is only one manufacturer left in the market, leading to monopolistic pricing. In other cases, companies have run into problems with their manufacturing processes, causing unexpected shortages. And in infamous cases, greedy CEOs have hiked prices figuring that desperate patients would have little choice but to purchase their products. Then there’s the case of insulin. No monopoly issue here – three companies manufacturer insulin in the U.S., not a robust marketplace, but one, it would seem, that should put pressure on producers. No major manufacturing problems, either. There has been a steady supply of insulin on the market for more than a half century. And there haven’t been any insulin company executives I know of who have been hustled in front of grand juries lately. Yet insulin prices are rising to dizzying heights. In 1991, according to a recent study in JAMA, state Medicaid programs typically paid less than $4 for a unit of rapid acting insulin. After accounting for inflation, that price has quintupled in the meantime. What explains the gravity-defying cost of insulin? I am not an expert on pharmaceutical pricing, but a few factors go a long way to e Continue reading >>
Insulin Injections Vs. Insulin Pump
Are you considering switching from insulin injections to insulin pump therapy? Stacy O’Donnell, RN, BS, CDE, and Andrea Penney, RN, CDE, at Joslin Diabetes Center, give the pros and cons of each method. Insulin Injections Injections require less education and training than pump therapy. “Many people don’t realize the amount of work involved with pumps,” Penney says. “Using a pump requires professional training and close diabetes management.” Injection therapy is cheaper than pump therapy. Cons Low blood glucose levels can occur because you may be using different types of insulin. Frequent injections mean you may develop resistant areas of the body where insulin will not absorb properly. Insulin Pump Pros The pump delivers insulin continuously throughout the day, causing fewer sudden highs and lows in blood glucose levels. Insulin delivery is more accurate and precise. There will be less needle sticks. You may have one injection (hook up) every three days versus 15-18 injections in a three-day period with injection therapy, according to O’Donnell. Adjusting your own insulin allows a more flexible lifestyle. Cons There is a greater risk of developing diabetic ketoacidosis (DKA), however, O’Donnell believes this can be prevented. “Patients are testing blood glucose levels frequently and are also well-educated on what to do if this occurs.” It is attached to your body all day, reminding you and others that you have diabetes. Pump supplies are expensive. Continue reading >>
- Relative effectiveness of insulin pump treatment over multiple daily injections and structured education during flexible intensive insulin treatment for type 1 diabetes: cluster randomised trial (REPOSE)
- New diabetes treatment could eliminate need for insulin injections
- Smart Insulin Patch Could Replace Painful Injections for Diabetes
Is Insulin The New Epipen? Families Facing Sticker Shock Over 400 Percent Price Hike
Is insulin is the new EpiPen? In the last eight years, the average price per milliliter of insulin has skyrocketed by over 200 percent. But there's one major difference. If you can't get an EpiPen, there's a chance you might die. If your body doesn't have insulin, you certainly will die. "It feels like they're holding my kid ransom," said Tiffany Cara, whose son has diabetes. Only three major companies make insulin in the U.S. and each has steadily ratcheted up prices, sometimes in lockstep. Since 2004, the manufacturer list price for insulin, known as wholesale acquisition cost, is up by triple digits. Novo Nordisk's insulin Novolog is up 381 percent, Eli Lilly's Humalog is up 380 percent and Sanofi's Lantus is up 400 percent, according to data from Truven Health Analytics. That's sending some diabetic families into sticker shock. Six-year-old Dorian Carra loves to play outside his Texas home and dress up as a super hero. Specifically, Captain America, the World War II version. His mom says her outgoing boy has "never met a stranger." But four years ago he couldn't stay awake. He was breathing oddly. His parents brought his rag doll body to the E.R. Doctors said his blood sugar levels had spiked to 965 milligrams of glucose per deciliter of blood. A normal range is 80 to 140. The diagnosis was type-1 diabetes. The prescription was insulin, every day, for the rest of his life. Recently those treatment costs doubled after the Carra's health insurance company switched to cover another brand. Even though the brands are clinically the same, the new medicine isn't available in the dosages he needs, so they have to stick with the more expensive kind. Tiffany Carra, a thirty-two-year-old IT field support analyst, says it now costs them $1,880 a year for insulin and supplies. 6 Continue reading >>
Why Is Insulin So Darn Expensive?
