Other Costs For Mass Production
Costs of excipients were added based on prices listed online by large chemical manufacturers and typical excipient composition . We added an additional 20% margin for operating expenditures and profit. We undertook a sensitivity analysis on these cost assumptions.
An analysis by IMS Health estimated that for diabetes medicines, importation and distribution costs added 23% to the manufacturer price in Brazil, 23% in India, 41% in Indonesia and 11% in South Africa. Therefore, to allow comparison of estimated prices with reported government procurement prices, we added 20% to represent the cost of importation and distribution.
How The Companies Justify Their Price Increases
With Type 1 diabetes, which affects about 5 percent of people with diabetes in the US, the immune system attacks the insulin-producing cells in the pancreas, leaving the body with little or none of the hormone. In Type 2 diabetes, the pancreas still makes insulin, but the body has grown resistant to its effects. In both cases, patients rely on insulin medication to keep energy from food flowing into their bodies.
The US is a global outlier on money spent on the drug, representing only 15 percent of the global insulin market and generating almost half of the pharmaceutical industrys insulin revenue. According to a recent study in JAMA Internal Medicine, in the 1990s Medicaid paid between $2.36 and $4.43 per unit of insulin by 2014, those prices more than tripled, depending on the formulation.
The doctors and researchers who study insulin say it is yet another example along with EpiPens and of companies raising the cost of their products because of the lax regulatory environment around drug pricing. They are doing it because they can, Jing Luo, a researcher at Brigham and Womens Hospital, told Vox in 2017, and its scary because it happens in all kinds of different drugs and drug classes.
In countries with single-payer health systems, governments exert much more influence over the entire health care process.
The US doesnt do that. Instead, America has long taken a free market approach to pharmaceuticals.
Costs Of Vials And Syringes
Syringes usually cost between $15 and $20 for a box of 100 depending on where you get them from. Based on where you live, you can purchase them over the counter or online at diabetes supplies stores.
Vial prices vary for each brand and may change with little notice.
For example, a recent internet price search found that Humalogs list price is roughly $325 per 10 ml vial. Admelog is priced at around $200 per 10 ml vial, while the recently released authorized generic of Humalog is priced at $170 per 10 ml vial. The price varied depending upon pharmacy location.
With insurance, a copay and coinsurance rate can be as low as $5, but it can sometimes rise as high as 50 percent or more of the total cost.
Retail pharmacies like Walmart offer older versions of Regular and NPH human insulin for just $25 per vial.
You and your doctor will work together to determine the best insulin for you.
You May Like: Treatment Of Type 1 Diabetes In Child
Costs Of Insulin Pumps
Without insurance, a new insulin pump costs about $6,000 out of pocket, plus another $3,000 to $6,000 annually for ongoing supplies, like batteries and sensors. The cost varies depending on the features, software, brand, and size of the pump.
But youll also need to pay separately for the insulin delivered via the device, so the cost for using an insulin pump without good insurance coverage can be tremendous.
Genetic Disorder May Reveal How Statins Boost Diabetes Risk
“A lot of time we get caught up in some of the hype,” Riggs says. “When a new medicine comes out and it has theoretical advantages, we buy into that and think newer is better.”
The company that made the new form of insulin, called Humulin, launched a large marketing effort aimed at doctors and patients shortly after its release.
But newer drugs aren’talways better, says Dr. Adriane Fugh-Berman, a professor of medicine and pharmacology at Georgetown University. That’s partly because drug companies don’t have to prove that a new drug is better than what is already on the market they just have to prove that it’s not worse.
Insulin made via recombinant DNA technology in 2009.
“In government-funded studies that have compared older drugs to newer drugs, often older drugs come out looking better or equal to newer drugs,” Fugh-Berman says.
For example, some patients have found that animal-derived forms of insulin work better for them, she says. They cause less variability in blood sugar, and fewer episodes of hypoglycemia.
And while those older kinds of insulin are not available in the U.S., they are available elsewhere.
“In Canada, there actually is still an animal-derived insulin on the market, and that was really due to the efforts of consumer advocates,” Fugh-Berman says.
“But there’s concern that the cost savings will be nowhere near as robust as they have been with generic drugs,” Greene says.
Correction March 19, 2015
Don’t Miss: Financial Help With Diabetic Supplies
Switching To Newer Insulin For Type 2 Diabetes Comes At A Cost
Greene wondered why that was the case. Why was a medicine more than 90 years old so expensive? He started looking into the history of insulin, and has about his findings in this week’s issue of the New England Journal of Medicine.
The story of insulin, it turns out, starts back in the late 1800s. That’s when scientists discovered a link between diabetes and damaged cells in the pancreas cells that produce insulin.
In the early 1920s, researchers in Toronto extracted insulin from cattle pancreases and gave it to people who had diabetes, as part of a clinical trial. The first patient was a 14-year-old boy, who made a dramatic recovery. Most others recovered as well. Soon, insulin from pigs and cattle was being produced and sold on a massive scale around the world.
