8 ms·

This is bogus. Wal-mart sells insulin for $24.88 a vial without prescription currently. It's only the newer 'guchi' insulin brands that are crazy expensive.

This is bogus. Wal-mart sells insulin for $24.88 a vial without prescription currently. It's only the newer 'guchi' insulin brands that are crazy expensive. Stuff from 1996 that is compared to in this article is actually cheaper than it was in 1996 (adjusted for inflation).

minitoar 5y ago
it’s “Gucci”, like the luxury brand
- lotsofpulp 5y ago
  Funnily enough, also a "luxury" brand.
burkaman 5y ago
It's not branding, the newer insulin is significantly different and better for almost every patient. https://diabetesstrong.com/walmart-insulin/ https://diabetesstrong.com/walmart-insulin/ It's likely not what your doctor prescribed, it doesn't last as long, it requires you (or your young children) to eat on a very specific schedule, it can't be used with an insulin pen or insulin pump, it's just all around a worse and less effective treatment.
- jart 5y ago
  When were these newer insulins invented? Are they a recent thing? Was it the case that twenty years ago, "Walmart" insulin was the only insulin?
  - jimrandomh 5y ago
    1996. https://en.wikipedia.org/wiki/Insulin_lispro https://en.wikipedia.org/wiki/Insulin_lispro
- gruez 5y ago
  Seems like everything is working as intended? A corporation invests money to develop a better product, and the government gives them a 20 year monopoly on it so they charge a premium and recoup their investment. As a patient if you want to pay the premium for it, you can get the better product, otherwise you can still stick with whatever walmart's selling. It's worse, but it's not any worse than what you'd had if the company didn't come along and invented the better product.
  - lotsofpulp 5y ago
    But that does not make for emotion inducing tweets.
  - OriginalNebula 5y ago
    Do you think a gross profit margin of 93% is fair?
    - lotsofpulp 5y ago
      Define fair and unfair. If it was so "unfairly" lucrative, I would have to ask why everyone does not invest in pharma? Why are tech companies where much of the VC funds land? Perhaps it is because there a huge amount of risk involved?
  - DerpyBaby123 5y ago
    That's not what is happening. It has nothing to do with a patent monopoly or recouping any investment: FTA: >In 1996, a vial of Humalog produced by Eli Lilly cost $21. Today, it's priced at $324 despite the cost of production remaining steady. >Rising costs are nothing new. Insulin prices tripled from 2002 to 2013, and doubled between 2012 and 2016. To put this into perspective, in 1996 a vial of Humalog produced by Eli Lilly cost $21. Today, it's priced at $324 despite the cost of production remaining steady. If everything is working as intended, it begs the question, what institution intended for patients to die from rationing insulin[0], and why is the USA ok with that institution's intention? [0]https://www.ontrackdiabetes.com/live-well/diabetes-management/insulin-rationing-what-it-why-its-so-dangerous https://www.ontrackdiabetes.com/live-well/diabetes-managemen...
- sparrish 5y ago
  Novolin is available as an insulin pen. I use it twice-a-day and it's available at the prices specified.
hef19898 5y ago
Or, you know, public health care. But I digress.
foxyv 5y ago
The hard part is getting doctors to offer prescriptions for the cheaper brands as an alternative. A lot of doctors will prescribe the most expensive drug simply because they believe or know that it is better in some way without regard to it's cost. It's changed a lot recently as doctors have become more aware of the cost of these drugs. But you still have to self advocate for less expensive drugs. Less savvy people often have trouble getting transparency into drug costs. Often even the doctors can't get a straight answer on pricing and insurance coverage.
- lotsofpulp 5y ago
  It has been many years since pharmacies have been allowed to substitute brand name medications with generic medications. In fact, doctors have to write "dispense as written" if they want the patient to only get the brand name medication they prescribe. Additionally, managed care organizations (MCOs, commonly known as insurance companies) do not pay for brand name medications just because a doctor prescribes them. If the MCO is aware of a generic option, then they will only pay for the generic or they will ask the doctor for a "prior authorization" to justify the use of a brand name medicine (such as the generic version not working). The pediatricians I have visited in recent years even have the MCOs' formulary available for the patient in their systems, so they can see which medicines need a prior authorization and which do not so there is no time wasted on figuring out what the MCO will pay for without prior authorizations.
- throwaway0a5e 5y ago
  > A lot of doctors will prescribe the most expensive drug simply because they believe or know that it is better in some way without regard to it's cost. This is so obnoxiously common across every profession. People are willing to piss away other people's money on "the best" without even telling them what the options are.
- sparrish 5y ago
  But you don't need a prescription...
  - foxyv 5y ago
hooande 5y ago
this is very true. prices of name brand insulin need to come down, but there is a low cost option available for those that need it
- cestith 5y ago
  Patient outcomes for the insulin aspart pens and the vials of generic insulin at Walmart are so different that many doctors refuse to prescribe the cheap stuff except as a very last resort. There's no simply substituting. These are two different brands of a generic statin pill or something. Although it's all insulin, these are very different drugs. The dosages for the same insulin in the same patient can vary, and the calculations or charts for what to take when vary across types of insulins. The handling instructions vary. There's different patient training for a pen vs. a vial and syringe.
  - sparrish 5y ago
    Novolin is available as a pen without prescription. Costs a bit more ($45 for 5 pens).
    - cestith 5y ago
      That fixes the pen issue, but it's still not the same insulin most doctors prescribe and can't be easily substituted without medical consultation. Having it available inexpensively and without a prescription is a compromise, per Novo Nordisk themselves. https://khn.org/news/you-can-buy-insulin-without-a-prescription-but-should-you/ https://khn.org/news/you-can-buy-insulin-without-a-prescript...
