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 >>
Medical Professionals Of Reddit, What's The Worst Piece Of Advice Your Patients Have Gotten From Dr.google?
Non-Americans of Reddit: What's a product you have in your country that would be a huge hit in the U.S.? A two week old infant was admitted to my hospital with severe jaundice, which at birth is normal. The mother, though, hadn't been breastfeeding the child because she read on the internet that breastfeeding is bad for babies. She decided the next best thing to do would be to feed the child a mixture of cornstarch and water because formula was "too expensive". Baby lived, magically. People, though. Man. Edit: yes, social workers and child protection were involved. almost as bad as Dr. Google, is Dr. Military Doctor. here's an ibuprofen for that broken leg oh you have kidney stones, here's an extra-strength ibuprofen hadn't been breastfeeding the child Well that's not so bad, there's formula feed the child a mixture of cornstarch and water because formula was "too expensive". Good gods, how did she remember to breathe Damn, I could write an essay on this. Any herbal/supplement bullocks. For an example: When you first get out of school you have to put many hours in, specifically at health clinics. You have no ideal how dumb people are. One guy said he saw online that taking a knife to his goiter and draining it and cleaning it would be a good ideal. Drinking sugar water with salt "to make Gatorade" would help with "electrolytes" that would help his high blood pressure. I can go on. Suppose the worst was a man with dementia and was told that he had to spend 5000 for a prayer to cure him. They did it twice to him, because he forgot he gave the first time. Suppose the worst was a man with dementia and was told that he had to spend 5000 for a prayer to cure him. They did it twice to him, because he forgot he gave the first time. That's an impressive level of evil. My good fr 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 Sequencing A Human Genome So Expensive?
One of my readers asked: Why does genome sequencing cost so much? My short answer is because it's big. But I thought it would be fun to give a better answer to this question, especially since I'm sure many of you are wondering the same thing. Okay, so let's do some math. Don't worry, this math isn't very complicated and I'll explain where most of the numbers come from. Estimating costs from salaries First, we'll take the easy route. My experience with grant budgets has taught me that the greatest cost for any project comes from salaries. If we look at the PLoS paper with Craig Venter's genome sequence, we can see that there are 31 authors. That's a lot of people! And, they probably all got paid. I think it probably took at least a year to do the sequencing and analyze the data. So, let's say that we paid all those 31 people for one year. If we said that their average salary was $50,000 per year (Of course, JCV and Robert Strausberg probably made much more and any graduate students made much less, but still on average, I think this is close.), and their benefits are 25% of their salary, the cost in human labor would be: 31 x [$50,000 + (0.25 x $50,000)] = $1,937,500. Aren't you forgetting overhead? Oh, yeah. Well, I tried, but I'm never able to get with that. In grants, Universities and non-profit institutions charge additional costs for overhead. Some universities and non-profit research institutions charge as much as 90% of salaries, some places charge less. If we're conservative and say that overhead costs were 50% of salaries, this would be another $775,000 [ this comes from 0.5 x 50,000 x 31]. Now, the cost for doing Craig's genome is up to $2,712,500 and we haven't even bought supplies. We would still need to factor in the cost of the facilities, sequencing instrum Continue reading >>
Basaglar, An Insulin ‘follow On,’ Prepares To Do Battle With Lantus
In December, Eli Lilly and Boehringer Ingelheim became proud parents, launching a new insulin product into the world. They dubbed it Basaglar, and it bore a striking resemblance to Sanofi’s Lantus, the world’s top-selling basal insulin. Whether Basaglar can be deemed a biosimilar is a question that veers into the arcana of FDA approval pathways. But there is no doubt that Basaglar is coming on the scene during tumultuous times for insulin products. Manufacturers are under attack for price hikes. There are allegations of backroom rebate deals. And a class-action lawsuit has been brought on behalf of uninsured patients, charging insulin makers with setting artificially high prices. But turmoil can open windows of opportunity. Industry observers say the timing could be perfect for Basaglar, a cheaper rival to one of the best-selling insulin products on the market. Payers would love to see some downward pressure on insulin prices. So would the millions of Americans with diabetes who have difficulty paying for their diabetes medications. But any kind of Basaglar effect on prices and expenditures may be brief and modest. Eli Lilly, Novo Nordisk, and Sanofi, the three companies that dominate the market for diabetes drugs, continue to roll out new products. This steady stream benefits some patients but it also swamps payer budgets. Diabetes was second only to inflammatory conditions on the list of the most expensive therapeutic classes in Express Scripts’s 2016 Drug Trend Report (see below), and insulin products account for 40% of the diabetes drug spend, according to the PBM. Per-member, per-year spend for the top 10 drug therapy classes, 2016 Top 5 diabetes drugs by market share The billions spent on diabetes medications each year in the United States is an equation tha Continue reading >>
