[clarkrinker]

Every time this stuff comes up it feels like we focus on the politics and not the people with diabetes.

If you or your kid or your friends have Type 1 and are struggling to make your insulin out of pockets please, please, please call the Eli Lily hotline and get the copay card. They've dropped the monthly cost for Humalog to $35.

Don't ration. Work the system. https://www.humalog.com/savings-support

[chefkoch]

Wich is around the list price you pay for two weeks of insulin in germany.

[nceqs3]

Every drug company gives away their drugs for free to people who can't afford it in the US. It's sad that not enough people take advantage of patient assistance programs.

[epmaybe]

This is apologist thinking at best, intentionally misleading at worst.

You are correct that companies do have patient assistance programs. What you’re leaving out is that this applies to a small subset of people that usually have to be denied federal/state insurance, not have any other kind of insurance, and make less than 4x federal poverty level.

additionally, they rarely provide a lifelong supply. Imagine being a diabetic and novo nordisk, who makes most of the insulin types on the market, only gives you a four month supply.

Oh wait, thats exactly the terms of their patient assistance program.

[dillondoyle]

There are some examples like Truvada which seem to be very open.

Gilead would reimburse any out of pocket costs.

Even still it's just a sick game to bilk insurance companies, and thus us insurance premium payers, out of more money while pretending to be looking out for consumers. The monthly cost on my really great insurance was still over $1k out of pocket, which took a bunch of paper work and over a month to get back. Poor people don't have that luxury.

Oh and now that Gilead's license has run out they have a new very expensive PrEP drug magically appear. Which they tout doesn't have as bad long term downside on your organs. The skeptic in me seems to think the timing is too perfect. if there is a safer drug throw it out asap. maybe they did, I can't know that but I have a strong distaste for Gilead in particular.

For-profit healthcare is one of the biggest moral failings of our country.

[emodendroket]

Not only that, but the people who most need the assistance are also the likeliest to have trouble jumping through all the hoops. I used to work for a nonprofit who would administer these patient assistance programs and after a while I felt like I was just getting a lower wage for being part of what was clearly mostly a service to for-profit companies.

[GrinningFool]

Not only this, on top of it all - as if it's not hard enough to ask for 'handouts' - they require you to submit evidence that you don't make too much money.

Just a W-2 or a federal tax return should do - not like those poor people should care about their data or privacy or dignity or anything ~s

[emodendroket]

You're lucky if they settle for that and don't want all your bank statements.

[ineedasername]

No, they really don't. Some don't offer much of anything. Many of those end up providing benefits for the poorest of the poor, but if you're a little above that you're out of luck. Also if you have something like Medicare you can hit certain phases in coverage where you have to pay a much larger part of the cost. Being on any government program disqualifies you from most of these discount programs, so if you're on an expensive Rx you can still be stuck paying a few hundred $$ a month-- more than many can afford.

These discount programs aren't some big secret people don't know about. I see that argument thrown out in defense of high prices but it simply isn't true. Every doctor prescribing drugs knows about them and tells their patients about them. If people are going without necessary medication because they don't know about a discount program then they are extreme outliers.

These discount programs are simply marketing & lobbying tools used to give politicians cover when they all continue to ignore meaningful healthcare reform.

[bingidingi]

Many people simply don’t know about them! I grew up poor and the amount of work that goes into finding and using some services is ridiculous. We bought a house using some assistance programs and at a couple points were speeding across the city to get paperwork in by sone deadline no one told us about (luckily we had a car!).

Not to mention that services like foodstamps can be unreliable… I’ve probably spent hours of my life holding up checkout lines because my card didn’t process…

not having money is one thing, but being poor also obliterates your time if you use various services…which in my experience is worse… you’re always tired and agitated. Someone is always messing up your paperwork, because of course civil servants are often underpaid and overworked themselves.

[distribot]

I had a similar upbringing. All the hours of my childhood in the local health and human services offices and WIC nutritional centers turned me off of civil servants and bureaucrats. It felt like they were always condescending and snippy, or pretending my parents' English was way harder to understand than it is, or just delighting in telling us our stuff was out of order.

Looking back they were probably just overworked and exhausted, but man.

[bingidingi]

I felt the same for a while too, but then I met someone that happened to work for child services. These are some caring and empathetic people working for peanuts and they aren’t really treated well by anyone, management and clients alike. This person in particular hated the work but didn’t want to quit for fear of letting their clients (children) down.

People blame bureaucracy, and maybe there’s some truth there, but if these people were treated half as well as many tech workers are then maybe we could actually start making progress against the stereotype of miserable experiences.

[throwaway0a5e]

It's real easy to become a jaded clock puncher when you're a social worker on a six person team that can barely eek out three people's worth of work because three of the people are deadbeats who's only qualifications are an ability to deposit paychecks and knowing someone who was owed a favor by a politician or appointed high level bureaucrat. The one party states have it the worst because the "next guy's cronies" can't clean house without annoying people within their own network because they're all from the same party. That's assuming they're not union positions and they can actually be fired or laid off in a practical manner.

Nobody who has drive and wants to get shit done lasts very long in that environment. There are occasional pockets of "good" but they don't last because when they accomplish too much people move up and out or they get reigned in by the rest of the system.

