[ng12]

> If you ask the patients there’s a world of difference between the cheap genetics and the main brand products

The main problem is the $25 insulin is R and not fast-acting. It's not the difference between generic and name-brand, it's about using an insulin that takes over twice as long to be absorbed by your body.

[hjk05]

It really boggles my mind that every article on insulin goes through this cycle: “the producers are scammers it the same product put out a hundred years ago but they have new patents!!!” “It’s cheaply available in the old form” “but that’s not the same product!!”

You can’t have it both ways. Cheap alternatives are available. But yes newer main brand products are better in tons of ways, which is not surprising as they are culmination of decades of research. You can’t both claim there are no differences and than want those differences in the cheaper generics.

[rland]

The patent is expired on the “new version,” Humalog. It expired sometime in the early 2010s. However, because it is produced biologically (altering RNA in bacteria) instead of chemically, additional regulations prevent a genetics from entering the market.

It is this additional regulation that should be subject to scrutiny, since the price of humalog has continued to rise, even after its patent expired. A vial of humalog costs~$5-10 to manufacture, while its list price is nearly $300 and rising quickly. I’m guessing because pharmas want to milk their golden cow while these regulations are still in place. We could drop the price of Humalog 90% within a matter of days by simply cutting regulation against import, as it is already being manufactured safely abroad.

By the way, when Humalog was under patent, on day one, the list price was something like $30 per vial.

Using cheaper alternatives is also strongly correlated with worse outcomes, including amputations and death.

In a word, yes, it literally is exactly as unconscionable and greedy as it looks on the tin.

[hjk05]

> I’m guessing because pharmas want to milk their golden cow

It’s a wired definition of milking a product to lower your take home year after year. The PBMs have rebates close to 70% they are literally making more on the drugs than both the companies producing them and the companies providing them through insurance. List prices are high because the people who own the consumer side of the market don’t care how high the prices go as long as they can set up rebates that increase their own profits.

[ng12]

I agree that the reporting is sub-par but that's not really what's going on. Insulin R and rapid-acting insulin are two separate medications. All insulin manufacturers produce both types and a generic is only available for NPH, despite the fact that the overwhelming majority of Type 1 diabetics are prescribed fast-acting. Additionally most diabetics are prescribed to take a long-lasting insulin as well since the body needs insulin 24-hours a day, there is no generic for this variant either.