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Walmart unveils low-price analog insulin amid rising diabetes drug costs
- inetsee 5y agoThe retail price of my Humalog is $280 a vial. I have insurance so my cost is a fraction of that. Also, I don't know how Novolog compares to Humalog, but $73 a vial is a step in the right direction for diabetes patients who are uninsured or underinsured.
- ska 5y agoOut of curiosity if you don't mind, how many vials/[unit time] do you need, and is this variable per person or mostly just between people?
- rharb 5y agoCan't speak to the parent but vials per time can both change per person and between people. My wife requires quite a bit more insulin while pregnant for example - she had to make changes to her pump's settings while in the hospital to accomodate it.
- ska 5y agoThanks! I looked up some rough usage stats due to the recent related discussion, but didn't easily find something clear about variability.
- nefitty 5y agoI was curious about this too. Hopefully someone with firsthand experience will correct me/add on to my comment. I hear about insulin a lot but I’ve never gotten an idea of how dosage works. What I found: 1 unit of insulin will cover 10g of carbohydrates [1] Humalog insulin comes in 3 mL (300 units) vials or 10 mL (1000 units) vials. [2] The list price of a Humalog U-100 10 mL (1,000 units) vial is $274.70 [3] In type 1 diabetes, most people need a total of 0.5 - 0.8 units of insulin per kilogram of body weight each day. [4] In patients with type 2 diabetes, marked obesity, and insulin resistance, total daily insulin doses of 200 to 300 units are often required. In this setting, management for most patients includes a total of 1.0 to 2.0 units of insulin per kilogram per day; thus, in very obese patients, a larger total dose is required. [5] In type 2 diabetes, the average weight is 96.5kg - 98.9kg. [6] The average American weight in 2020 was 181 lbs. So around 82kg. [7] With the above details, in type 2, about 100 - 200 units are needed per day. That’s $989 - $1978 per year. In type 1, $494 - $791. 1. https://www.medicalhomeportal.org/link/3822 https://www.medicalhomeportal.org/link/3822 2. https://www.nationwidechildrens.org/family-resources-education/health-wellness-and-safety-resources/resources-for-parents-and-kids/managing-your-diabetes/chapter-five-taking-insulin https://www.nationwidechildrens.org/family-resources-educati... 3. https://www.lillypricinginfo.com/humalog https://www.lillypricinginfo.com/humalog 4. http://www.diabeticretinopathy.org.uk/prevention/insulindoseinsulin.htm http://www.diabeticretinopathy.org.uk/prevention/insulindose... 5. https://www.patientcareonline.com/view/insulin-dosing-how-high-can-you-go https://www.patientcareonline.com/view/insulin-dosing-how-hi... 6. https://care.diabetesjournals.org/content/29/3/493 https://care.diabetesjournals.org/content/29/3/493 7. https://news.gallup.com/poll/328241/americans-average-weight-holds-steady-2020.aspx https://news.gallup.com/poll/328241/americans-average-weight...
- CollinEMac 5y ago"1 unit of insulin will cover 10g of carbohydrates" This varies significantly from patient to patient actually. The same goes for basal rates (how much insulin you need to maintain a healthy blood glucose level excluding what you eat). As you mentioned, weight is a big factor but so are other things like age, sex, diet, activity level, stress level, and just how well your body reacts to the insulin. Some people respond very well to artificial insulin while others just don't for some reason. I believe it can also depend on how long you've been using insulin. Your body can slowly stop responding as well as it used to. The numbers you came up with as an average sound pretty reasonable, but it's important to remember that daily dosage will vary quite a bit between individuals.
- ska 5y agoThis is the part I had trouble finding any quantification of (not that I looked properly).
- wanderingmoose 5y agoIt is variable. But I'm 220, 6'6" I use ~24 units per day basal rate (continuously pumped, amount programmed over 24 hours) And 1 unit of insulin per 15 grams carbohydrate. I usually average ~50 units per day. Additionally my pump (tandem x2) has a lot of loss due to their loading system. For 300 units loaded, you get 250 deliverable units. Reloads happen about every 5 days. For use per month, I have 2 vials per month prescribed. If you are thinking about cost: pump insertion sets and continuous glucose monitoring sensors are all very expensive as well.