  - erosenbe0 5y ago
    There is no substituting but also no easy comparison of how much worse the regular stuff is, since the population using R is often underinsured and unable to afford other elements of prevention and care.
deleted 5y ago
[deleted]
Jeff_Brown 5y ago
A friend had insurance problems for years and often had to use Walmart insulin instead. He's now going blind, and his doctors suspect that's why. </anecdote>
sithlord 5y ago
This is so incredibly wrong - and trying to claim something you know obviously nothing about is hilarious. The different between NPH (regular insulin) (maybe R too, not sure??) sold by walmart and Fast Acting insulins (Novolog, Humalog, Apidra) is massive. Fast acting insulins start working at about in about 30 minutes and "peak" at like 2 hours, and may slowly have some effects for another 1-2 hours. NPH on the other hand, starts working at ~2 hour mark and continues to work slowly until peaking at like 6 hours and slowly degrades away, that means its in your system for something like 9 hours - trying to meal plan around multiple doses of that is unsafe at best. R is slightly better but still remains and slowly peaks closer to 4 hours. These are obviously GREAT IF and only IF you dont have access to fast acting. I applaud Walmart for giving access to these, as they are way better than nothing. source: Type 1 diabetic
- TheFreim 5y ago
  Would it be possible to get a limited amount of the fast acting stuff for unpredictable situations and then normally use the "cheap" stuff? I don't know how this works so I would like some info from someone who seems to know.
  - reddiky 5y ago
    Possible, sure, but not ideal. The "fun" thing about T1 diabetes is that every meal becomes an unpredictable situation based on exercise, sleep, stress, etc etc. Slightly exaggerated, but only slightly: Imagine you could only drink water 6 hours before you got thirsty, but if you drank too much you might pass out (at any point 2-6 hours from now) or if you drank too little you're doing major damage to your body. Really the only way to manage with that kind of insulin is to live a very, very low carb lifestyle. Its doable, but it limits your variety and leaves you prone to other potential issues.
  - sithlord 5y ago
    Not likely, also lets not forget - as a Type 1 diabetic, you also take long acting insuling (unless you are on a pump). So, for example, a pump uses only fast acting insulin - and it gives a small amount (known as "basil") every 5 minutes (+/- depending on pump). Whereas, if you use pens (or from a vial) with direct injection, you also take a long acting insulin (levemir, Lantus, etc) once or twice a day (they are supposed to last 24ish hours but often people find splitting their total daily dose up into morning and night has better results). And these insulins cost even more than the fast-acting stuff.
elliekelly 5y ago
This is like saying a car and a bicycle are equivalent means of transportation. Sometimes a bike is the right solution for some people and a bike is usually better than nothing but it’s really not fast enough to be a practical solution for most people’s daily needs. Edit: Perhaps high speed internet vs dial-up would be a better analogy to spare us the comments about how bikes are actually better than cars...
myelin 5y ago
Type 1 diabetic here. Managing T1D even with the "Gucci" insulins (I use Novolog and have tried Fiasp) is still a huge pain in the butt; you have to give yourself a dose of insulin a fairly precise amount of time before eating, and accurately judge how much you're going to need, which is half science and half wild guesswork. My per-meal dosage requirements vary randomly from month to month -- a dose that would be fine one month is either inadequate or deadly on another month, and the only way to tell if you've got it right is to obsessively monitor your blood sugar. And that's with the $700/vial insulin... the $25/vial stuff is stone age technology by comparison; you have to take it twice a day, and then eat at two specific times afterwards, or you'll go hypoglycemic (unconscious or maybe dead hypoglycemic, not just the feeling-a-bit-tired kind that people who don't use insulin are familiar with). The situation right now is that the best and most expensive T1D technology, even the various "artificial pancreas" solutions, still gives you nothing like the experience of a normal pancreas. It would be really nice if the Walmart insulin were a viable long term solution for the cost problem, but unfortunately the negative health effects of older insulin tech are considerable :(
- giles7777 5y ago
  Have you tried low-carb eating? I've been doing it for years and it seems to be an easier method then insulin(type2 borderline when I started, so not exactly the same).
  - pimeys 5y ago
    When you eat lots of fat and protein as a T1, you just get a slowly rising glucose that needs insulin and is harder to control compared to carbs with less fat. T1 is really complex even with a low carb diet, if you don't only eat vegetables, but meatier food.
    - myelin 5y ago
      Yeah, T1 is pretty much just a pain whatever you do. Low carb does make it quite a bit easier, and I imagine would pretty much be the only safe way to eat if you were using a non-rapid insulin. Unfortunately (doctor's orders) I also have to cut back on the cholesterol, which seems to be very high in all my favorite low-carb foods :( It's a constant experiment; it may turn out to make more sense to eat more fat but take statins, but I need to wait a bit longer and see how my lipids look with the current diet. (BTW I'm actually doing fine -- pretty decent control/A1C -- but I had to rant in response to the Walmart insulin suggestion above!)
pluto7777 5y ago
Goodrx shows lispro generic $48.85 per vial. Humalog 'guchi' is $142.55. If you're fortunate enough to have diabetic retinopathy and can't read the tiny print, the larger kwikpens are only $270.28. Lets not even get into the real guchi brands.
rland 5y ago
Walmart insulin is not lispro/glargine, it is R/N, which is a different formulation. Treatment of type 1 with R/N is associated with significantly higher mortality, A1C, and complication risk, and, of course, much lower quality of life. Bear in mind: when you mis-dose insulin, your blood turns into acid. No endocrinologist would ever recommend treatment with older insulins over the new stuff. The only way it happens is because of cost.

