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If that's actually the case that puts all the "You're literally killing us with expensive insulin prices" people in a very negative light. At best they're ill-i

If that's actually the case that puts all the "You're literally killing us with expensive insulin prices" people in a very negative light. At best they're ill-informed, at worst they're being intentionally deceptive to achieve political aims.

RHSeeger 5y ago
What you've said is true. Refusing to use the older insulins is what is killing people. Having to use the older insulins is shitty, and it shouldn't be happening, but it's not the thing that's killing people. However, actually _saying_ that tends to get people up in arms, harassing you about how it how it shouldn't be necessary for people to use the older insulins, and how the newer insulins shouldn't cost what they do. Even though everyone actually agrees with them and they're arguing against a point that nobody it actually trying to make. It is... frustrating trying to get people to understand that you agree with them, but you're talking about something different. I had this exact discussion with one such person yesterday, and I was trying to explain that they are sabotaging their own goals by misrepresenting the issues. And that I WANT them to succeed in changing things, but they're making it harder to do so. Edit: You're already being downvoted for stating something that is obviously and undeniably true, because people are not bothering to understand what you're saying. I'm sorry for that.
- HarryHirsch 5y ago
  Having to use the older insulins is shitty, and it shouldn't be happening, but it's not the thing that's killing people. In a way it is killing people, blood sugar control is much easier with a mix of the newer insulins, and patience compliance is much higher. This directly translates into better quality of life and lower disease burden from diabetes complications. No one can argue that pharmcos shouldn't be paid for R & D that increases quality of life, in civilized countries the taxpayer should and will pay for your medication if it's an improvement over what's already at market. But here people seem to be arguing that if you can't afford anything else there's still Walmart short-acting Humalog, and you get to bear all the risk, and that's just fine.
pimeys 5y ago
I have to ask, are you suffering from a Type 1 diabetes? If not, at least for me, this answer kind of misses the point completely. Type 1 is a hell to manage. It is REALLY hard. Like I actually use an open source pancreas to control my glucose levels so now I can sleep every night without having to worry about dying. This is in Europe where the insurance covers everything and prices are cheaper than in US. Using the Walmart insulin makes everything much much more complex, and even for the smartest of us, even with the best possible insulins, managing T1 is a HUGE pain and can kill you quite fast. I hope I misread your comment...
- RHSeeger 5y ago
  I do have type 1 diabetes, and I lived on R/L for over a decade. The point being made here is > The high price of tier 1 insulins is killing people Is (more or less) a lie. While > The high price of tier 1 insulins is making people's lives considerably worse and their diabetes harder to manage. Is (more or less) true. When you try to push for change and use, as part of your argument, a lie, you sabotage yourself. People can point at what you're saying and, ignoring the validity of what you're trying to achieve, say "you're lying". That's bad. The truth is that there are good reasons why tier 1 insulins should not cost as much as they do, not by a long shot. And destroying your own progress towards changing things is counter productive. Just don't do it.
  - burkaman 5y ago
    It is not a lie if you think about real human behavior, rather than a theoretical rational automaton. There are real, documented cases of people who were prescribed insulin they could not afford, tried to ration it, and died as a direct result. Maybe their doctor told them not to use it, or they didn't live near a Walmart, or they didn't know it existed. Maybe they tried the Walmart stuff and almost died because it's so difficult to manage, so their doctor told them to switch back to the best treatment available. I promise they did not die to make a political point. One in four patients in the US have rationed insulin because of the cost: https://news.yale.edu/2018/12/03/one-four-patients-say-theyve-skimped-insulin-because-high-cost https://news.yale.edu/2018/12/03/one-four-patients-say-theyv... It is simply untrue to say the high cost only forces people to use the cheaper Walmart generic. That isn't what happens. They ration it, and sometimes they die. Finally, it doesn't make sense to say that the high price is making diabetes harder to manage, but isn't killing people. That's like saying speeding doesn't kill, it just makes the car harder to manage.
icelancer 5y ago
It's the same with basically every other campaign that wants to grab headlines. It literally makes no sense that insulin prices are killing people and it's unavailable, and a basic amount of research shows that yeah indeed, it's clickbait intended to hook you into a more complex discussion. I pay zero attention to people and news sources that repeat that behavior more than once. Lead with the truth.
- RHSeeger 5y ago
  You are a prime example of WHY that lie is bad. The discussion they are trying to drag you into is an important one, and well worth having. However, by starting out with a lie, they are driving you away before they can even start the conversation with you about it. A conversation where you might agree with them.
ska 5y ago
How cheap is the cheap option? I found some references for "old" versions that claim price increase from $17 in 1997 to $138 today, another from $21 to $255. Going by inflation only those would be around $30-40. I don't know how much a typical diabetic needs per month (I imagine it varies) but I could see that being a problem for a lot of people if that is, say a monthly supply.
- RHSeeger 5y ago
  > How cheap is the cheap option About $25, that last I checked. The ones you're talking about, I believe, are the "newer" ones (which are not very new). The prices of those have shot up over the years (in the US) for no good reason. It's shameful.
  - ska 5y ago
    I guess my mistake was thinking 20 plus years was old enough, that would be out of patent.
    - RHSeeger 5y ago
      My understanding it that they are out of patent, but regulations make it hard for new players to enter the market. Since the number of companies making them are so limited, even the generics cost a lot. For example, Basaglar is a "generic" of Lantus, but it's still expensive. Here’s How to Save on Basaglar, the Expensive Lantus “Generic” https://www.goodrx.com/blog/basaglar-expensive-lantus-generic-how-to-save/ https://www.goodrx.com/blog/basaglar-expensive-lantus-generi... > Basaglar contains the same kind of insulin as Lantus (insulin glargine), and while it is cheaper—Basaglar costs about 15% less than Lantus—it is still expensive, with a cash price of around $450 for a 30-day supply. Unlike normal generics, the bio-similars need to go through their own clinical trials and prove they work the same as the original. They can't just "use the same ingredients" and release it. Mind you, that doesn't explain the extreme price markup, but it does explain why these "generics" don't follow the same "85% cost reduction" of normal generics. They still have, effectively, a costly R&D phase. At least, that's my understanding.
KittenInABox 5y ago
It's extremely hard to manage your health with old insulins because they're so much less precise. Imagine if you were programming but your keyboard works such that any key you type might be +3/-3 key presses actually. Except in the case of diabetes, this results in the loss of body parts and blindness.
dv_dt 5y ago
The people who can least afford healthcare also have the most external constraints on their work and life, making it the most difficult to make good, non-harmful use of older insulin in the long term. There are plenty of cases of people literally dying because of difficulty managing insulin due to cost. It’s nice to say other low cost forms are available while handwaving away actual deaths as well as accumulative long term damage from difficult insulin management. https://khn.org/news/insulins-high-cost-leads-to-deadly-rationing/ https://khn.org/news/insulins-high-cost-leads-to-deadly-rati... Many of the “newer” forms are 20+ years old, and are also extremely low cost to produce.

