Epipen Is Not Alone – Lantus And Other Insulin Top The Price Charts
The increase of EpiPen prices has dominated the media for the past two weeks, but there’s another pricey injectable lifesaving prescription drug that nobody is talking about and is used by millions of Americans every day – insulin. Insulin is a drug that is used every single day by most Type 1 diabetic Americans to help control the effects of diabetes. Insulin Price Increases According to a report from the Alliance of Community Health, between 2010 and 2015 the average price for six diabetic drugs, including four types of insulin, increased by over 160%. Over a decade earlier, in 2002, a patient could purchase insulin for $213 per month. In 2013, that same insulin cost $736 each month. According to Marissa Howell, a single mother of a daughter who has Type 1 Diabetes, the cost is actually around $850 every month for insulin, alone. This does not include other expenses associated with diabetes like diabetic testing supplies, pump supplies, alcohol wipes, glucagon, etc. “The cost of having Type 1 Diabetes is outrageous,” said Howell. “In the past, I have had to forego paying other bills so that I could afford to pay cash for prescriptions. Unfortunately, there’s not a ‘payment plan’ at pharmacies.” Help from Rx Advocacy Luckily, in the past year, she’s only had to pay $50/month for all of her daughter’s insulin. She joined a prescription assistance program called Rx Advocacy by LowestMed. She applied and was accepted within a month. It’s different than most prescription assistance programs, because there is no insurance or income limitation. You can have insurance and still qualify; you can have a high income and still qualify. The Rx Advocacy program is not limited to insulin prescription drugs, but can help with nearly all FDA-approved drugs, inc Continue reading >>
Ways To Save Money On Insulin
This week I received an email from a customer and diabetic pet owner asking if veterinarians are in collusion on making insulin so pricey. I promise you, we are not! Shoot, most of the insulins I prescribe these days (Glargine, NPH, Levemir) I have owners get at their own pharmacy. We veterinarians don’t have a whole lot of say in the price of insulin. Nonetheless, we often are left pondering the costs of things. Just this week I had a load of dirt delivered to my house to fill in ruts made in my yard by a cement truck when I had my driveway repaired. I believe that is probably the most unappealing way I’ve spent $175 in a very long time. And then I got to shovel and wheelbarrow the expensive dirt into the ruts. During that exercise, I got to spend several hours shoveling and wondering how that pile of dirt was worth so much money! Enough grumbling about the price of my dirt and back to the costs of insulin… One reason I prefer owners get insulin from a pharmacy is that diabetes is relatively common in humans. Pharmacies will have to be price competitive to get your business. Additionally, when I have ordered a particular insulin for pets (say if I inherited a patient who was on PZI or Vetsulin) sometimes owners may then not want it for some reason. I’m stuck with the choice of keeping product in the clinic fridge that may expire or shipping it back to the manufacturer on ice. Honestly, I prefer having owners get their insulin from a pharmacy! Now, before you think I’m against Vetsulin or PZI let me tell you I’m not. They are great insulin choices! I’m just personally accustomed to using Glargine as my “go to” insulin for cats and I got out of the habit of using Vetsulin for dogs when it went off the market a few years ago. Today I’m going to share m Continue reading >>
Soaring Insulin Prices Prompt Insurance Shift
Since 2002, the cost of insulin has increased by almost 200 percent, according to a new study.Video provided by Newsy Newslook Corrections and clarifications:This story has been updated to reflect fact that Basaglar can’t be used in an insulin pump. Many parents of diabetic children and adults suffering with type 1 or type 2 diabetes are bracing for changes in insurance coverage of their insulin next year, as prices of the vital medication continue to soar. Higher insurance deductibles and changes in the prescription brands covered by some insurers are raising concerns among some people with diabetes. CVS Caremark, a pharmacy benefit manager (PBM), will no longer cover the insulin brand Lantus in favor of a new biosimilar version, Basaglar. Biosimilars are considered the generic versions of "biologic" drugs that are based on natural sources. The company also announced a program last week to further keep diabetes costs down, following a similar move in August by competitor Express Scripts. Diabetes is an epidemic in the United States, affecting nearly 10% of the population or about 29 million people, according to the Centers for Disease Control and Prevention. Of those, more than 8 million people are undiagnosed. Type 1 diabetes — often still called juvenile diabetes — can occur when people are children or adults. Type 2 diabetes is becoming more common with the increase in obesity and sedentary behavior. Prices for Humalog and many insulin brands have increased from about $300 to $500 between January 2013 to October 2016, according to drug discount search company GoodRx. Lantus increased about 60% — from $240 to $380 — in the same time period, GoodRx says. (Photo: T1D Exchange) "It’s definitely unfortunate prices are going up so much and impacting the people Continue reading >>
When You Can't Afford The Insulin That You Need To Survive | How To Use The Cheap "old-school" Insulin