The high cost of insulin is preventing a vast number of American diabetes patients from getting their blood sugar stable, Jeremy Greene, MD, PhD, professor of medicine and history of medicine at Johns Hopkins University, explained in a recent paper published in the New England Journal of Medicine. Dr. Greene told National Public Radio (NPR) that his patients’ blood sugar can be so out of control that “you can’t even record the number on their glucometer.” This lack of diabetes management is largely due to the fact that there are no low-cost or generic insulin options in the United States, NPR reported in a March 19, 2015 article. Insulin has been around for 90 years, a truth that shocked Dr. Greene and his colleagues since it can cost diabetics up to $400 a month despite its age. Insulin’s Animal Beginnings Insulin goes back to the 1800s, when scientists were beginning to understand the relationship between diabetes and damaged cells in the pancreas. But it wasn’t until the 1920s in Toronto, Canada that they extracted insulin from cattle pancreases and found they helped patients in a trial experience a speedy remission of symptoms. With these discoveries, cattle and pig pancreas extract was soon being sold on a large scale to diabetics throughout the world. But this animal-based insulin wasn’t the best form for everyone. Many needed multiple injections daily and experienced minor allergic reactions. Over the following decades, researchers began to make purer forms of the drug with better quality ingredients to stem the negative reactions and to reduce the number of injections required every day. In the 1970s, a new technique of creating insulin was pioneered using recombinant DNA technology, which put the human gene for insulin into bacteria and allowed fo Continue reading >>
Insulin Is Expensive Because The Government Makes It Expensive
The Washington Post had an interesting column by a doctor that discussed the difficulties his diabetic patients face dealing with the high cost of insulin. While the doctor, David Trigdell, does call for measures by the government to reduce the price that patients and insurers have to pay for the drug, he doesn't ask the most basic questions about why the price is high in the first place. This gets back to how the government finances medical research. To a large extent it relies on patent monopolies, and other types of monopoly rights, to pay for drug research. These monopolies are the reason that insulin is expensive. If it were sold in a free market, insulin would be cheap, and Dr. Trigdell's patients would have little trouble covering the cost. Of course, it is necessary to pay for the research, but there are other mechanisms. The most obvious would be for the government to pay for the research upfront as it is doing now in the case of the development of a Zika vaccine by Sanofi. (Unfortunately, in this case, the government is both paying for the research and planning to give Sanofi a monopoly on its distribution.) If drug research was paid for upfront it would have the benefit that all research findings would be fully open (that could be a condition of the funding) and there would be no reason for unnecessary duplicative research, as no one would have the incentive to try to innovate around a patent just to develop a copycat drug. I discuss this in chapter 5 of Rigged: How Globalization and the Rules of the Modern Economy Have Been Structured to Make the Rich Richer (it's free). Continue reading >>
Why Is Insulin Still So Expensive?
There is an excellent article in the March 19th, 2015 issue of the New England Journal of Medicine by Drs. Greene and Riggs entitled, “Why Is There No Generic Insulin? Historical Origins of a Modern Problem.” According to the article: 21 million people in the US have diabetes 6 million people take insulin for their diabetes (i.e. 29% of those with diabetes use insulin) The monthly cost for insulin without insurance is $120 – $400 The article describes how insulin was originally discovered in 1921 at the University of Toronto in Canada and the University subsequently licensed the patent to two pharmaceutical companies, Eli Lily in the US and the company that eventually became Novo Nordisk in Denmark. Both of those companies were then allowed to patent improvements in the manufacturing process. Those improvements have been dramatic. Original insulin was extracted from pigs and cows and had problems with impurity. Over time, the purification process improved, the absorption rates could be adjusted (to better regulate blood sugar) and eventually insulin could be ‘manufactured’ by genetically engineered bacteria so that it was much more pure and safe. However, each of these improvements extended the life of the patent. Older versions of insulin were not even available on the market. This dynamic may change in the near future as the Food and Drug Administration has approved the making of ‘biosimilar’ medications. Not to get technical, but because insulin is a ‘large biologic molecule’ it is essentially impossible to manufacture a ‘generic’ version of it that is exactly the same. However, ‘similar’ insulins that still act in the body in a similar fashion can be produced. It is these ‘biosimilar’ insulins that are now allowed to be produced. I am n Continue reading >>
Is My Test, Item, Or Service Covered?
How often is it covered? Medicare Part B (Medical Insurance) doesn’t cover insulin (unless use of an insulin pump is medically necessary), insulin pens, syringes, needles, alcohol swabs, or gauze. Medicare prescription drug coverage (Part D) may cover insulin and certain medical supplies used to inject insulin, like syringes, gauze, and alcohol swabs. If you use an external insulin pump, insulin and the pump may be covered as durable medical equipment (DME). However, suppliers of insulin pumps may not necessarily provide insulin. For more information, see durable medical equipment. Your costs in Original Medicare You pay 100% for insulin (unless used with an insulin pump, then you pay 20% of the Medicare-approved amount, and the Part B deductible applies). You pay 100% for syringes and needles, unless you have Part D. To find out how much your specific test, item, or service will cost, talk to your doctor or other health care provider. The specific amount you’ll owe may depend on several things, like: Other insurance you may have How much your doctor charges Whether your doctor accepts assignment The type of facility The location where you get your test, item, or service Continue reading >>
Why Are Diabetes Medications So Expensive And What Can Be Done To Control Their Cost?