RHSeeger 5y ago

What you've said is true. Refusing to use the older insulins is what is killing people. Having to use the older insulins is shitty, and it shouldn't be happening, but it's not the thing that's killing people. However, actually _saying_ that tends to get people up in arms, harassing you about how it how it shouldn't be necessary for people to use the older insulins, and how the newer insulins shouldn't cost what they do. Even though everyone actually agrees with them and they're arguing against a point that nobody it actually trying to make. It is... frustrating trying to get people to understand that you agree with them, but you're talking about something different. I had this exact discussion with one such person yesterday, and I was trying to explain that they are sabotaging their own goals by misrepresenting the issues. And that I WANT them to succeed in changing things, but they're making it harder to do so. Edit: You're already being downvoted for stating something that is obviously and undeniably true, because people are not bothering to understand what you're saying. I'm sorry for that.

HarryHirsch 5y ago
Having to use the older insulins is shitty, and it shouldn't be happening, but it's not the thing that's killing people. In a way it is killing people, blood sugar control is much easier with a mix of the newer insulins, and patience compliance is much higher. This directly translates into better quality of life and lower disease burden from diabetes complications. No one can argue that pharmcos shouldn't be paid for R & D that increases quality of life, in civilized countries the taxpayer should and will pay for your medication if it's an improvement over what's already at market. But here people seem to be arguing that if you can't afford anything else there's still Walmart short-acting Humalog, and you get to bear all the risk, and that's just fine.

pimeys 5y ago

I have to ask, are you suffering from a Type 1 diabetes? If not, at least for me, this answer kind of misses the point completely. Type 1 is a hell to manage. It is REALLY hard. Like I actually use an open source pancreas to control my glucose levels so now I can sleep every night without having to worry about dying. This is in Europe where the insurance covers everything and prices are cheaper than in US. Using the Walmart insulin makes everything much much more complex, and even for the smartest of us, even with the best possible insulins, managing T1 is a HUGE pain and can kill you quite fast. I hope I misread your comment...

