3 ms·

Can someone explain to me why insulin, essentially a commodity, can fetch any significant price over cost? Why isn't there more competition? Is barrier to entry

Can someone explain to me why insulin, essentially a commodity, can fetch any significant price over cost? Why isn't there more competition? Is barrier to entry for low-cost competitors the difficult of manufacture? Or is it patent enforcement? If it's patent enforcement, wouldn't a bill that reforms the patent protection for insulin makers make a lot more sense than this bill?

_aavaa_ 5y ago
If I were to bet, it would be the manufacturing requirements placed on pharmaceutical companies. I am not saying they're unjustified (e.g. sterilization requirements), just that they're onerous.
- imglorp 5y ago
  Plus they're using insulin revenues for other activities.
Auracle 5y ago
When people complain about high insulin costs, they’re complaining about new formulations that work much better. You can get the old stuff at Walmart for (relatively) cheap. The new stuff is probably under patent, although even when that runs out there are roadblocks for generic manufacturing - and that goes for every medication. The fact that patent holders can draw out the process longer than they’re supposed to should be reformed, but that doesn’t get as many political points as capping the price to the consumer.
- deepnotderp 5y ago
  The flip side of that is that many of the newer formulations are slight tweaks, but doctors will generally prescribe the drug that the latest pharma sales rep to visit was selling (yes really). They also tend to not want to change the way they’ve always done things and prescribe a cheaper formulation.
s1artibartfast 5y ago
It's not patents, most early insulin is off patent. Most of the barriers are regulatory and profitability. It is worth noting that bidens 35 is a copay limit, not a limit on what your insurance pays. As a example for profitability, this non profit hopes to bring the total cost down to 30: https://www.google.com/amp/s/amp.cnn.com/cnn/2022/03/03/politics/civica-insulin-affordable-drug/index.html https://www.google.com/amp/s/amp.cnn.com/cnn/2022/03/03/poli...
nradov 5y ago
Insulin isn't one single medication. The basic generic (commodity) forms are already fairly cheap. WalMart sells it for $25, and most patients with insurance coverage pay less. I do understand that this expense can be a burden for low income patients, and it would be reasonable to subsidize them. https://www.diabetesselfmanagement.com/blog/relion-insulin-for-25-a-vial-at-walmart/ https://www.diabetesselfmanagement.com/blog/relion-insulin-f... The really high prices are for patented, branded forms of insulin which have different release profiles. Those are often preferred because they do a better job of maintaining the patient's blood glucose in the correct range. Depending on the formulation they may start acting faster, or require less frequent injections. https://www.goodrx.com/healthcare-access/research/how-much-does-insulin-cost-compare-brands https://www.goodrx.com/healthcare-access/research/how-much-d...

_aavaa_ 5y ago

If I were to bet, it would be the manufacturing requirements placed on pharmaceutical companies. I am not saying they're unjustified (e.g. sterilization requirements), just that they're onerous.

imglorp 5y ago
Plus they're using insulin revenues for other activities.

Auracle 5y ago

When people complain about high insulin costs, they’re complaining about new formulations that work much better. You can get the old stuff at Walmart for (relatively) cheap. The new stuff is probably under patent, although even when that runs out there are roadblocks for generic manufacturing - and that goes for every medication. The fact that patent holders can draw out the process longer than they’re supposed to should be reformed, but that doesn’t get as many political points as capping the price to the consumer.

deepnotderp 5y ago
The flip side of that is that many of the newer formulations are slight tweaks, but doctors will generally prescribe the drug that the latest pharma sales rep to visit was selling (yes really). They also tend to not want to change the way they’ve always done things and prescribe a cheaper formulation.

s1artibartfast 5y ago

It's not patents, most early insulin is off patent. Most of the barriers are regulatory and profitability. It is worth noting that bidens 35 is a copay limit, not a limit on what your insurance pays. As a example for profitability, this non profit hopes to bring the total cost down to 30: https://www.google.com/amp/s/amp.cnn.com/cnn/2022/03/03/politics/civica-insulin-affordable-drug/index.html https://www.google.com/amp/s/amp.cnn.com/cnn/2022/03/03/poli...

nradov 5y ago

Insulin isn't one single medication. The basic generic (commodity) forms are already fairly cheap. WalMart sells it for $25, and most patients with insurance coverage pay less. I do understand that this expense can be a burden for low income patients, and it would be reasonable to subsidize them. https://www.diabetesselfmanagement.com/blog/relion-insulin-for-25-a-vial-at-walmart/ https://www.diabetesselfmanagement.com/blog/relion-insulin-f... The really high prices are for patented, branded forms of insulin which have different release profiles. Those are often preferred because they do a better job of maintaining the patient's blood glucose in the correct range. Depending on the formulation they may start acting faster, or require less frequent injections. https://www.goodrx.com/healthcare-access/research/how-much-does-insulin-cost-compare-brands https://www.goodrx.com/healthcare-access/research/how-much-d...