minitoar 5y ago

it’s “Gucci”, like the luxury brand

lotsofpulp 5y ago
Funnily enough, also a "luxury" brand.

burkaman 5y ago

It's not branding, the newer insulin is significantly different and better for almost every patient. https://diabetesstrong.com/walmart-insulin/ https://diabetesstrong.com/walmart-insulin/ It's likely not what your doctor prescribed, it doesn't last as long, it requires you (or your young children) to eat on a very specific schedule, it can't be used with an insulin pen or insulin pump, it's just all around a worse and less effective treatment.

jart 5y ago
When were these newer insulins invented? Are they a recent thing? Was it the case that twenty years ago, "Walmart" insulin was the only insulin?
- jimrandomh 5y ago
  1996. https://en.wikipedia.org/wiki/Insulin_lispro https://en.wikipedia.org/wiki/Insulin_lispro
gruez 5y ago
Seems like everything is working as intended? A corporation invests money to develop a better product, and the government gives them a 20 year monopoly on it so they charge a premium and recoup their investment. As a patient if you want to pay the premium for it, you can get the better product, otherwise you can still stick with whatever walmart's selling. It's worse, but it's not any worse than what you'd had if the company didn't come along and invented the better product.
- lotsofpulp 5y ago
  But that does not make for emotion inducing tweets.
- OriginalNebula 5y ago
  Do you think a gross profit margin of 93% is fair?
  - lotsofpulp 5y ago
    Define fair and unfair. If it was so "unfairly" lucrative, I would have to ask why everyone does not invest in pharma? Why are tech companies where much of the VC funds land? Perhaps it is because there a huge amount of risk involved?
- DerpyBaby123 5y ago
  That's not what is happening. It has nothing to do with a patent monopoly or recouping any investment: FTA: >In 1996, a vial of Humalog produced by Eli Lilly cost $21. Today, it's priced at $324 despite the cost of production remaining steady. >Rising costs are nothing new. Insulin prices tripled from 2002 to 2013, and doubled between 2012 and 2016. To put this into perspective, in 1996 a vial of Humalog produced by Eli Lilly cost $21. Today, it's priced at $324 despite the cost of production remaining steady. If everything is working as intended, it begs the question, what institution intended for patients to die from rationing insulin[0], and why is the USA ok with that institution's intention? [0]https://www.ontrackdiabetes.com/live-well/diabetes-management/insulin-rationing-what-it-why-its-so-dangerous https://www.ontrackdiabetes.com/live-well/diabetes-managemen...
sparrish 5y ago
Novolin is available as an insulin pen. I use it twice-a-day and it's available at the prices specified.