- inetsee 5y agoI am an unusual case: I am LADA (Latent Autoimmune Diabetes in Adults), sometime called Type 1.5. I am autoimmune (and therefore insulin dependent) but I didn't become symptomatic until my early 40s. Also, my weight hovers around 160 lbs, so my comments do not apply to type 2 diabetes patients who are significantly overweight. I use Lantus as my long acting insulin, and Humalog as my fast acting insulin. I receive a shipment of three 10ml vials of each every 3 months (so I use 1 a month). I use 30 units of Lantus a day, and a variable number of units of Humalog, averaging 25 units a day. Thus, 1 vial of Lantus lasts me slightly over 30 days, which is how long you should use a vial of insulin before replacing it. Figuring out how many units of insulin to take can be difficult. This year I got a Freestyle Libre 2 glucose monitor which has alarms which will alert me if my glucose goes above or below preset limits. Fortunately, I am sensitive to hypoglycemia; sensitive enough that I will wake up if I go low while I am sleeping, but I can still get as low as a glucose reading of 40 point before I feel the effects, which upsets me and freaks out my wife. The alarm is set for 80 points, so I can take some carbs before I get seriously hypoglycemic. I adjust my Humalog injections based on my glucose readings and my carb intake using a formula I have adjusted over long experience. I may take as little as 1 unit (if I just need to bring my glucose reading down) or as much as 12 units with a meal, but most of the time I take about 8 units with a meal.
- CollinEMac 5y agoI've used both Novolog and Humalog (depending on what my insurance likes) and I didn't notice any difference in effectiveness for me. Everyone's different though.
- missedthecue 5y ago"More than 34 million people in the U.S have diabetes, and about 1.5 million Americans are diagnosed every year, according to the American Diabetes Association." Wow. That's double the rate of a country like France. An ounce of prevention really is worth a pound of cure.
- mkr-hn 5y agoDo France and the US use the same diagnostic criteria?
- deleted 5y ago[deleted]
- hansvm 5y agoFrance has 6% of the population diagnosed with diabetes, contrasted with 8% in the USA. Both countries are estimated to have a total rate (including undiagnosed individuals) of 10-11%.
- s1artibartfast 5y agoDo you have a source for equivalent undiagnosed prevalence? Looking around, first response on google shows US prevalence is much high higher and increasing while France is lower and decreasing https://www.indexmundi.com/facts/indicators/SH.STA.DIAB.ZS/compare#country=fr:us https://www.indexmundi.com/facts/indicators/SH.STA.DIAB.ZS/c...
- EarthIsHome 5y ago> An ounce of prevention really is worth a pound of cure. We have the technology. The cure is cheap. It's criminally insane that the US doesn't make life-saving or life-bettering drugs more available for free.
- bigmattystyles 5y agoYes, but isn't the real 'cure' in modifying our diets so it doesn't happen in the first place? At this point, tax and put warnings on sugar and carb-rich foods. Use the revenue to subsidize healthier foods to offset the regressive effect of a sugar/carb tax. I know about food deserts and fresh food availability, but the real way to fix this issue is upstream from already having diabetes.
- benjohnson 5y agoIt's good business to keep your customers alive.
- Threeve303 5y agoUnless you're a funeral director
- deleted 5y ago[deleted]
- cptskippy 5y agoHas Walmart entered that market yet?
- trimbo 5y agoYes https://www.walmart.com/browse/home/caskets/4044_4431611_1058564 https://www.walmart.com/browse/home/caskets/4044_4431611_105...
- tyingq 5y agoIf I change the sort order to Price Low->High, I get this really odd captcha telling me to "Press and Hold" a pill shaped button. And I can't solve it, it's in a "Try Again" loop. Weird.
- cptskippy 5y agoWeird, it worked immediately for me. $879 is the cheapest casket if that's what you're after. The cheapest items were all urns.
- hansvm 5y agoShort-term vs long-term gains. You want your customers to stay alive longer to have more kids and more total customers.
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- dangerboysteve 5y agoDonated to openinsulin.org yesterday which is a very cool project.
- tj-teej 5y agoEveryone will have kids one day or knows someone who will. And if that kid is born with type-1 diabetes they will require insulin everyday or else they will die. The inventor of insulin sold the patent for $1 because the thought that it would not be available to all was unconscionable. It is absolutely unacceptable that insulin is not free and available to all (including to those who can afford it at the cost of financial stability). The idea that someone without means should have to pay Walmart $86 for a worse low-budget insulin is disgusting.
- SirSavary 5y agoThe $86 insulin is not worse.
- hourislate 5y agoI agree that Insulin should be free for everyone, it just makes sense. But you make it sound as if Walmart is making money on this. I would bet it barely covers their cost (Break Even). They did this because they have the power to do this (twist some arms). Don't blame Walmart, blame your government for allowing Big Pharma to charge 80% more in the USA than they do almost anywhere else in the World.
- solarkraft 5y agoWhy would it be worse?
- cabraca 5y agoBecause this old style insulin acts slower than the more modern version and requires a rigid eating schedule. See: https://diabetesstrong.com/walmart-insulin/ https://diabetesstrong.com/walmart-insulin/
- wbl 5y agoThe article says that this is one of the newer ones distinct from the formulation they already sell.
