3 ms·

> Insulin costs under $5 to make. Alright, here's what I don't understand: Why isn't the market working here? Why doesn't someone sell insulin at cheaper price

by dilap 5y ago

> Insulin costs under $5 to make. Alright, here's what I don't understand: Why isn't the market working here? Why doesn't someone sell insulin at cheaper price, steal the ~ whole market, and make a killing? Is there some sort of cartel gentlemen's agreement? Is it impossible to get licensed to sell insulin? Something else? Gotta be something, right?!

adamredwoods 5y ago
According to this article, the market was working. Various generic insulin was approved and the price for some insulins was dropping or holding steady: https://www.goodrx.com/healthcare-access/research/how-much-does-insulin-cost-compare-brands https://www.goodrx.com/healthcare-access/research/how-much-d... >> Like generics, follow-on products have also helped to bring down insulin prices overall. Generics contain the exact replicas of the active ingredients in a brand-name medication. But biologic drugs like insulin are nearly impossible to recreate. So sometimes, manufacturers make close copies of them instead, known as “follow-ons” or “biosimilars.” Biosimilars tend to be more expensive than generics but less expensive than brands. >> For example, Admelog was approved as the follow-on to Humalog in 2017. The average retail price for a 3mL vial of Admelog is now $54, compared to $123 for the same-size vial of Humalog. Lantus has a follow-on, too: Basaglar, approved in 2016. By price per insulin unit, Basaglar is 23% cheaper than Lantus. In July 2021, the FDA also approved insulin glargine, a biosimilar to be used interchangeably with Lantus. In its first quarter, retail prices for a unit of insulin glargine were about 60% lower than retail prices for a unit of Lantus.
- lesuorac 5y ago
  IMO the article does not claim the market is working. Insurance companies are not including those generics in their plans so people can't use them. I bet if congress cap'd how much they could charge for insulin they might be incentivized to get people to pick a cheaper (generic) option. > However, we’ve seen that limited insurance coverage [1] can prevent some patients from accessing these savings. [1]: https://www.goodrx.com/classes/insulins/generic-insulins-see-low-fills-insulin-lispro-insulin-aspart https://www.goodrx.com/classes/insulins/generic-insulins-see...
  - foogazi 5y ago
    > Insurance companies are not including those generics in their plans so people can't use them. Are they not available to patients directly?
    - lesuorac 5y ago
      Depends on the word directly but the article touches on that. "insulin lispro" is a generic. > they discovered that insulin lispro was not available at 83% of pharmacies. Among those pharmacies, 69% of them said that they could not order insulin lispro even if the patient did not need it right away. Pharmacies’ inability to offer or order the cheaper generic most likely contributed to the low fill rate for insulin lispro. > Additionally, one of the nation’s largest pharmacy benefit managers, Express Scripts, announced in their 2019 formulary exclusions that insulin lispro would not be covered by their plans. They instead listed the brand Humalog as their preferred insulin drug. This decision may also have contributed to the low fill rate of insulin lispro since Express Scripts is responsible for 24% of the nation’s prescription drug insurance claims.
      - foogazi 5y ago
        > Depends on the word directly Like an OTC you buy at the store or shipped to your home without insurance

by dilap 5y ago

adamredwoods 5y ago

According to this article, the market was working. Various generic insulin was approved and the price for some insulins was dropping or holding steady: https://www.goodrx.com/healthcare-access/research/how-much-does-insulin-cost-compare-brands https://www.goodrx.com/healthcare-access/research/how-much-d... >> Like generics, follow-on products have also helped to bring down insulin prices overall. Generics contain the exact replicas of the active ingredients in a brand-name medication. But biologic drugs like insulin are nearly impossible to recreate. So sometimes, manufacturers make close copies of them instead, known as “follow-ons” or “biosimilars.” Biosimilars tend to be more expensive than generics but less expensive than brands. >> For example, Admelog was approved as the follow-on to Humalog in 2017. The average retail price for a 3mL vial of Admelog is now $54, compared to $123 for the same-size vial of Humalog. Lantus has a follow-on, too: Basaglar, approved in 2016. By price per insulin unit, Basaglar is 23% cheaper than Lantus. In July 2021, the FDA also approved insulin glargine, a biosimilar to be used interchangeably with Lantus. In its first quarter, retail prices for a unit of insulin glargine were about 60% lower than retail prices for a unit of Lantus.

lesuorac 5y ago
IMO the article does not claim the market is working. Insurance companies are not including those generics in their plans so people can't use them. I bet if congress cap'd how much they could charge for insulin they might be incentivized to get people to pick a cheaper (generic) option. > However, we’ve seen that limited insurance coverage [1] can prevent some patients from accessing these savings. [1]: https://www.goodrx.com/classes/insulins/generic-insulins-see-low-fills-insulin-lispro-insulin-aspart https://www.goodrx.com/classes/insulins/generic-insulins-see...
- foogazi 5y ago
  > Insurance companies are not including those generics in their plans so people can't use them. Are they not available to patients directly?
  - lesuorac 5y ago
    Depends on the word directly but the article touches on that. "insulin lispro" is a generic. > they discovered that insulin lispro was not available at 83% of pharmacies. Among those pharmacies, 69% of them said that they could not order insulin lispro even if the patient did not need it right away. Pharmacies’ inability to offer or order the cheaper generic most likely contributed to the low fill rate for insulin lispro. > Additionally, one of the nation’s largest pharmacy benefit managers, Express Scripts, announced in their 2019 formulary exclusions that insulin lispro would not be covered by their plans. They instead listed the brand Humalog as their preferred insulin drug. This decision may also have contributed to the low fill rate of insulin lispro since Express Scripts is responsible for 24% of the nation’s prescription drug insurance claims.
    - foogazi 5y ago
      > Depends on the word directly Like an OTC you buy at the store or shipped to your home without insurance