hef19898 5y ago

Or, you know, public health care. But I digress.

foxyv 5y ago

The hard part is getting doctors to offer prescriptions for the cheaper brands as an alternative. A lot of doctors will prescribe the most expensive drug simply because they believe or know that it is better in some way without regard to it's cost. It's changed a lot recently as doctors have become more aware of the cost of these drugs. But you still have to self advocate for less expensive drugs. Less savvy people often have trouble getting transparency into drug costs. Often even the doctors can't get a straight answer on pricing and insurance coverage.

lotsofpulp 5y ago
It has been many years since pharmacies have been allowed to substitute brand name medications with generic medications. In fact, doctors have to write "dispense as written" if they want the patient to only get the brand name medication they prescribe. Additionally, managed care organizations (MCOs, commonly known as insurance companies) do not pay for brand name medications just because a doctor prescribes them. If the MCO is aware of a generic option, then they will only pay for the generic or they will ask the doctor for a "prior authorization" to justify the use of a brand name medicine (such as the generic version not working). The pediatricians I have visited in recent years even have the MCOs' formulary available for the patient in their systems, so they can see which medicines need a prior authorization and which do not so there is no time wasted on figuring out what the MCO will pay for without prior authorizations.
throwaway0a5e 5y ago
> A lot of doctors will prescribe the most expensive drug simply because they believe or know that it is better in some way without regard to it's cost. This is so obnoxiously common across every profession. People are willing to piss away other people's money on "the best" without even telling them what the options are.
sparrish 5y ago
But you don't need a prescription...
- foxyv 5y ago

hooande 5y ago

this is very true. prices of name brand insulin need to come down, but there is a low cost option available for those that need it

cestith 5y ago
Patient outcomes for the insulin aspart pens and the vials of generic insulin at Walmart are so different that many doctors refuse to prescribe the cheap stuff except as a very last resort. There's no simply substituting. These are two different brands of a generic statin pill or something. Although it's all insulin, these are very different drugs. The dosages for the same insulin in the same patient can vary, and the calculations or charts for what to take when vary across types of insulins. The handling instructions vary. There's different patient training for a pen vs. a vial and syringe.
- sparrish 5y ago
  Novolin is available as a pen without prescription. Costs a bit more ($45 for 5 pens).
  - cestith 5y ago
    That fixes the pen issue, but it's still not the same insulin most doctors prescribe and can't be easily substituted without medical consultation. Having it available inexpensively and without a prescription is a compromise, per Novo Nordisk themselves. https://khn.org/news/you-can-buy-insulin-without-a-prescription-but-should-you/ https://khn.org/news/you-can-buy-insulin-without-a-prescript...
- erosenbe0 5y ago
  There is no substituting but also no easy comparison of how much worse the regular stuff is, since the population using R is often underinsured and unable to afford other elements of prevention and care.

deleted 5y ago

[deleted]

Jeff_Brown 5y ago

A friend had insurance problems for years and often had to use Walmart insulin instead. He's now going blind, and his doctors suspect that's why. </anecdote>

sithlord 5y ago

This is so incredibly wrong - and trying to claim something you know obviously nothing about is hilarious. The different between NPH (regular insulin) (maybe R too, not sure??) sold by walmart and Fast Acting insulins (Novolog, Humalog, Apidra) is massive. Fast acting insulins start working at about in about 30 minutes and "peak" at like 2 hours, and may slowly have some effects for another 1-2 hours. NPH on the other hand, starts working at ~2 hour mark and continues to work slowly until peaking at like 6 hours and slowly degrades away, that means its in your system for something like 9 hours - trying to meal plan around multiple doses of that is unsafe at best. R is slightly better but still remains and slowly peaks closer to 4 hours. These are obviously GREAT IF and only IF you dont have access to fast acting. I applaud Walmart for giving access to these, as they are way better than nothing. source: Type 1 diabetic