Acids, alcohol and pancreatic tissue were separated, bathed and mixed in this laboratory of a 1946 insulin factory in Bielefeld, Germany.hide caption
Acids, alcohol and pancreatic tissue were separated, bathed and mixed in this laboratory of a 1946 insulin factory in Bielefeld, Germany.
But for some, the early forms of the medicine weren’t ideal. Many people required multiple injections every day, and some developed minor allergic reactions.
“All of these innovations helped to make insulin a little bit safer, a little bit more effective,” Greene says.
Greene says there’s no one reason that companies stopped producing the older animal versions, but they clearly felt it would not be profitable.
The Cost Of Cataracts In Diabetic Cats
When glucose builds up dangerously high in the bloodstream, a cat may suffer from organ damage, particularly to the eyes. Cataracts typically make the affected eye or eyes white and cloudy in appearance. When a cataract forms, the eyes lens becomes opaque, which causes full or partial blindness in the affected eye.
Cataract surgery is the usual treatment recommendation and can cost around $3500 to have performed on your kitty.
Read Also: How Does Diabetes Cause Kidney Failure
How Much Will It Cost To Install And Run A Small Scale Insulin Production System
Recently, we published a blog that addressed the question of how many people with diabetes would a small-scale system could serve. Through our calculation, we estimated that a small-scale production system could serve an expected total of 13,000 people with diabetes the estimates range from 4,000 to 45,000. In this post, we would like to evaluate the cost and feasibility of this solution.
The two main costs are upfront costs and recurring costs. The upfront price for new commercial equipment will be $73 per person with diabetes served however, it can range from $7 to $20 if some equipment is second hand. If we project the use of open production hardware, this cost could come down to $4 per person. The upfront price only takes into account the equipment, not the cost of R& D provided by the Open Insulin Project to remain in the commons. The recurring cost will cover consumables, salaries, quality processes, packaging, and rent. The recurring cost will be around $7 per vial so ~$14 per month for a person with diabetes.
Still, looking at the cost of such a system using the excessively expensive proprietary hardware shows that even in the worst case, producing insulin in small scale, locally based groups is economical and can deliver prices to insulin users far below those charged to users under the current system, even after insurance.
Equipment – $73/person with diabetes served
The small-scale production system will have six main components:
Salaries – $1/vial
Reasons For The High Cost Of Insulin
- Gavlak G.
- et al.
|Reasons for the high cost of insulin|
|Vulnerable population who is willing to pay high costs to have access to a lifesaving drug|
|Pharmacy benefit managers and other middlemen who benefit from a high list price|
|Lobbying power of insulin manufacturers|
|Possible policy level solutions|
|Value-based reimbursement and pricing, and laws and regulations governing price increases|
|Easier path for biosimilar entry, including reciprocal approval of biosimilars|
|Governmental or nongovernmental agency to oversee pricing|
|Transparency on rebates|
|Solutions that can be implemented by physicians and institutions|
|Discussion with patients about affordability|
|Awareness about sources of information on prices|
|Practice guidelines that take cost into account|
|Preference of lower-cost biosimilars in formularies|
- Hancock J.
- Lupkin S.
|1921: Discovery of insulin|
|1923: First insulin patented|
|1946: Neutral protamine Hagedorn insulin|
|1950s: Lente insulin|
|1970s: Improved purified insulins|
|1984: Recombinant human insulin|
biosimilarsgenericsN Engl J Med.
- Hancock J.
- Lupkin S.
- Hancock J.
- Lupkin S.
- Hancock J.
- Lupkin S.
- Hancock J.
- Lupkin S.
- Mazziotta J.
Recommended Reading: Best Sweetener For Baking For Diabetics
Us House Votes To Cap Insulin Cost At $35 Per Month
We were unable to process your request. Please try again later. If you continue to have this issue please contact .
The U.S. House of Representatives approved a bill on November 19 that would cap insulin prices at $35 per month for Americans with diabetes.
The House approved the social spending bill H.R. 5376, also known as the Build Back Better bill, by a vote of 220-213. The bill will now be sent to the U.S. Senate for approval.
Among the bills provisions, beginning in 2023, Medicare Part D and private group or individual health care plans cannot apply a deductible or charge more than $35 for a 30-day supply of insulin. For Medicare Part D, plans could charge no more than $35 for whatever insulin products they cover in 2023 and 2024. In 2025, all insulin products will fall under the cap under a drug negotiation provision also included in the bill.
If the bill is later passed by the U.S. Senate and signed into law by President Joe Biden, the insulin cap will take effect beginning in 2023.
As Healio previously reported, insulin prices have been on the rise over the last 20 years. According to 2017 data from the Health Care Cost Institute, insulin prices nearly doubled from 2012 to 2016, with the average price for a 40-day supply of insulin increasing from $344 to $666 during that span.