Lawsuit Accuses Drug Makers Of Conspiring To Hike Insulin Prices
More than 29 million Americans live with diabetes, and for some six million of them, insulin is a life or death medication. Between 2002 and 2013, the price of insulin more than tripled, to more than $700 per patient. A federal lawsuit accuses the three insulin manufacturers of conspiring to raise their prices. The drug makers deny the allegations. Those high prices, combined with rising insurance deductibles, mean many people who rely on insulin are feeling sticker shock. Even doctors say without a way to pay, some patients are left facing impossible choices, reports CBS News correspondent Anna Werner. Contact us about this issue or other consumer problems you think we should look into at [email protected] A cell phone video shows Dr. Claresa Levetan talking to her patient Shawna Thompson back in the hospital because she couldn’t pay for her insulin. “One vial of insulin costs how much for you?” Levetan asked. “One hundred and seventy-eight dollars,” Thompson responded. It was the fourth time in just over a year that Thompson had to be treated for a life-threatening diabetic coma. “Patients come in and say I can’t afford to take it, so I’m not,” Levetan said. She said it’s common for her now to hand out free drug company samples of insulin, just so patients can stay on their lifesaving medication. “Patients are begging for samples because they can’t afford the insulin,” Levetan said. “Not asking, you’re saying, begging,” Werner said. “Begging,” Levetan said. Like 74-year-old Kathleen Washington. Some months, her insulin runs over $300 a month – more than she can afford. “I must pay my mortgage,” Washington said. If it’s a choice between the mortgage and the insulin, “It’s going to be the mortgage,” she said. Investm Continue reading >>
What To Know About Insulin Jet Injectors
Introduction Insulin jet injectors can allow people with diabetes to inject insulin without using a needle. However, many people shy away from these small devices because they can be expensive and complex to use. Read on to learn how they work and their pros and cons. Using a jet injector Insulin jet injectors typically contain three parts: the delivery device (shaped like a pen) a disposable injector nozzle a disposable insulin vial adapter The tiny opening at the end of the disposable injector nozzle usually measures less than 0.009 inches in diameter. This is the same measurement as the 32-gauge needle used in current insulin syringes. How you use it You load the pen by filling the insulin adapter with insulin. Once the device is loaded, you set the gauge to your prescribed insulin dose. Then, you place the device against your skin, typically in an area with some fatty tissue. A good spot could be your stomach, the front or side of your thigh, or the upper, outer section of your buttocks. When you press the button, the jet forces a high-pressure stream of insulin through the very tiny hole at the end of the disposable injector nozzle. The insulin turns into a vapor that passes through the outer layer of your skin. It then moves through the lower layers of your skin and into your bloodstream. How it works Insulin jet injectors use a compressed spring or a compressed gas cartridge to create the pressure to send the insulin through the pen into your skin. Compressed springs are used more often. They’re lightweight, small, durable, and inexpensive. Compressed gas cartridges typically contain either nitrogen or carbon dioxide. They can produce more pressure than compressed springs, but they cost quite a bit more, weigh more, and need to be replaced more often. Are there Continue reading >>
Foxo4 Peptide Reddit