Note: BootCamp for Betics is not a medical center. Anything you read on this site should not be considered medical advice, and is for educational purposes only. Always consult with a physician or a diabetes nurse educator before starting or changing insulin doses. Did you know that all type 1 diabetics and some type 2 diabetics need injectable insulin in order to live? Put another way, if a diabetic needs insulin in order to live, and the diabetic does not get insulin, the diabetic will die. Diabetic death from Diabetic Ketoacidosis is a grisly process, during which acid starts running through your bloodstream, searing your vessels and organs while your body shrivels up in dehydration as it tries to push the acid out of your body through your urine and lungs, and, left untreated, the condition shuts down your organs one by one until you are dead. If you're lucky, your brain will be the first thing to swell itself into a coma and you'll be unconscious for the remainder of the organ failures. In some cases, this grisly diabetic death can take a few days or weeks to complete its process. Or, if you're one of the luckier less-resistant insulin-dependent type 2 diabetics, you may actually get away with staying alive for quite a few years and suffer only some heart disease, stroke, kidney damage/failure, neuropathy, limb amputations and blindness. (my intent in describing how lack of insulin leads to death is not to cause fear in people with diabetes or their loved ones; rather, my intent is to make clear the reality that injectable insulin is absolutely vital to diabetics who depend on injectable insulin to live) While I'd love to go off on a political rant about how insulin should be a basic human right for all insulin-dependent diabetics (and why the hell isn't it?), that' Continue reading >>
Relion Insulin: Everything You Need To Know
For my patients who have no insurance, ReliOn products at Walmart are a lifesaver. In North Carolina, we never funded Medicaid expansion. Some people could receive Obamacare through the federal marketplace, but others were left in the gap where it was too costly for them. The tax penalty was less, so they took the penalty instead of buying coverage. For those with Type 1 and Type 2 Diabetes in the no insurance gap, for those in the “Medicare donut hole,” and for those in disaster situations, ReliOn insulin is available at a very affordable cost. If you want insulin at a cheaper cost, it is important to be aware of some of the differences between ReliOn insulin and name brand insulins. Renee’s story Renee had Type 1 Diabetes, and couldn’t afford her insurance coverage here in North Carolina. After running her insurance cost numbers on the Federal Marketplace, she would have to pay $300 per month for catastrophic coverage that wouldn’t even cover her diabetes medications. Her husband had lost his job, and she worked at a grocery store, where she didn’t make a living wage, or have any insurance benefits. She came in crying. She needed help, because she had lost her insurance coverage, and she was about to run out of her insulin. She was afraid of what might happen to her, and what might happen to her little boy, if she ran out of her insulin. We referred her to a social worker who could help her with needed resources, and see if she could qualify for Medicaid, or start social security disability determination so she could get insurance when determined disabled. In the meantime, we spoke with her doctor, and he gave us conversion doses for Renee to switch to the ReliOn brand of insulins at Walmart. She had to take a combination of ReliOn Humulin N injections twi Continue reading >>
The Best Ways To Save On Cat Insulin
If your cat has diabetes, you are probably familiar with insulin -- the hormone that regulates glucose levels in the blood. You are probably also familiar with just how expensive this drug can be. Fortunately, there a number of ways to bring down the cost of this important treatment. Here are some tips for saving on cat insulin. Typical Cat Insulin Costs Your cat’s insulin can cost anywhere from $30-$150. The price will vary depending on if you decide to buy from your veterinarian, from an internet retailer, or using a pharmacy benefits plan. The price will also depend on whether you purchase a brand name or generic drug. Many pet owners don’t realize that they don’t have to buy their pet’s medications from their veterinarian. Because of this, many people end up spending on an arm and a leg on insulin when they don’t have to. Veterinarians and clinics generally markup their medications anywhere from 100% and 160%, and most also charge a $5 to $15 dispensing fee.* Buying medication online is a much more affordable option. Internet retailers keep prices low by buying medications in bulk and having fewer administrative costs. If you decide to order insulin online, it will require special packaging and overnight shipping to ensure that it stays cold, and this can sometimes mean higher shipping costs. Even so, buying insulin online will probably still be cheaper than buying from your veterinarian. Buying Brand Name vs. Generic Insulin A common misconception is that generic drugs don’t work as well as those with brand names. In reality, generic drugs contain the same active ingredients and have the same medicinal effects as their brand name versions. The only reason they cost less is because the manufacturer of the generic product did not have pay for the developm Continue reading >>
Lantus
