... but wow, just woooow. It's so incredibly depressing that I'm calling this "good." Sometimes the sheer insanity of the United States health care system overwhelms me. The fact insulin isn't a few dollars or free is beyond disheartening. It's like the system itself saying the Sackler's just didn't have enough imagination exploiting people, and destroying lives, for profit. "Oh? You don't need to get them addicted if they'll die without it... silly, Sacklers. #BusinessMASTER"
I keep hoping one day folks in the US will get tired of being screwed on their healthcare and living in fear of getting sick... shrug
Captured implies a change in behavior or an outside force acting on them, and that isn't accurate.
Only politicians that fall in line are given the support necessary to succeed.
To me, the term captured reduces the agency which is our responsibility to exercise as citizens (at least in the U.S. where I'm based.)
/steps off soap box.
They have? According to testimony by Sanofi, even though list price have went up 126%, net price has actually gone down 25%.
https://www.finance.senate.gov/imo/media/doc/26FEB2019BRANDI...
This is a government problem, not a healthcare system problem.
To maintain this standard of living you're always going to be dependent on someone, it's not a government problem.
meanwhile there are people dying from lack of food in the richest nations on earth.
don't get me wrong, there is plenty wrong with healthcare.
I get that there are people who have to skip meals in the USA, but does anyone really get to the point of dying?
As someone with good but very expensive health insurance, any time I bring up health insurance prices, the response from people who get cheap health insurance through their employers is basically, "F* you, got mine"
Unfortunately, the block of people with stable corporate jobs also tend to have a lot of political power and are in no hurry to see their perks upended.
Type 2 can pay for it themselves. Their condition was caused by themselves.
--those are the people you feel comfortable shitting on for their circumstances?
(And there absolutely is a predisposition to Type 2 diabetes in some populations and not in others.)
90-95% of type diabetics have type 2 diabetes. Of those, around 95% can completely eliminate insulin dependency by straightforward dietary modifications. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6104272/
Under what moral framework should these people (around 90% of diabetics) receive insulin at others’ expense? I can see at least a first-order argument for having everyone else pay for obligate insulin dependents’ medication, but I struggle to see an argument for foisting the cost of an entirely preventable dependency on everyone else.
If that argument strikes you as problematic, it might be because society is better when it's generally well educated and healthy.
> Forty percent (31/78) of CCI participants who began the study with insulin prescriptions … eliminated the medication
There's a second-order argument of the form "We will all be better off if we invest in healthcare. Society is not zero-sum."
As do all but specialized grocery stores because this is the majority of food produced. How about we go after the food producers instead? Or the subsidies that enable this?
I frequently work at state fairs & arts and crafts festivals on the east coast. The amount of very overweight and obese people is simply astounding.
About half of one coke is the average adult’s recommended sugar intake. I know more people than I’d like who have at least one soda every day, and some who have multiple every day.
Nearly everything in our supermarkets has a lot of sugar. Including common things like bread and pasta sauce. Last time I checked at publix, I only found -one- type of bread that didn’t have a lot of sugar in it. Finding a protein bar without tons of sugar was rather difficult. Etc.
Combine this with sitting all day + driving everywhere and we’ve got a huge problem.
Now, it's a mix of societal and economical (and more) that's making people eat a certain way. Changing your eating behavior can be difficult, especially if you've eaten a certain way for the past 16-18 years.
I'm not saying it's Walmart's fault, but it's also not just an individual willingness to change that's in play here. The United States clearly has a problem of obesity, which is related to Type 2 diabetes.
As a type 1 diabetic myself, Walmart's offerings on R or Regular insulin saved me a few times. Once when I was simply out of insulin and did not have insurance. Then when I was caught in another city for work and ran out due to needing to extend my stay. I am slightly disappointed to see that one, the price is not the same as their human insulin which is around 25 dollars per vial I believe. Two, it will require a prescription. The times I bought their cheapest insulin, this was not required. However, I hope this is the right direction.
I wish more people knew about Walmart's $25/vial regular insulin. Like you said, it's available without a prescription at any Walmart (except in Indiana). Dosing needs to be adjusted relative to insulin analogs, but it's a viable option for anyone in a money pinch who hasn't yet gone through the process of signing up for patient assistance programs for their analog.
Just... die?