Is Competition Part Of The Problem
In the 95 years since insulin was developed, a number of drug companies have been making and selling it. But even with all those companies making insulin, competition hasnt resulted in lower prices its had the opposite effect. In fact, some brands of insulin have seen prices increase by more than 150 percent in the last five years alone.
These price increases can spread like wildfire, with drug companies matching competitors price hikes in whats known as shadow pricing. Like our recent blog post about the EpiPen, this is just one more example of the irrational world of drug prices.
Blue Cross and Blue Shield of North Carolinas spending on insulin has been on a steep incline for years. Each year, BCBSNC spends about $250 million on all medications, with insulin making up 13 percent of the total.
And as complicated as our health care system is, some of the math is very simple. In the case of insulin:
You May Like: Cheapest Insulin In The World
Diabetes: Should I Get An Insulin Pump
You may want to have a say in this decision, or you may simply want to follow your doctor’s recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them. Get the facts Key points to remember An insulin pump can free you from a strict regimen of meals, sleep, and exercise, because you can program it to match your changing schedule. After you learn how to work with a pump, it can make living with diabetes easier. But it takes some time and effort to learn how to use the pump to keep it working properly and to control your diabetes. Using a pump includes checking your blood sugar many times a day and carefully counting the grams of carbohydrate that you eat. Using an insulin pump can keep your blood sugar at a more constant level so that you don’t have as many big swings in your levels. People who use pumps have fewer problems with very low blood sugar. Many insurance companies cover the cost of insulin pumps, but they have strict guidelines that you will have to follow before they will pay.Continue reading > >
Regulation Of Drug Prices
One way that Canada maintains the cost of insulin is through something called the Patented Medicines Prices Review Board . PMPRB was established in 1987 and amended in 2019 . In a nutshell, the PMPRB ensures that patented drug prices are not excessive . To do so, the board considers a products therapeutic benefits relative to existing comparable drugs, consumer price index changes, and the price of the drug in a group of reference countries . The board also reports trends in pharmaceutical sales and pricing for all medicines . The 2019 PMPRB amendments include analyzing new factors such as cost-effectiveness, changing the group of reference countries to be more comparable to Canada, and changing reporting requirements .
The PMPRB has limitations, though. For example, it only regulates the factory gate price of prescription drugs or the price that patent holders charge wholesalers, hospitals, or pharmacies for their drug. The factory gate price is not the price that a person actually pays at a pharmacy . The final price depends on how much wholesalers and retailers mark up, how much pharmacists charge for filling the prescription, and how much insurance is willing to cover . The hidden costs contributing to the total prescription drug cost are very hard to analyze due to lack of transparency in the industry and variability between province, payment plan, and drug type.
Don’t Miss: Diabetes And Heat Exhaustion Symptoms
Insulin In America: A Right Or A Privilege
Even as a medical student, I was interested in the history of insulin. As an endocrine fellow, I read The Discovery of Insulin by Michael Bliss . It is a book anyone interested in diabetes should read, as life before insulin is difficult to appreciate by todays standard of care, at least in the United States. Amazing stories of what people did to obtain insulin are plentiful, perhaps none more dramatic than Eva Saxls story, with her husband making insulin in Shanghai, China, for the more than 200 Jews who escaped Nazi persecution during World War II .
But in the United States, access to insulin had never been a problem. As a medication required for survival by 10% of those with diabetes, it was always available, although for decades quite crude by todays standards. The insulin patent from the University of Toronto was sold for $1 with the understanding that cheap insulin would become available . Through the years, insulin remained affordable. Even with the introduction of human insulin in 1982 and then insulin analogs in 1996 , the increases in insulin pricing did not seem to be a concern. At least in the United States, the vast majority of patients requiring insulin had access to all of the insulin analogs as they were developed.
What Does Cat Diabetes Cost To Manage
When it comes to the cost of cat diabetes, theres a lot for you to know. For starters, National Pet Diabetes Month arrives each year in November, and represented by the color blue, it brings up a valuable subject we all need to know more about, including what diabetes can cost, and how it might affect your vet bills in the future.
Heres a breakdown on what diabetes in cats looks like and the overall cost of treating cat diabetes.
Diabetes is a chronic illness found in many animals such as humans, dogs, and cats. Diabetes is a metabolic disorder that affects a cats ability to process food correctly. A healthy cat can process and break down their food into smaller components, like glucose. Glucose is then absorbed into their cells with the help of insulin.
However, acat with diabetes is unable to make insulin or cannot utilize their insulin correctly. This leaves a cat with diabetes unable to use the glucose from food, which leaves them with a lack of fuel to run on.
A diabetic cats inability to process glucose also puts them at risk of having too much glucose in their bloodstream. This can potentially lead to damage to organs, such as the eyes, nerves, heart, kidneys, and blood vessels. Cats with diabetes are prone to weakness of the hind legs after high blood glucose levels have damaged this areas nerves.
You May Like: Can You Get Rid Of Diabetes Type 1