Lantus glargine by Aventis long-acting analog U100 Special, pH 4 Line new molecular entity Also known as Glargine (generic) Similar to Levemir, PZI[1] ultralente, Ultratard (duration) Action in cats varies by animal onset variable, asymmetric peak 5-14h (4-20 h as per Nelson)[2] duration 9-24h (10-16 h as per Nelson)[3] Action in dogs onset inconsistent, peak 0.5 to 6 hours, inconsistent, duration about 13hr but inconsistent-beef/pork PZI has longer duration (10-16 h as per Nelson)[4][5][6] Use and Handling Type clear Shelf Life refrigerate, until date on package When opened 28 days at room temp, up to 6 months when stored in the refrigerator (2C to 8C)[7] In pen 28 days at room temp Notes protect from light and heat do not mix with other insulins do not dilute do not prefill syringe discard if precipitate or cloudiness discard if frozen Do not use intravenously[8] Do not use intramuscularly[9] Lantus is the brand name for insulin glargine, an insulin analog made by Aventis[10]. Lantus is a very long-acting insulin (lasting up to 24 hours in humans) that uses pH reactions to form micro-precipitates under the skin, which create a time-release action. Because of cats' faster metabolism, long-acting insulins like Lantus (and perhaps Levemir) are gaining a good reputation in veterinary research for regulating cats for a full 12 hours at a time, often better than some of their shorter-acting cousins. Proponents of Lantus in feline use point out that it lasts a full 12 hours in many cats, has a very gentle onset, a negligible peak, and (some claim) less chance of triggering hypo or rebound than faster-acting insulins. The famous Queensland University studies[11] showed that a simple protocol (in a 24-hour monitored, veterinary environment, with a Low-carb diet) could bring ma Continue reading >>
The Real Reason Insulin Is So Expensive
Insulin costs continue to rise and this is unfortunate considering millions of people desperately rely on it. Insulin is the hormone in our body that allows glucose (sugar) to get into the cells of our body that need glucose for energy. Produced in the pancreas, insulin is considered the “most powerful” hormone in the body. It was first discovered in 1922 and first derived from pigs and cows. In an article published by Estay Greene, director of pharmacy programs at Blue Cross Blue Shield’s North Carolina, Greene explains that about 30 years ago insulin manufacturers eventually created biologic insulin that saved us from our reliance on animals for insulin and brought huge improvements in insulin quality. He writes, and this is a fun fact, that “most insulin is made from E. coli bacteria.” These new insulin are much more similar to what we produce naturally as humans but they are incredibly expensive. The cost of insulin has been consistently rising throughout the life of a now 14 year old, tripling in fact, between 2002 and 2013. This isn’t quite the case for other countries outside the United States, however, so what is happening here that is causing Americans to pay so much? Has Competition Been a Negative Factor? Greene writes that “In the 95 years since insulin was developed, a number of drug companies have been making and selling it. But even with all those companies making insulin, competition hasn’t resulted in lower prices – it’s had the opposite effect. In fact, some brands of insulin have seen prices increase by more than 150 percent in the last five years alone.” He explained that “these price increases can spread like wildfire” with any competitors raising their prices in step with one another. Senator Bernie Sanders along with Repr Continue reading >>
A 93-year-old Drug That Can Cost More Than A Mortgage Payment Tells Us Everything That's Wrong With American Healthcare
A person administers an injection of insulin. AP Insulin has been around since 1923, so it came as a surprise in July 2015 when Cole LePere's doctor told his mother, Janine, to prepare to pay a lot at the pharmacy for it. Cole, who was 10, had just been found to have Type 1 diabetes. But even the pharmacist was shocked to see the price. Over and over, the pharmacist told Janine LePere, "This is really expensive." Each time she would respond, "I know, thanks, but I still need the medicine." The pharmacist finally gave the LePeres the supplies — and a bill for $1,550. That was after a $350 coupon. As lawmakers and the public scrutinize dramatic price increases for other old drugs — most recently with the Mylan-owned EpiPen, which saw its cost go up by 500% in the past nine years — the next flash point may be insulin, a drug both ubiquitous and complicated. And the story of why the LePeres are now paying as much as their mortgage payment on insulin, even though they have insurance and even though there are competing drugs on the market, is really the story of what has happened to the healthcare industry in America since the start of the century. The need for insulin The human body produces its own insulin. Some people can't. When he got the diagnosis, Cole LePere found himself one of nearly 29.1 million Americans known to have one of the two types of diabetes. Cole's kind, known as Type 1, is an autoimmune disease. His body mistakenly kills so-called beta cells that are supposed to make the body's insulin, a hormone that helps people absorb and process the sugar in food. The roughly 1.25 million people in the US who have Type 1 diabetes need to inject insulin to live. Type 2 diabetes, the more common form, is something that develops either based on genetic or lifesty Continue reading >>
- What a Cool Animation! Tells You Everything You Need to Know About The Basics of Diabetes
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- Researchers develop contact lens that tells people with diabetes when they need to take medication
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 >>
How Do I Get Lantus Insulin Less Expensively?