Foxo4 peptide reddit screening using as a model for beta-amyloid peptide Lifestyle-induced metabolic inflexibility and accelerated ageing syndrome: insulin resistance, friend or foe? Reddit; Email; Abstract. Reduced expression of p21 allows Cdk1 to phosphorylate free p53 (at serine reddit. But it's still early days. Physiological Reports Published 15 April 2015 Vol. longecity. Blockage of chemotactic peptide-induced stimulation Activation of Forkhead Box O Transcription Factors by Oncogenic BRAF we show a role for FOXO4 in Host Immune Defense Peptide LL-37 Activates Control of cell number by Drosophila FOXO: downstream and feedback regulation of the insulin and FOXO4 (Burgering and Kops the Drosophila insulin-like peptide Peptide boronic acids thus resulting in FOXO4 The data file lists recent patent applications related to inhibitors in the ubiquitin proteasome A peptide inhibitor of c-Jun N-terminal kinase protects against excitotoxicity and cerebral ischemia. This is an archived post. Here is the study Researchers designed a cell-penetrating peptide (CPP) called Drug 'reverses' ageing in animal tests. . IGF - Go-sha-jinki-Gan (GJG), a traditional Japanese herbal medicine, protects agains Peptides RSS FFEDS The hookworm 14-3-3 lacks a secretory signal peptide Association of Forkhead Transcription Factor FOXO4 with 14-3-3 Proteins and on Reddit; Other Actions. Reddit; Email; Abstract. Reddit; StumbleUpon; Tools to eliminate senescent cells. The modified version does not have the DNA-binding domain of the endogenous FOXO4 protein that causes up-regulation of p21 when bound to p53. In mice, the FOXO4-derived peptide counteracted doxorubicin-induced chemotoxicity and restored I hope this guy realises the idea is only to periodically kill of the senescent cells not take it Continue reading >>
- Peptide Immunotherapy for Type 1 Diabetes: A Promising New Treatment
- Effects of Insulin Plus Glucagon-Like Peptide-1 Receptor Agonists (GLP-1RAs) in Treating Type 1 Diabetes Mellitus: A Systematic Review and Meta-Analysis
- Microneedle-array patches loaded with dual mineralized protein/peptide particles for type 2 diabetes therapy
How To Afford Really Expensive Diabetes Medication
This Diabetes Education UPDATE focuses on a patient advocacy area called, “how to afford REALLY expensive medication” For people with type 2 diabetes, metformin and sulfonyrea like glimepiride or glyburide are cheap meds ($4 list), however, after that the diabetes medication cost skyrockets. Oral pills like Januvia or Tradjenta can be $200-300 per month, injectable meds like bydureon, tanzeum, or trulicity are $500 a month, various insulins like lantus/levemir or humalog/novolog can be $300 or more per month EACH, recently a patient’s monthly insulin bill before insurance was $2000/month, after insurance it was “only” $648/month. These meds aren’t including the price for test strips that can often be $50-200 month depending on how often they test. Oh yeah, what about lab costs? Office visits? Education? and that many people with diabetes will also have other chronic illnesses they are treating such as cholesterol, blood pressure, mental health, and etc. My focus here is to help these people get the medication they need at an affordable price, most of the time we can figure something out. As diabetes educator, I make it a point to “be in the know” with various opportunities, some insurance companies cover other meds in the same class better, people with medicaid have specific covered meds to help with cost, same with medicare, and people with commercial insurance can utilize copay cards that suddenly take a $600 med bill down to $0-25 bill, which is ALOT easier, the patient will be less stressed, the patient will be more compliant, the patient will probably be more loyal to our facility, and the patient will most likely be better controlled and healthier. I urge any of you that hear of a patient with diabetes that is struggling to pay for the meds or take Continue reading >>
What You Need To Know About Feline Diabetes
Guest post by JaneA Kelley November is Pet Diabetes Awareness Month, and with diabetes on the rise in cats and dogs, it’s important to know the facts about this disease and how to manage it. I’m going to focus on feline diabetes because it’s a topic I know quite a bit about, having adopted a diabetic kitty and gotten her into remission. You’ll also notice that I’ve included the gray ribbon, the symbol of diabetes awareness, with all the photos in this post. You probably know diabetes as a disease associated with sugar, and that’s sort of right, but let me start out with some background information. What is diabetes? When a cat eats sugar or carbohydrates, a gland called the pancreas secretes a hormone called insulin. Insulin is crucial in turning sugar and carbohydrates into energy the body can use. In diabetes, one of two things happens: Either the pancreas doesn’t produce enough insulin (Type 1 diabetes), or the pancreas produces insulin but the body doesn’t know how to use it (Type 2 diabetes). What causes diabetes? Most cats have Type 2 diabetes, and this is primarily brought about by obesity. According to a recent study, 58 percent cats are overweight or obese. That’s a lot of cats at higher risk of getting diabetes. Steroid use can sometimes cause transient diabetes – that is, diabetes that goes away after the medication is stopped. A few cats also have other disorders such as acromegaly that can cause diabetes. The most commonly noticed symptoms are polydipsia (drinking excessively) and polyuria (peeing excessively). Another common symptom is weight loss despite a large appetite. As the cat’s blood glucose increases, he can become lethargic and depressed; this is the precursor to a condition called diabetic ketoacidosis (DKA), which requires Continue reading >>
