[jablongo2]

As a type-1 diabetic and user of Lilly and Novo Nordisk insulins, this article is spot on. People are literally dying in some cases due to this dysfunction.

One thing that is not mentioned is that the dynamics of prescription-writing in the first place is anti-competitive in terms of price. Fiasp and Humalog are equivalent fast acting insulins from Novo-Nordisk and Lilly - competition will only happen when patients can decide which one to take instead of their doctors, who are not sensitive to small price differences (and in most cases are not themselves taking the drug).

[disabled]

Agreed 100%. I have T1D myself, in addition to 2 rare autoimmune neurological diseases that affect my peripheral nervous system.

Last time I checked (in March 2019), you could buy 13.5 [10 mL] vials of Novorapid/Novolog in Canada for 1 [10 mL] vial of Novorapid/Novolog in the United States. I am actually going to buy insulin in Canada on a trip in a couple of weeks due to formulary restrictions imposed by my insurance company (cannot obtain this type of insulin via insurance--not due to cost...).

It makes me absolutely sick to my stomach that people with T1D ration insulin. You cannot safely or effectively ration insulin with T1D, ever.

Anyways, I am one of the most stubborn people you will ever meet, but honestly, I do not see a future in this country (the United States). I expect the Affordable Care Act to be either partially or completely overturned next year (June-July 2020), based on the rare cases where the Solicitor General did not defend a case at the Supreme Court. Based on those cases, the likelihood of a partial or complete overturn of the ACA is staggeringly high.

I am trying to warn you that things may get really bad, and to be prepared. Consider other countries, with universal healthcare, in fact, even actually any country in the European Union. They will accept you regardless of the cost of your medical care, as long as you can get a visa. Same goes for citizenship, in the long run. No medical inadmissability restrictions whatsoever.

The Anglo-Saxon countries (US, UK, Canada, Australia) are largely closed to immigration, and the latter 2 have medical inadmissability criteria. Remember that.

[rayiner]

> s a type-1 diabetic and user of Lilly and Novo Nordisk insulins, this article is spot on. People are literally dying in some cases due to this dysfunction

How many people would be dying if there wasn’t the same level of incentives to research these drugs in the first place?

Diabetes is a common health problem around the world. Nothing stopped say a non-profit or government from beating Lilly and Novo Nordisk to the punch developing these drugs. But profit seeking corporations are simply better at innovation than governments and non-profits.

[pasquinelli]

The basic science behind insulin-the-drug wasn't innovated by profit seeking corporations. Applying that basic science to make a usable drug wasn't innovated by profit seeking corporations either. A cursory glance at the wikipedia page for insulin tells me the innovation was done be german, american, and canadian scientists at public universities, starting in the 1880s and not developing into a usable drug until the 1920s.

I don't think a profit seeking corporation would've done that.

[disabled]

There have been recent peer-reviewed journal articles about how much insulin would cost to produce for each person with type 1 diabetes per year.

It is somewhere between $75-$125 USD for a person with T1D per year.

Remember, T1D is an autoimmune and insulin-dependent form of diabetes. Within 5 years post-diagnosis (if not much sooner) your body basically effectively no longer produces any insulin whatsoever.

[rayiner]

If the basic science was the hard part, why did it take 40 years to go from basic science to “usable drug?”

[kshacker]

Remember this was before the era of Facebook, even email and fedex now that I think of it, and they might have also been fighting the world war.

[markbnj]

The whole point of the article is that the manufacturers aren't developing new drugs. The drugs haven't changed in decades. They're making small changes to delivery systems and other ancillary aspects and then patenting these new variations, as well as engaging in the usual quid pro quo wink wink old boy network anti-competitive manipulation of regulatory regimes.

[rayiner]

Insulin has changed quite dramatically over the decades. Earlier iterations of insulin are available as generics. But newer versions act faster and have fewer side effects.

[markbnj]

The article referred to specific insulin products and the specific practices of the manufacturers in those cases, not "insulin" in the generic sense. If you feel the article is in error then responding to the incorrect points would have been more useful than issuing a blanket defense of for-profit drug manufacturing.

[Nasrudith]

None in that case - insulin is perhaps the worst specific case to cite. https://en.m.wikipedia.org/wiki/Insulin#History_of_study

[rayiner]

As the article explains, we aren’t talking about that original insulin. We are talking about the new fast acting forms with fewer complications.