November 2, 2013-- How do I get Lantus Insulin Less Expensively? DCIN receives this question a few times a week from US caregivers of diabetic cats. I am often amazed by the question because of the “good” insulins for diabetic cats, Lantus can be the least expensive per unit. The problem often lies in knowing how to find the insulin inexpensively. (The hints I give also apply to Levemir, another human insulin often used by diabetic cats.) Your vet gave you a prescription that probably read “U100 Glargine/Lantus 10ml vial.” Lantus is the brand name for the generic insulin Glargine. Lantus is an insulin for humans and is only available from a human pharmacy (although some vets do hold some in stock). The company Sanofi makes Lantus, and no other companies currently make a generic Glargine because Sanofi still has an international patent on the insulin. That may change in 2014, and by then Sanofi may have developed a “second-generation” Lantus that is patent protected. Lantus is a U100 insulin, which describes the concentration of the insulin in the liquid suspension. A 10ml vial is the insulin’s containment device. It is a small glass bottle with a rubber stopper at the end that you pierce with a syringe. At a US retail pharmacy, a 10ml vial of Lantus can cost about $180 to $200. WOWZA! That does seem cause for sticker shock. A 10ml vial of U100 insulin holds 1000 units of insulin. At $200/vial, that is a price of $.20/unit. If your cat gets 2 units of insulin twice a day, that is $.80/day for its insulin (if you could completely use a vial of Lantus insulin). It would cost less each day to give your cat its life-saving medicine that to buy a soda from a vending machine. However, the problem with buying Lantus in a 10ml vial is that, properly handled, Lantus Continue reading >>
Price Tag On Old Insulin Skyrockets
Retired nurse Mary Smith was having trouble controlling her type 2 diabetes on her regular insulin regimen, so her doctor decided to put her on something stronger. Amber Taylor, MD, director of The Diabetes Center at Mercy Medical Center in Baltimore, wrote Smith a prescription for Humulin U-500 insulin, a much more concentrated form of the drug. It could deliver far more active ingredient at far less overall volume, which was important since Smith's insulin doses were getting high. But when Smith showed up at the pharmacy, she was told she'd have to shell out $900 for a vial. "There was no way I could afford that," Smith told MedPage Today as she recalled the pharmacy visit, which happened about a year ago. And the price has gone up since then: Now a single bottle of highly concentrated Humulin U-500 insulin that lasts a diabetes patient about one month costs $1,200 wholesale -- more than five times the $220 it cost in 2007. Those increases have far surpassed those for the less concentrated Humulin U-100, which only rose three times during that period, at a rate comparable to the rest of the insulin market, a MedPage Today analysis found. Although less than 5% of all diabetes patients are taking U-500, Taylor and other clinicians are wondering why an old insulin that had been on the market for many years and had remained relatively cheap suddenly became a valued commodity. "I've had patients with a $2,500 deductible who can't put down $1,200 for a bottle of insulin," Taylor told MedPage Today. "For them, it's pay the mortgage or buy my insulin -- what do you want me to do?" An Old Drug With a High Price Tag Insulin is an old drug. Eli Lilly first put it on the market in 1923, and its more concentrated U-500 formulation, which was made from beef pancreas, appeared in 19 Continue reading >>
Why Is Insulin So Expensive?