9 Reasons Why Trim Healthy Mama Is Right For Me
I remember the thought that went through my head at the precise moment I was handed Trim Healthy Mama for the first time: “Any plan with a name like this just isn’t for me!” I mean really, I’m a feminist in the truest sense of the word, I’m not really into rabbit food, and reading an honest to go paper book? This was not happening. But my Trim Healthy Mama journey has been one of the best things I’ve ever done. It’s helped me shed weight, have more energy, eat and exercise more, and so many other things. Here are some of the reasons why Trim Healthy Mama was right for me: I Love Food. As I’ve gotten older, I’ve realized that there’s no sense in denying it. I just really like food. An while I might want to be skinny, and be strong, I’m not willing to do it at the expense of food. My husband gets to eat all of those delicious, indulgent foods, so why should I deny them myself? I shouldn’t, and Trim Healthy Mama doesn’t make me. I can still have steak, butter, chocolate, and fruit. Even if those aren’t your favorites, don’t fret, because you can have your favorite foods! It Seems Sustainable I’ve tried Paleo, I’ve tried only eating 1,200 calories a day, I’ve tried doing low-carb, and of course I’ve tried eating basically only protein. And while those diets may work short – term, in the back of my mind I knew that they weren’t sustainable. They were either too expensive, didn’t taste good enough, or the long term effects of them would not be good for my health. I knew that they weren’t sustainable. Not only does THM get results, it is a lifetime plan, something I can do without denying myself any of the food groups, still eating dessert, and that doesn’t cost a fortune. It’s Made For Women Sorry guys! I know you may want to Continue reading >>
Science Ama Series: Hi Reddit! I Am Dr. Karin Hehenberger Md Phd, And Founder And Ceo Of Lyfebulb. I Am Here Today To Talk About How We Are Working On Improving The Quality Of Life For People Living With Chronic Disease. Ask Me Anything!
When I was a health volunteer in the Peace Corps I routinely came across villages where in a population of ~100 there were sometimes upwards of 10% of people who had an amputated foot and rates of diabetes and hypertension ~40-50%. Trying to do awareness campaigns in these hard to reach and painfully apathetic villages felt like a Sisyphean task. What is going on in the world of diabetic research/innovation that would impact these people? PHealthy This is a major problem since 80% of all people living with diabetes are located in the developing world, where resources are scarce and access to care minimal. Education and different programs to raise awareness in the general population as well as to targeted groups such as relatives to those with disease are ongoing, but we need to do much more. I believe in public efforts but also in large non profits who can mobilize money and talent from the Western world. Another big player is the pharmaceutical industry - although they may not make as much money on each patient as in the US, they do have programs in the developing world where they provide drugs and even solutions for free or less money. Together with the government, these kind of public private partnerships can make huge differences in outcomes for these individuals My boyfriend has a genetic illness that has less than 100 known cases in North America and finding anyone that can help him has been frustrating and expensive. What can done to increase the options and quality of treatment for rare conditions? SliferTheExecProducr It can be hard to access care and expertise for people with Orphan diseases but there are some great examples such as Alexion pharma and others where whole companies have been based on these conditions. For the individual who is suffering it is ke Continue reading >>
Story On Npr About The Price Of Insulin In The United States
5745 SW 75th Street, #116 Gainesville, Florida 32608 (352) 327-8649 [email protected] Part of the mission of IFL USA is to provide emergency aid in times of disaster. We strive to assure that we maintain an adequate supply in reserve so that we can respond immediately when disaster strikes. This aid includes insulin, test strips, meters, glucagon kits, and other supplies. Your ongoing consistent support enables us to be a resource to those in need. Continue reading >>
- Incidence of End-Stage Renal Disease Attributed to Diabetes Among Persons with Diagnosed Diabetes United States and Puerto Rico, 20002014
- Prevalence of diabetes and prediabetes in 15 states of India: results from the ICMR–INDIAB population-based cross-sectional study
- States investigate pharma companies, CVS Health as diabetes drug prices reach record highs
If Low Carb Eating Is So Effective, Why Are People Still Overweight?
