What's left out of most conversations around insulin. - The incidence rate for diabetes has skyrocketed over the past 25 years. It's estimated that 100 million

What's left out of most conversations around insulin. - The incidence rate for diabetes has skyrocketed over the past 25 years. It's estimated that 100 million Americans are now living with diabetes or prediabetes. - Most of the patents for the newer insulins are mostly on manufacturing processes. Read up on Lusduna if you want to see how difficult it is to bring an insulin to market in the US. - Biosimilars are significantly more costly to bring to market than generic drugs. - Alex Azar, and every other secretary of HHS have had the ability to allow legal importation of drugs from Canada since 2003. We actively choose not to. While IMO the risks are worth the benefits, I will concede the other side does have a valid argument against importation. - The price difference is with fast acting insulins. These insulins offer a higher quality of life relative to the older insulins. The clinical benefits of using a fast acting insulin versus something like Novolin 70/30 (aka Walmart insulin) are negligible, while the price difference is substantial. (Talk to your physician before switching insulins) From the people I've talked with, fast acting insulins are a godsend if you have diabetic children or can't keep a regimented schedule. - All of the companies that manufacture insulin are public and you can read through their financial statements to verify that what they are saying is true. All that being said... I'm surprised that an enterprising Canadian has not exploited insulin arbitrage. You can buy insulin over the counter without a prescription in the USA and Canada. Canadian law does not prohibit exportation of drugs to the United States. Theoretically you could set up an escrow service that connected Canadians who wanted to make a buck with American diabetics. The service could offer insurance in case a delivery was not made and you needed to buy insulin in the US. Obviously this would complicate things with your insurance. No insurance company is going to cover bootleg Canadian insulin when it comes to your deductible.