3 ms·

Doctors also have a duty to prescribe the best available drug, which is why you dont see people who cant afford modern insulin prescribed "last gen insulin."

by basch 7y ago

gowld 7y ago
Do you have a source for that? This doctor disagrees: https://www.statnews.com/2018/04/03/doctors-cost-prescribing-medications/ https://www.statnews.com/2018/04/03/doctors-cost-prescribing...
- basch 7y ago
  PMID: 25785977 >What’s surprising is that the trailing edge of old insulin products did not generate a market for generic competition but rather became a set of obsolete products that were promptly removed from the U.S. market. Pork and beef insulins are not merely underutilized, they are unavailable for human use in the United States. Even when practitioners prescribe NPH and R insulin in place of insulin glargine and insulin aspart, these cheaper prescriptions are filled with newer recombinant products sold under brand names. And yet on the whole, it’s hard to say that contemporary patients who cannot afford their insulin (let alone the patent-protected glucometers and test strips required to adjust the dose) are well served by having as their only option an agent that is marginally more effective than those that could have been generically available 50 or 30 or 10 years ago, had generics manufacturers introduced cheaper versions when patents expired. I shouldnt blame the doctors, my comment was a little facetious. Some "low cost" versions did come out in 2019, but it feels more like the diamond industry selling both natural and lab made diamonds at different price points. Back to my original point, Doctors seem to agree that analog insulin is preferable to older formulas. - https://www.healthline.com/diabetesmine/why-not-more-affordable-generic-insulin https://www.healthline.com/diabetesmine/why-not-more-afforda... >Since we’re talking about cheaper insulin, Novo Nordisk’s Novolin ReliOn brand deserves a mention here. Sold for just $25 a vial without a prescription at Walmart, ReliOn includes “Regular” (short-acting), NPH (longer-acting), and 70/30 (biphasic insulin), a combination of the other two. These ReliOn products are not generics or biosimilars, but rather older “human” insulins — as opposed to the newer “analog” versions being produced today. Many patients and doctors agree that these older formulations clearly don’t provide the same level of blood glucose management as newer insulins. But if you’re forced to choose between using them and doing without or rationing insulin, these older insulins are certainly preferable. The risk is real. https://www.usatoday.com/story/news/nation/2019/08/09/man-dies-otc-insulin/1942908001/ https://www.usatoday.com/story/news/nation/2019/08/09/man-di...

Doctors also have a duty to prescribe the best available drug, which is why you dont see people who cant afford modern insulin prescribed "last gen insulin."

by basch 7y ago

Doctors also have a duty to prescribe the best available drug, which is why you dont see people who cant afford modern insulin prescribed "last gen insulin."

gowld 7y ago

Do you have a source for that? This doctor disagrees: https://www.statnews.com/2018/04/03/doctors-cost-prescribing-medications/ https://www.statnews.com/2018/04/03/doctors-cost-prescribing...

basch 7y ago
PMID: 25785977 >What’s surprising is that the trailing edge of old insulin products did not generate a market for generic competition but rather became a set of obsolete products that were promptly removed from the U.S. market. Pork and beef insulins are not merely underutilized, they are unavailable for human use in the United States. Even when practitioners prescribe NPH and R insulin in place of insulin glargine and insulin aspart, these cheaper prescriptions are filled with newer recombinant products sold under brand names. And yet on the whole, it’s hard to say that contemporary patients who cannot afford their insulin (let alone the patent-protected glucometers and test strips required to adjust the dose) are well served by having as their only option an agent that is marginally more effective than those that could have been generically available 50 or 30 or 10 years ago, had generics manufacturers introduced cheaper versions when patents expired. I shouldnt blame the doctors, my comment was a little facetious. Some "low cost" versions did come out in 2019, but it feels more like the diamond industry selling both natural and lab made diamonds at different price points. Back to my original point, Doctors seem to agree that analog insulin is preferable to older formulas. - https://www.healthline.com/diabetesmine/why-not-more-affordable-generic-insulin https://www.healthline.com/diabetesmine/why-not-more-afforda... >Since we’re talking about cheaper insulin, Novo Nordisk’s Novolin ReliOn brand deserves a mention here. Sold for just $25 a vial without a prescription at Walmart, ReliOn includes “Regular” (short-acting), NPH (longer-acting), and 70/30 (biphasic insulin), a combination of the other two. These ReliOn products are not generics or biosimilars, but rather older “human” insulins — as opposed to the newer “analog” versions being produced today. Many patients and doctors agree that these older formulations clearly don’t provide the same level of blood glucose management as newer insulins. But if you’re forced to choose between using them and doing without or rationing insulin, these older insulins are certainly preferable. The risk is real. https://www.usatoday.com/story/news/nation/2019/08/09/man-dies-otc-insulin/1942908001/ https://www.usatoday.com/story/news/nation/2019/08/09/man-di...