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- abruzzi 5y agoMy insulin copay every three months is $100 ($50 for the Novolog fast acting, and $50 for the Tresiba slow acting insulin.) My insurance's portion is closer to $4000 for that 3 months, lst time I looked. Type I Diabetes is expensive, there was a period when I was unemployed and uninsured where I had to pay for type N and type R out of pocket, but the analogs like Novolog and Tresiba is so much easier to control. This is a very good thing.
- thehappypm 5y agoI'm curious to see how people will vilify Walmart for this one. Making insulin more affordable is clearly a good thing, right?
- pempem 5y agoCan we not vilify Walmart and still be upset that we're putting a small bandaid on a pretty huge gouge?
- bingidingi 5y agoChoosing to profit off of it is choosing to let some people die if they can’t afford it. Doesn’t seem like a clearly good thing to me.
- thehappypm 5y agoIf they didn't do this, insulin would be fundamentally more expensive. Making a cheap version available at prices that a typical American can afford even without insurance, seems like a BIG step forward.
- bingidingi 5y agoOk but why not sell it at cost and really shake things up and save lives?
- thehappypm 5y agoI mean, they basically are. Walmart is known for having razor-thin profit margins.
- rbanffy 5y agoWe can vilify Walmart for a number of things even if this one is not one of them. They need to pull a lot of nice things to get to neutral.
- solarkraft 5y agoThis was bound to happen, huh? From what I've read the insulin market was/is protected against new competitors with tons of legal red tape someone with enough capital "just" had to get through. Edit: Wait. Novo Nordisk, their producer, is one of the established insulin vendors. Why are they helping to reduce prices? Also, does anyone have an estimate of how high the margins still are?
- friedegg 5y agoBecause there's a push for insulin affordability, and they look really really really terrible when someone brings up a chart of the rise in the price of insulin over the past few decades. https://divabetic.org/2017/06/08/transparent-pricing-works-handbags-cant-work-health-care/insulin-prices-humalog-novolog-v2/ https://divabetic.org/2017/06/08/transparent-pricing-works-h... They fear a Congressional inquiry and federal price caps. Normally, you'd expect a new medicine entering the market to get cheaper as the production ramps up, yet it's gone the opposite direction, even after the patent has expired.
- bart_spoon 5y ago> Wait. Novo Nordisk, their producer, is one of the established insulin vendors. Why are they helping to reduce prices? The big insulin makers like Novo and Lilly have been bearing the brunt of the PR disaster that is drug pricing, but reaping little of the benefit, as, according to them, their revenue per unit has barely budged in decades. Increased costs are to appease the insurance companies/PBM middle men (because due to the rebate system, they don't actually have to pay those increased costs). Both Novo and Lilly have attempted ways to cut out the middle men, with reduced payment programs, like the one mentioned in the article, or through "savings cards". However insurance companies have gone out of their way to combat these, limiting their effectiveness. I think what's notable here is that Walmart actually has enough corporate muscle to allow a pairing with the pharma companies that the insurance companies will struggle to combat.
- gruez 5y ago>according to them, their revenue per unit has barely budged in decades source?
- LQexplanation 5y agoBefore commenting about exercises and healthy diet - check difference between Type 1 and Type 2 diabetes...
- avelis 5y agoIt's surprising that not many know about T1D. Also that the inventors gave the patent for free to prevent what we are seeing today in corporate America.
- RHSeeger 5y agoThis is huge news. Sure, it's not the end goal of cheap/affordable insulin for all diabetics, but it is a great step in that direction. Walmart should be applauded for taking this step (and I'm usually first in line to hate on Walmart); kudos to them.
- adventured 5y agoAnd the US does not particularly need to urgently aim for ~$10-$15 as in many other affluent nations. This is a mistake commonly made by those griping about insulin prices, they expect that somehow magically we should just warp to $12 insulin pricing. That desire for step-skipping is never going to happen, that's a great way to never get anywhere. The reality of the giant mess of a healthcare system the US has means it can't work that way, and thinking otherwise is pure fantasy. Instead, $30-$40 would do just fine compared to where we're coming from, it would be tremendous progress. Once we get there, we can target ways to reduce it further to try to get closer to in-line with other nations. As you note, this improvement is welcome, and we should then focus on going after the next step-forward improvement.