RHSeeger 5y ago
I do have type 1 diabetes, and I lived on R/L for over a decade. The point being made here is > The high price of tier 1 insulins is killing people Is (more or less) a lie. While > The high price of tier 1 insulins is making people's lives considerably worse and their diabetes harder to manage. Is (more or less) true. When you try to push for change and use, as part of your argument, a lie, you sabotage yourself. People can point at what you're saying and, ignoring the validity of what you're trying to achieve, say "you're lying". That's bad. The truth is that there are good reasons why tier 1 insulins should not cost as much as they do, not by a long shot. And destroying your own progress towards changing things is counter productive. Just don't do it.
- burkaman 5y ago
  It is not a lie if you think about real human behavior, rather than a theoretical rational automaton. There are real, documented cases of people who were prescribed insulin they could not afford, tried to ration it, and died as a direct result. Maybe their doctor told them not to use it, or they didn't live near a Walmart, or they didn't know it existed. Maybe they tried the Walmart stuff and almost died because it's so difficult to manage, so their doctor told them to switch back to the best treatment available. I promise they did not die to make a political point. One in four patients in the US have rationed insulin because of the cost: https://news.yale.edu/2018/12/03/one-four-patients-say-theyve-skimped-insulin-because-high-cost https://news.yale.edu/2018/12/03/one-four-patients-say-theyv... It is simply untrue to say the high cost only forces people to use the cheaper Walmart generic. That isn't what happens. They ration it, and sometimes they die. Finally, it doesn't make sense to say that the high price is making diabetes harder to manage, but isn't killing people. That's like saying speeding doesn't kill, it just makes the car harder to manage.

icelancer 5y ago

It's the same with basically every other campaign that wants to grab headlines. It literally makes no sense that insulin prices are killing people and it's unavailable, and a basic amount of research shows that yeah indeed, it's clickbait intended to hook you into a more complex discussion. I pay zero attention to people and news sources that repeat that behavior more than once. Lead with the truth.

RHSeeger 5y ago
You are a prime example of WHY that lie is bad. The discussion they are trying to drag you into is an important one, and well worth having. However, by starting out with a lie, they are driving you away before they can even start the conversation with you about it. A conversation where you might agree with them.

ska 5y ago

How cheap is the cheap option? I found some references for "old" versions that claim price increase from $17 in 1997 to $138 today, another from $21 to $255. Going by inflation only those would be around $30-40. I don't know how much a typical diabetic needs per month (I imagine it varies) but I could see that being a problem for a lot of people if that is, say a monthly supply.

RHSeeger 5y ago
> How cheap is the cheap option About $25, that last I checked. The ones you're talking about, I believe, are the "newer" ones (which are not very new). The prices of those have shot up over the years (in the US) for no good reason. It's shameful.
- ska 5y ago
  I guess my mistake was thinking 20 plus years was old enough, that would be out of patent.
  - RHSeeger 5y ago
    My understanding it that they are out of patent, but regulations make it hard for new players to enter the market. Since the number of companies making them are so limited, even the generics cost a lot. For example, Basaglar is a "generic" of Lantus, but it's still expensive. Here’s How to Save on Basaglar, the Expensive Lantus “Generic” https://www.goodrx.com/blog/basaglar-expensive-lantus-generic-how-to-save/ https://www.goodrx.com/blog/basaglar-expensive-lantus-generi... > Basaglar contains the same kind of insulin as Lantus (insulin glargine), and while it is cheaper—Basaglar costs about 15% less than Lantus—it is still expensive, with a cash price of around $450 for a 30-day supply. Unlike normal generics, the bio-similars need to go through their own clinical trials and prove they work the same as the original. They can't just "use the same ingredients" and release it. Mind you, that doesn't explain the extreme price markup, but it does explain why these "generics" don't follow the same "85% cost reduction" of normal generics. They still have, effectively, a costly R&D phase. At least, that's my understanding.

KittenInABox 5y ago

It's extremely hard to manage your health with old insulins because they're so much less precise. Imagine if you were programming but your keyboard works such that any key you type might be +3/-3 key presses actually. Except in the case of diabetes, this results in the loss of body parts and blindness.

dv_dt 5y ago

The people who can least afford healthcare also have the most external constraints on their work and life, making it the most difficult to make good, non-harmful use of older insulin in the long term. There are plenty of cases of people literally dying because of difficulty managing insulin due to cost. It’s nice to say other low cost forms are available while handwaving away actual deaths as well as accumulative long term damage from difficult insulin management. https://khn.org/news/insulins-high-cost-leads-to-deadly-rationing/ https://khn.org/news/insulins-high-cost-leads-to-deadly-rati... Many of the “newer” forms are 20+ years old, and are also extremely low cost to produce.