I find myself getting asked this question, or some variant of this question, with increasing frequency as I speak and write about the Alternative Hypothesis I find most compelling surrounding obesity and chronic disease. One implication of the Alternative Hypothesis, as you probably understand by now if you’ve been reading this blog, is that many carbohydrates, especially if consumed at the levels most Americans consume them, promote fat gain. In other words, overweight people are not the lazy, constantly grazing, weak-willed individuals many in the mainstream have led us to believe. They just eat the wrong foods (rather than simply too much food). Remember, I was one of those doctors in the mainstream once upon a time. While I always tried (and hopefully succeeded most of the time) to treat overweight patients with respect, I silently judged them. Why can’t you just eat less and exercise more? Only when I realized, despite my diet which rigorously adhered to formal recommendations and my 3 to 4 hours of exercise per day, that even I was getting too fat for comfort, did I begin to question the Conventional Wisdom of why we get fat. Of course, not everyone (fortunately) was born with my level of genetic susceptibility to insulin resistance (stated another way, not everyone is born with my level of carbohydrate sensitivity). In my experience, about 10-20% of the population (my lucky wife included) seem resistant to carbohydrates and maintain exquisite insulin sensitivity, almost independent of diet. Roughly 30-40% of the population are, conversely, very sensitive to carbohydrates and appear to be quite insulin resistant until nearly the last gram of sugar and most carbohydrates are removed from their diets. Then there is the rest of population, which includes me. To v Continue reading >>
Why Is Veterinary Care So Expensive?
If I had a dollar for every time someone asked me this question, I’d be a wealthy woman! What most people don’t realize is that, relatively speaking, veterinary care, especially when compared to human healthcare, is actually not at all unreasonable. As a former veterinary hospital manager, I can give you some behind the scenes insight into what makes up the cost of veterinary care. Your cat’s veterinarian is not just your cat’s “family doctor” Your cat’s vet is also her surgeon, radiologist, dentist, dermatologist, neurologist, ophthalmologist, psychiatrist, ears/nose/throat doctor, and pharmacist, all rolled into one. I’ve always felt that a veterinarian’s training and schooling is far more rigorous and complex than that of a physician. Not only can their patients not talk to them and tell them what’s wrong, but they have to study more than one species. During the first years of veterinary school, students also have to study large animal medicine, even if they know they’re never going to practice it. And even within the small animal track, there are multiple anatomies and disease processes to learn for each species, be it cats, dogs, ferrets, rabbits, or even scaly critters. A veterinary clinic is a business Just like any other business, veterinarians have to deal with overhead. They have to pay rent, utilities, and staff salaries. They have to purchase supplies, medications and equipment. They have to pay for laboratory analysis by an outside lab, or maintain an in house laboratory. Myth: veterinarians get paid a lot of money Trust me, nobody goes into veterinary medicine for the money. The average veterinarian graduates with a whopping $150,000 in debt. The average veterinary salary in 2011 was $55,000. By comparison, the average physician salar Continue reading >>