The GP was bemoaning that Walmart is selling the analogs for $70+ instead of the $25 they sell human insulin for.
A vial of analog insulin costs something like $6-7 to produce, probably less at Walmart scale. The distribution costs probably make the net cost somewhere still in the $7-10 range.
That’s a $60-65 or ~90% margin per Vial.
5-10 million or so insulin users in the US, let’s assume Walmart captures 3 million, at 3 vials per month.
$180 * 12 * 3mil ~~ 6.5 Billion.
Current market cap 400B
Lots of assumptions, but Walmart may have just added 2% of market cap per annum by insulin sales?
> A vial of analog insulin costs something like $6-7 to produce, probably less at Walmart scale. The distribution costs probably make the net cost somewhere still in the $7-10 range.
Don't forget the R&D costs of getting a generic drug approved and setting up the manufacturing. It may cost <$10 to produce at scale, but getting there isn't free.
Hopefully Walmart's pricing trends downward toward the $25/vial price of regular insulin.
Actually, I hope this move spurs more chain pharmacies to start developing their own analogs, furthering competition in the space. Race to the bottom would be great.
Sure, OTC stuff may differ given the different markets, but I’m highly skeptical of this spurring any sort of race to the bottom that doesn’t also come with large asterisks around quality, qualification to purchase, etc.
Where are you getting the $6-7 figure from? Artisan insulin makers? Feels like every insulin maker out there operates at walmart's scale, if not bigger. If that's where we're getting the $6-7 figure from, then it's not reasonable to expect it to drop any further.
$5.32-8.87 cost of production depending on the insulin analog.
As noted above, I did not account for R&D and manufacturing capacity.
Regardless, I tried to estimate conservatively at a $12-13 per vial overall cost. My napkin math is certainly wrong.
The point is that Walmart still stands to generate a multi-billion dollar per year profit on the sale of this insulin. (Unless my market capture estimate is wrong by an order of 6+, which it could be)
To be clear, I’m not opposed (in fact grateful) that Walmart is competing in the insulin market. However, I still find it unfortunate that we in the United States pay more for Insulin than any other country in the world, even with this competition.
Benevolent? It's not exactly hard to be more benevolent than the medical establishment.
You can be a picture of health shopping at Walmart, just as you can be a danger to yourself shopping at whole foods.
Walmart is also famous for selling regular insulin for $25/vial for many years now. Regular insulin isn't always as easy to dose as the modern insulin analogs, but it's a viable option for most people who are cost-constrained who don't otherwise have access to insurance.
>Regular Human Insulin which has an onset of action of 1/2 hour to 1 hour, peak effect in 2 to 4 hours, and duration of action of 6 to 8 hours.
The insulin they're offering:
>starts to work about 15 minutes after injection, peaks in about 1 hour, and keeps working for 2 to 4 hours.
For example, if you have maybe 15 grams more of carbohydrates than you planned and you did R (old insulin), then you will either have to wait or, what they did for me in school back at that time, send em to P.E for awhile (since exercise _mostly_ and _usually_ lowers blood sugars) ;-).
Insulins are interesting.
I would like to live in a world where we can both be sensitive about certain topics, but also be able start hard discussions - for example "don't live an unhealthy lifestyle, exercise, eat better, or you're going to be the only one to blame if you get sick from X, Y, Z".
This is an insulin analog, which is a more modern patented drug.
Regular insulin is available for $25/vial at Walmart already. Could be cheaper, yes, but at that price it's already approaching their costs of production, distribution, and sales.
I hope the price of this insulin analog trends downward toward the $25 price of regular insulin.
I wonder if every company was like this, what would happen to the world.
Not meaning to cast any shade at this insulin product; it looks like a substantial improvement over what the US "market" for insulin was offering before.
Also, they are likely to sue walmart for whatever BS reason. But, walmart probably figures they can get through it unscathed.
Out of pocket, Fiasp costs 7.50 euro per 3ml, Novorapid costs 6.50, Novomix 30 is 7 euro, Triseba 12 euro, even the ridiculously pricy Xultophy is only 30 euro. The idea that "We halved the price" when the price is literally ten times too high, and not presenting it as "a start, we intend to bring the price down far more over the next few years" but as "and then we stopped, we're undercutting and that's all we're interested in" is... insane?