Abstract PURPOSE OF REVIEW: The purposes of this study were to describe how medication prices are established, to explain why antihyperglycemic medications have become so expensive, to show trends in expenditures for antihyperglycemic medications, and to highlight strategies to control expenditures in the USA. RECENT FINDINGS: In the U.S., pharmaceutical manufacturers set the prices for new products. Between 2002 and 2012, expenditures for antihyperglycemic medications increased from $10 billion to $22 billion. This increase was primarily driven by expenditures for insulin which increased sixfold. The increase in insulin expenditures may be attributed to several factors: the shift from inexpensive beef and pork insulins to more expensive genetically engineered human insulins and insulin analogs, dramatic price increases for the available insulins, physician prescribing practices, policies that limit payers' abilities to negotiate prices, and nontransparent negotiation of rebates and discounts. The costs of antihyperglycemic medications, especially insulin, have become a barrier to diabetes treatment. While clinical interventions to shift physician prescribing practices towards lower cost drugs may provide some relief, we will ultimately need policy interventions such as more stringent requirements for patent exclusivity, greater transparency in medication pricing, greater opportunities for price negotiation, and outcomes-based pricing models to control the costs of antihyperglycemic medications. Continue reading >>
How To Get Insulin At A Cheaper Price
Insulin can be expensive. If you’re one of the 6 million Americans with diabetes relying on this main-stay treatment, you could be paying out-of-pocket costs anywhere from $120 to $400 per month, according to a 2015 New England Journal of Medicine commentary. Drugs such as Lantus (insulin glargine) and Levemir (insulin detemir) have seen significant cost increases, according to a recent trend report by pharmacy benefit manager Express Scripts. One reason for the high prices is the lack of generic options for insulin. So for now, you’re stuck having to search around to find affordable options. Where do you shop for more affordable insulin? For some people though, high drug costs can mean making difficult financial choices. Our national polls show people might cut back on groceries and paying bills to pay for their medications. To minimize your costs, consider these options: Prescription Assistance Programs If you don’t have health insurance or are without drug coverage, look into applying for a patient assistance program (PAP). Through the nonprofit NeedyMeds, you can find some programs that offer free or low-cost insulin as long as you meet the eligibility requirements. Those are usually based on your insurance status, income, and diagnosis. You might also qualify for a diagnosis-specific program that can help you save on syringes, pumps, and other diabetes supplies. Pharmacists are also a great resource and can help you find a PAP that meets your financial needs. Switch Drugs Another way to save is by asking your doctor whether there’s a lower-priced insulin that’s right for you. While “long-acting” is a more popular type of insulin, it's also more expensive, but that doesn’t necessarily mean it works better. “It’s mostly a marketing ploy,” says M Continue reading >>
Why Is Insulin So Expensive?
Why is Insulin so Expensive? The reason why insulin is so expensive is a loaded and complicated question. It wasn’t always this way. To understand how insulin pricing works, we must first look into the history of the drug itself. Insulin was created in 1922 and it was originally derived from animals. Around 30 years ago, researchers discovered biologic insulin and today it’s most commonly created from bacteria! This new form of insulin is better for diabetics to use because it’s closer molecularly to what we produce on your own (when compared to animal insulin). However, this had the effect of slowly but surely raising prices in the United States because it’s expensive to produce. The cost of insulin has tripled between 2002 and 2013, as more Americans are diagnosed with diabetes. Many people believe that with so many companies making the drug, prices should go down, but instead, insulin continues to be very expensive. Making Insulin Affordable The largest insulin manufacturers put the blame on increased insulin pricing for three main reasons. First, the cost rises because it is expensive to make and second because pharmacy benefit managers are raising the prices artificially. Lastly, and most importantly, blame is shifted to the complicated insurance reimbursement processes and confusing prescription assistance programs. An increased demand for insulin because of more cases of diabetes and higher insulin prices even raise insurance premiums for patients. Luckily, there is hope and you can offset the expensive insulin prices. The prescription assistance programs we work with provide quality and affordable access to insulin for diabetics across the United States. Trying to join the right prescription assistance program on your own is not easy because the paperwor Continue reading >>