A recent opinion piece in the New York Times by Kasia Lipska, an endocrinologist from the Yale School of Medicine, takes the three pharmaceutical giants who dominate the U.S. insulin market to task for their shocking price hikes. Lipska asserts that in the five-year period from 2010 to 2015, “the price of Lantus (made by Sanofi) went up by 168 percent; the price of Levemir (made by Novo Nordisk) rose by 169 percent; and the price of Humulin R U-500 (made by Eli Lilly) soared by 325 percent.” Fred Banting and Charles Best, the researchers who discovered insulin in 1923 must be rolling in their graves. They sold the patent for $1 to help enable the breakthrough diabetic treatment achieve quick and wide availability. Thanks to the discovery of insulin, quality of life and survival rates for diabetics have vastly improved. But diabetes is still the seventh leading cause of death in the United States. Close to 29 million Americans have diabetes—that’s 1 in every 11 people. For about 6 million, insulin is a necessary treatment. We’ve reported before about how Novo Nordisk, Sanofi and Eli Lilly dominate the U.S. insulin market, but we’ve never seen the price data presented so starkly. As Lipska points out, drug manufacturers aren’t the only contributors to insane insulin prices. The role of pharmacy benefit managers (PBMs) like Express Scripts, CVS Health and OptumRx also needs to be considered. These middlemen of the health care industry have a role in negotiating drug prices. They also profit from drug sales, which seems like a clear conflict. The top three PBMs bring in more than $200 billion per year in revenue. Incrementally different formulations of the drug allow companies to continue “evergreening” or extending their patent rights, hindering generic c Continue reading >>
Cheaper Insulin Is On The Way
With commentary by Alissa R. Segal , Pharm.D., RPh, CDE, CDTC, a Clinical Pharmacist at the Joslin Diabetes Center. Biosimilar insulin promises the same blood sugar control at a lower price, but is it as good as brand-name, and will you really save money? The first “biosimilar” insulin—made with a formula that copies an approved, name-brand insulin— is set for sale in the U.S. later this year. Now a new study in the journal Diabetes, Obesity & Metabolism says it works as well as the brand-name drug it’s based on. But as insulin costs skyrocket, experts say the “copycat” insulin Basaglar, made by Eli Lilly, may give consumers a small price break—and note that switching may require extra attention to blood sugar levels at first. The U.S. Food and Drug Administration (FDA) approved Basaglar in late December; it is expected to hit pharmacies in late 2016. The drug has the same basic protein structure as the popular, long-acting insulin glargine Lantus and is made by a similar process. For regulatory reasons, the FDA calls copycat insulin a “follow-on” product, but the drugs are widely described as biosimilars by diabetes experts here and in other countries where they’ve already gained approval or are on sale. The new study, conducted by Eli Lilly, followed 452 type 1s and 299 type 2s who had been using Lantus and switched to Basaglar. After six months, their blood-sugar levels were the same on the new drug. According to the U.S. Food and Drug Adminstration (FDA), possible side effects with this insulin are in line with side effect risks with any type of insulin and include hypoglycemia, allergic reactions, injection site reactions, pitting at the injection site, itching, rash, fluid retention and weight gain. 1 Experts contacted by EndocrineWeb say con Continue reading >>
How Much Do Diabetes Supplies/medications Cost In The U.s.?
While everyone’s diabetes treatment plan, medications, and technology may be different, there is one thing we can all agree on: diabetes is expensive. In two previous posts at The Perfect D, I gave some sense of what the bare minimum of care for a U.S. adult with Type 1 diabetes would be and also financial resources and programs to help with the financial burden of living with diabetes. However, this post is about how much it could cost an adult with Type 1 diabetes if they used the technology and medications that are currently out on the market (and thought of as “the latest and greatest”) and paid out of pocket with no insurance. Research on this topic has shown me that: 1) prices can fluctuate wildly, so it pays to shop around and 2) there is a very big gap (financially, medically, and technologically) between the bare minimum and “surviving” and actually utilizing the tools and latest technology that is out there. So, the hypothetical person for this exercise is a Type 1 adult in the United States who weighs 60kg, just like the other calculation post I did. Ground Rules These prices are accurate on the websites I have referenced for December 1, 2014. They may change, they may add shipping, they may not offer the services, technology, or drugs on their website after this is posted. These prices are not a guarantee. They are to be used as a reference. The listing of prices/websites on this post does not mean that I endorse the company or product or service. I have not listed all the products available on the market for people with Type 1 diabetes. I have listed major ones to give you an idea of major manufacturers’ costs for the products that are available for general public viewing. I did not call any companies and ask for pricing. Why? Because I believe Continue reading >>