- davidthewatson 5y agoIt's worth noting that not all states in the United States require a prescription to buy insulin. To me, this raises questions about the statement in the CNBC article: "Starting this week, the retailer will sell an exclusive private-label version of analog insulin, ReliOn NovoLog, to adults and children who have a prescription." What's the implication for those who live in a state like Pennsylvania and do not need a prescription to buy insulin, much to the dismay of many in the medical community. https://www.researchgate.net/publication/42769372_Murder_by_insulin_Suspected_purported_and_proven_-_A_review https://www.researchgate.net/publication/42769372_Murder_by_... And finally, Wal-Mart has been driving this agenda through low priced insulins for years and deserves praise for that effort to affect change. Can we expect the same from Amazon now that they've chosen to enter the pharmacy business?
- bart_spoon 5y agoEveryone in this thread rightfully outraged by insulin prices needs to look into the rebate system and PBMs in America. Its an absurdly complicated environment, born out of a desire to drive drug costs down, that paradoxically drives them up. There's plenty of approaches to tackling drug prices, but dismantling the rebate system needs to be included. And frankly, the best way to dismantle the system is through some form of publicly available, universal health insurance. I believe in the power of healthy, free markets as much as anyone, but the current healthcare system is anything but. The lack of a non-profit seeking provider of health care, in a space where customers options are to pay whatever is charged or simply die, is not a functioning market. The rebate system was born out of what was a legislative bandage over this issue. Continuing to try and come up with cute solutions that avoid government provided healthcare for all will see similar results. Its why Americans spend so much more on insulin, and most other forms of healthcare services, than the vast majority of the world.
- s3r3nity 5y ago> ...in a space where customers options are to pay whatever is charged or simply die Look...I agree with the majority of your point, the majority of healthcare doesn't deal with such an obvious binary...and we aren't going to make progress on this issue unless we're willing to also have the conversation about healthcare within your control - e.g. individual responsibility for your healthcare. A number of close family members are doctors / surgeons of various kinds, so I've heard so many issues & complaints about the system. And while I would happily pay taxes to fix healthcare issues that are preventative (e.g. cancer screenings,) educational (e.g. nutrition,) and overall unpredictable (e.g. surprise brain aneurysms or the like,) I have no desire in paying for: - Someone who drank so much and annihilated their liver, requiring significant & expensive surgery - Someone who couldn't stop eating at McDonald's and hasn't touched a vegetable in a decade now wants lifetime insulin and kidney transplant - A hypochondriac who wants to see their doctor for every scratch, off-color skin mark, etc. - Someone voluntarily jumping off planes, doing dangerous sports, etc. without insurance, and expecting someone else will foot the bill - Someone who wants every and any blood test because they coughed once etc. etc. etc. Again...overall I agree with a more central payer system, but you won't get the conversation started with all the groups involved unless you acknowledge that there's some element of individual responsibility that you need to control for as well.
- memetcn 5y agoIt absolutely blows my mind that people are hyped about a Supermarket started selling insulin at low cost. And I'm writing from Turkey which you would think it would be terrible in managing any public infrastructure including health. My company pays equivalent to 400 USD per year for private health insurance, gives me unlimited access for surgeries, any treatment that I need to stay at hospital and a check-up per year. The insurance is valid in any private hospital including the ones that look like straight out of Space Odyssey. You know what's more interesting? If you think this is a good deal, then almost everyone in Turkey thinks this kind of service should be provided by public healthcare system and demand it. Not only for the people that can pay 400 USD per year. edit: I realized it sounds like you need to pay 400 USD for unlimited healthcare but you don't need to pay anything for the state hospitals. The insurance is for zero-cost treatment at the private hospitals. You do pay a contribution fee around 3-5 USD for every visit plus prescription at the state hospitals though. I believe it is for discouraging unnecessary visits to the hospitals but even that causes a stir.
- ipnon 5y ago“Americans can always be trusted to do the right thing, once all other possibilities have been exhausted.”
- grecy 5y ago> almost everyone in Turkey thinks this kind of service should be provided by public healthcare system and demand it In virtually all developed countries, it is provided. Hundreds of millions of people around the world live this way, right now.
- msandford 5y agoWe could do it in the US too! Convince the Democrats to give up $x billions in $something to do universal healthcare and I bet you could get a bunch of Republicans to support it. The problem is that neither party wants to make deals. They both want to have their existing programs AND to add extra ones on too. Everyone follows their incentives. None of them have the incentive to make a deal and get de-elected. They have lots of incentive to grandstand and call the other side bad-guys for being bad and not agreeing to this thing that "we all know is moral and right" that clearly we don't have some kind of 90% super-duper extra majority that all agree it's right. If we did, it would most likely be done already.
- tibbydudeza 5y agoAmerican healthcare and drug companies are the modern robber barons.
- imwillofficial 5y agoGreat job Walmart!
- bastard_op 5y agoIf Walmart can figure out how to do this, why aren't more businesses doing this? Rather than UberEats, you get UberInsulin.