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.
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 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.
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.
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.
> One in four patients say they’ve skimped on insulin because of high cost
> say they've
^ is the key component. I expect the vast majority of those people had a choice, and they chose not to take it. A poor choice, and a choice they shouldn't have to make, but a choice nonetheless.
The point is, if you're going to fight for positive change, use an argument that can't be trivially dismissed because it isn't true. Fight effectively.
Yes, why did they choose not to take it? Try to empathize with these people. Why did they do something so dangerous? Then follow it one step further. In the case of those that died, why did they die? What factors contributed to their death? If the price of insulin had been lower, and everything else was the same, would they have died?
I would argue these two statements are equivalent:
- My patient was killed by the high price of insulin.
- If the price of insulin had been lower, my patient would still be alive.
I suspect that you accept the second statement, but not the first. What's the difference?
To me, it's the difference between "is a requirement for" and "is the cause of".
- People drive cars.
- Cars are car jacked.
- If people did not drive cars, carjackings could not happen.
- People driving cars is a requirement for carjackings.
- People driving cars is not a cause of carjackings.
I understand that it is possible and truthful to argue that people driving cars is a cause of carjackings; it's just not my view of the meaning of those words.
By claiming that the companies are colluding and have raised the price, the charge is leveled that the companies are behaving immorally.
When people learn that the "old insulin" and "new insulin" are completely different products and that "old insulin" is still available at a low cost, the narrative and goodwill is shattered.
People hate being lied to and they hate being manipulated.
If you want to have a discussion that we should make the "new insulin" available for at low cost of for free, that is great! We can talk about the cost to manufacture and to develop drugs.
There are many smart people here and around the world, when we put our minds to a problem, we can find a solutions.
But by not acknowledging and downplaying the time and effort that companies and people have put into the "new insulin", then you are cheapening the work they have done and are signaling to everyone that you would do the same to their time and effort as well.
Saying that cheap insulin kills people seems like a hyperbolic, but essentially true statement.
It's well known that you need to keep all sorts of things under control with type 1 to avoid long-term health complications. Blood sugar is the most obvious.
I watched my father manage his for decades, starting in the 1980s. The technology improvements were interesting - his first insulin pump (about the size of a VHS tape), the custom software to data-dump his glucose meter, "supply-hacking" to keep the infusion sets affordable...
He still had management challenges despite being a dedicated, disciplined, marathon-running Mormon on the leading-edge of treatment. He was fortunate enough to be involved in the DCCT/EDIC trials at the University of Washington, and took the early lessons about future complications very seriously.
You make Diabetes harder to manage by removing modern improvements to the standard of care, and you are certainly going to see increases in deaths and severe negative outcomes.
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.
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.
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.
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.
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.
> 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.
I understand that argument.I hadn't thought of the issue of insulin being a biologic, so true generics aren't likely, hence biosimilars. None of this justifies a 10x+ price increase on the same product over 20 years of course.
By the way that same site had an interesting article breaking down costs normalized by insulin unit
By that table and some assumptions about approx 40 IU/day it looks like the cheapest you could get away with at full retail would be about $120/mo, assuming optimal usage etc. The most expensive version would be at least 5x that.
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.
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.
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.
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.
