6 ms·

I believe it gets payed for by insurance in basically any other country. I can only talk about germany: For type 1 diabetes insurance completely covers it. For

I believe it gets payed for by insurance in basically any other country. I can only talk about germany: For type 1 diabetes insurance completely covers it. For type 2 it may get fully covered but it depends on some factors, but even then you don't pay the full price, only a part since the insurance will almost always at least partially cover it. (this is based on a quick google search)

antirez 5y ago
In Italy no need for insurance, it's just the government that gives it you for free. But the problem is, I believe, different: it's the raw cost of the medication. Here in Europe even if the patient has to buy it, the cost is fraction.
- mngnt 5y ago
  Do you have any source I could read to see how it works in Italy? I live in central Europe (Slovakia) and insulin is also "free" here (if you are diabetic and have a prescription), but it´s not "paid by the government", it´s paid by the compulsory insurance everyone is paying (for me, it´s about 5% off of my net salary). I 100% agree to your second point. I found some data to compare: Humalog from Eli Lilly Netherlands costs 19,42 € per 10 ml vial in Slovakia [1] and $296.29 in the US [2]. Yep, that´s ~13 times as much (I ignore exchange rates, but it´s in the same ballpark). This is not saying much though, due to salary difference. Average monthly salary in Slovakia is 1133 € , while in the US it is $4692.5. Thus, an average Slovak can pay for 580 ml of insulin monthly (I´ll note here, they doesn´t have to pay, it´s covered by insurance), while an American can only get 158 ml of the same brand, same product insulin. On top of that is the manufacture price is up to $6.16 per vial. [5] [1] https://translate.google.com/translate?sl=auto&tl=en&u=https://www.adc.sk/databazy/produkty/detail/humalog-100-u-ml-228842.html https://translate.google.com/translate?sl=auto&tl=en&u=https... [2] https://www.drugs.com/price-guide/humalog# https://www.drugs.com/price-guide/humalog# [3]https://translate.google.com/translate?hl=&sl=sk&tl=en&u=https%3A%2F%2Fwww.minimalnamzda.sk%2Fpriemerna-mzda.php https://translate.google.com/translate?hl=&sl=sk&tl=en&u=htt... [4]https://www.bls.gov/oes/current/oes_nat.htm#00-0000 https://www.bls.gov/oes/current/oes_nat.htm#00-0000 [5]https://www.singlecare.com/blog/insulin-prices/ https://www.singlecare.com/blog/insulin-prices/
  - maxerickson 5y ago
    The "cash" price in the US is $142: https://www.goodrx.com/humalog?dosage=10ml-of-100-units-ml&form=vial&label_override=Humalog&quantity=1&sort_type=popularity https://www.goodrx.com/humalog?dosage=10ml-of-100-units-ml&f... (GoodRx doesn't have any direct user fees, they make money by understanding the stupid prescription drug system in the US) There's a generic that is $50 at several pharmacies.
    - mngnt 5y ago
      Thanks for pointing that out. GoodRx is not available from EU (Either due to GDPR or due to not being applicable to non-US readers, I guess). That invalidates my numbers a bit. However, it´s also pointing to another facet of this issue: the opaqueness of the pricing. In here, price of medication (including insulin) is regulated and it´s the same everywhere, for everyone and no seller-specific discount can be applied.
      - maxerickson 5y ago
        Yeah, they make money by working the convoluted US system. It isn't good that the prices vary, but it's been long enough that people with substantial drug costs should be doing some basic checks, discussing the highest quoted US prices doesn't reflect what people are paying.
    - steveklabnik 5y ago
      The "cash" price is $342. The $142 is from a $200 which has eligibility requirements, which don't allow you to get that discount in many cases.
      - maxerickson 5y ago
        What requirements are attached to using the PBM replacements? My understanding is that you go to a pharmacy that accepts them and give them a number to put into the computer. Or does using them disqualify people from other programs?

antirez 5y ago

In Italy no need for insurance, it's just the government that gives it you for free. But the problem is, I believe, different: it's the raw cost of the medication. Here in Europe even if the patient has to buy it, the cost is fraction.

mngnt 5y ago
Do you have any source I could read to see how it works in Italy? I live in central Europe (Slovakia) and insulin is also "free" here (if you are diabetic and have a prescription), but it´s not "paid by the government", it´s paid by the compulsory insurance everyone is paying (for me, it´s about 5% off of my net salary). I 100% agree to your second point. I found some data to compare: Humalog from Eli Lilly Netherlands costs 19,42 € per 10 ml vial in Slovakia [1] and $296.29 in the US [2]. Yep, that´s ~13 times as much (I ignore exchange rates, but it´s in the same ballpark). This is not saying much though, due to salary difference. Average monthly salary in Slovakia is 1133 € , while in the US it is $4692.5. Thus, an average Slovak can pay for 580 ml of insulin monthly (I´ll note here, they doesn´t have to pay, it´s covered by insurance), while an American can only get 158 ml of the same brand, same product insulin. On top of that is the manufacture price is up to $6.16 per vial. [5] [1] https://translate.google.com/translate?sl=auto&tl=en&u=https://www.adc.sk/databazy/produkty/detail/humalog-100-u-ml-228842.html https://translate.google.com/translate?sl=auto&tl=en&u=https... [2] https://www.drugs.com/price-guide/humalog# https://www.drugs.com/price-guide/humalog# [3]https://translate.google.com/translate?hl=&sl=sk&tl=en&u=https%3A%2F%2Fwww.minimalnamzda.sk%2Fpriemerna-mzda.php https://translate.google.com/translate?hl=&sl=sk&tl=en&u=htt... [4]https://www.bls.gov/oes/current/oes_nat.htm#00-0000 https://www.bls.gov/oes/current/oes_nat.htm#00-0000 [5]https://www.singlecare.com/blog/insulin-prices/ https://www.singlecare.com/blog/insulin-prices/
- maxerickson 5y ago
  The "cash" price in the US is $142: https://www.goodrx.com/humalog?dosage=10ml-of-100-units-ml&form=vial&label_override=Humalog&quantity=1&sort_type=popularity https://www.goodrx.com/humalog?dosage=10ml-of-100-units-ml&f... (GoodRx doesn't have any direct user fees, they make money by understanding the stupid prescription drug system in the US) There's a generic that is $50 at several pharmacies.
  - mngnt 5y ago
    Thanks for pointing that out. GoodRx is not available from EU (Either due to GDPR or due to not being applicable to non-US readers, I guess). That invalidates my numbers a bit. However, it´s also pointing to another facet of this issue: the opaqueness of the pricing. In here, price of medication (including insulin) is regulated and it´s the same everywhere, for everyone and no seller-specific discount can be applied.
    - maxerickson 5y ago
      Yeah, they make money by working the convoluted US system. It isn't good that the prices vary, but it's been long enough that people with substantial drug costs should be doing some basic checks, discussing the highest quoted US prices doesn't reflect what people are paying.
  - steveklabnik 5y ago
    The "cash" price is $342. The $142 is from a $200 which has eligibility requirements, which don't allow you to get that discount in many cases.
    - maxerickson 5y ago
      What requirements are attached to using the PBM replacements? My understanding is that you go to a pharmacy that accepts them and give them a number to put into the computer. Or does using them disqualify people from other programs?