TheFreim 5y ago
Would it be possible to get a limited amount of the fast acting stuff for unpredictable situations and then normally use the "cheap" stuff? I don't know how this works so I would like some info from someone who seems to know.
- reddiky 5y ago
  Possible, sure, but not ideal. The "fun" thing about T1 diabetes is that every meal becomes an unpredictable situation based on exercise, sleep, stress, etc etc. Slightly exaggerated, but only slightly: Imagine you could only drink water 6 hours before you got thirsty, but if you drank too much you might pass out (at any point 2-6 hours from now) or if you drank too little you're doing major damage to your body. Really the only way to manage with that kind of insulin is to live a very, very low carb lifestyle. Its doable, but it limits your variety and leaves you prone to other potential issues.
- sithlord 5y ago
  Not likely, also lets not forget - as a Type 1 diabetic, you also take long acting insuling (unless you are on a pump). So, for example, a pump uses only fast acting insulin - and it gives a small amount (known as "basil") every 5 minutes (+/- depending on pump). Whereas, if you use pens (or from a vial) with direct injection, you also take a long acting insulin (levemir, Lantus, etc) once or twice a day (they are supposed to last 24ish hours but often people find splitting their total daily dose up into morning and night has better results). And these insulins cost even more than the fast-acting stuff.

elliekelly 5y ago

This is like saying a car and a bicycle are equivalent means of transportation. Sometimes a bike is the right solution for some people and a bike is usually better than nothing but it’s really not fast enough to be a practical solution for most people’s daily needs. Edit: Perhaps high speed internet vs dial-up would be a better analogy to spare us the comments about how bikes are actually better than cars...

myelin 5y ago

Type 1 diabetic here. Managing T1D even with the "Gucci" insulins (I use Novolog and have tried Fiasp) is still a huge pain in the butt; you have to give yourself a dose of insulin a fairly precise amount of time before eating, and accurately judge how much you're going to need, which is half science and half wild guesswork. My per-meal dosage requirements vary randomly from month to month -- a dose that would be fine one month is either inadequate or deadly on another month, and the only way to tell if you've got it right is to obsessively monitor your blood sugar. And that's with the $700/vial insulin... the $25/vial stuff is stone age technology by comparison; you have to take it twice a day, and then eat at two specific times afterwards, or you'll go hypoglycemic (unconscious or maybe dead hypoglycemic, not just the feeling-a-bit-tired kind that people who don't use insulin are familiar with). The situation right now is that the best and most expensive T1D technology, even the various "artificial pancreas" solutions, still gives you nothing like the experience of a normal pancreas. It would be really nice if the Walmart insulin were a viable long term solution for the cost problem, but unfortunately the negative health effects of older insulin tech are considerable :(

giles7777 5y ago
Have you tried low-carb eating? I've been doing it for years and it seems to be an easier method then insulin(type2 borderline when I started, so not exactly the same).
- pimeys 5y ago
  When you eat lots of fat and protein as a T1, you just get a slowly rising glucose that needs insulin and is harder to control compared to carbs with less fat. T1 is really complex even with a low carb diet, if you don't only eat vegetables, but meatier food.
  - myelin 5y ago
    Yeah, T1 is pretty much just a pain whatever you do. Low carb does make it quite a bit easier, and I imagine would pretty much be the only safe way to eat if you were using a non-rapid insulin. Unfortunately (doctor's orders) I also have to cut back on the cholesterol, which seems to be very high in all my favorite low-carb foods :( It's a constant experiment; it may turn out to make more sense to eat more fat but take statins, but I need to wait a bit longer and see how my lipids look with the current diet. (BTW I'm actually doing fine -- pretty decent control/A1C -- but I had to rant in response to the Walmart insulin suggestion above!)

pluto7777 5y ago

Goodrx shows lispro generic $48.85 per vial. Humalog 'guchi' is $142.55. If you're fortunate enough to have diabetic retinopathy and can't read the tiny print, the larger kwikpens are only $270.28. Lets not even get into the real guchi brands.

rland 5y ago

Walmart insulin is not lispro/glargine, it is R/N, which is a different formulation. Treatment of type 1 with R/N is associated with significantly higher mortality, A1C, and complication risk, and, of course, much lower quality of life. Bear in mind: when you mis-dose insulin, your blood turns into acid. No endocrinologist would ever recommend treatment with older insulins over the new stuff. The only way it happens is because of cost.