Source: members of my household work in government providing social services.

[smeej]

Ah yes. The new administration's "house cleaning."

Better known by the people who actually work there as, "Shoving a bunch of people and papers around to show you're changing things, with no plan, strategy, or even background information to support a single thing."

If you think alternating parties solves the problems, you have another think coming your way!

[emodendroket]

Call me cynical but I don't think that's necessarily seen as a downside by the people in charge. It lets you have it both ways to technically offer assistance that many people find too difficult to actually get.

[edge17]

I'm curious, but what does "can't pay" mean? Does it mean the drug cost 100%+ of your income? 10% of your income?

[km3k]

Hard to say, but many drugs can go over 100%. Some could be several hundred percent or more depending on your income. https://www.reuters.com/article/us-vertex-pharms-fda/vertex-...

[dragonwriter]

It means “the manufacturer realizes they won’t get the price they charge from other channels from you, so is willing to settle for the PR and tax benefits (and whatever residual cost is still charged) rather than nothing.

[emodendroket]

I mean in many cases the product is still profitable for them at the reduced rate, but why settle?

[dragonwriter]

> I mean in many cases the product is still profitable for them at the reduced rate, but why settle?

Because for a customer who would pay nothing if their only choice was to get the drug at full price, settling for a reduced price (especially when you also get a tax deduction, and some PR benefit from advertising the discount for the needy) is more profitable than not settling.

[emodendroket]

You're not really getting what I'm saying. That's what the program allows them to do, while still charging an exorbitant rate to others.

[48309248302]

Sometimes essential medication costs USD $100,000 per year or more.

[DaiPlusPlus]

> Every drug company gives away their drugs for free to people who can't afford it in the US

I don't believe this is universally true though. For example, patent-encumbered novel delivery mechanisms for existing (generic) drugs, like Concerta. The drug company has nothing to gain by maintaining the administrative infrastructure for patient-assistance for drugs like that.

Another example are personalised therpaies, such as immunotherapy treatments - which cost so much because (as I understand it, please correct me if I'm wrong) they require individual experts to develop the personalized antibodies and whatnot - unlike with mass-produced medication pills/tablets/capsules that have negligible marginal cost: a company isn't going to give away a $100k therapeutic drug for free because it still is going to cost them $50k+ (numbers just made up btw).

[dragonwriter]

> Every drug company gives away their drugs for free to people who can't afford it in the US

No, they don’t all provide their drugs for free, but most of them offer directly or fund assistance programs that provide either free or reduced cost drugs.

[newbie789]

It’s amazing that you’re privy to this information!

I kind of figured all of the dead diabetics in the US that I’ve read about over the years was the result of a structural problem with our healthcare system. Apparently this is maybe an issue with suboptimal Google AdSense campaigns that led to fewer diabetics knowing about the font of free insulin?

What a revelation that the manufacturers that control the pricing of this life-saving drug (and apparently all other drugs) are actually blameless in every scenario and that anybody that rations and/or dies does so to themselves due to being dumb.

[newbie789]

I should clarify that I’ve lived with T1D folks in the US for my entire life and I’ve seen them have to choose between food/rent/car insurance/etc and insulin more times than I can count.

The comment that I’m responding to strikes me as either alarmingly uninformed about the material conditions that many, many diabetics find themselves in, naïveté based around completely believing some marketing pamphlet, or genuinely making statements in bad faith. I chose to respond in a sarcastic way in my previous comment because the nature of that statement is so incredibly outlandish and broad that it genuinely seems like a comment in bad faith.

“All pharmaceuticals are free if you just go to the website” is genuinely such a dada-esque-ly untrue statements for the majority of Americans that I can only imagine a person making that statement as a joke or a lie.

[nobodyandproud]

I remember this article and problem, and the problem hasn’t gone away.

This is the worst exploitation and gaming.

1% get the freebies. And 99% get to pay a price that’s 10x the sticker cost.

That’s a rip-off and a complete burden to insurance and tax payers.

[Clubber]

Got a link for this with some details? What does "can't afford," mean, how regularly is this available, how much of a hassle is it, etc.

[fencepost]

Ah, but are those assistance programs available to people on Medicare or Medicaid? I know a diabetic on Medicare so I've watched ads and lots of the ones that mention how little your copay can be seem to have a little note at the bottom of the screen "for patients on commercial insurance."

[clarkrinker]

The Part D reforms from this year cap insulin costs at [1] $35 a month. You can setup your social security benefit to have it automatically deducted

The premiums for part D in Washington State are about $40 a month [2]

Most Medicaid recipients don't pay out of pocket for insulin.

[1] https://www.medicare.gov/coverage/insulin [2] https://www.insurance.wa.gov/what-does-medicare-prescription... [3] https://www.commonwealthfund.org/publications/issue-briefs/2...

[fencepost]

Thanks, I'll pass that along to her. I think the insulin is a new thing this year, so it's possible she's not on a Part D plan in the "insulin savings model."

[GrinningFool]

> please, please, please call the Eli Lily hotline and get the copay card.

While this is a great thing, it's also necessary that you be prepared to fork over personal data - especially proof of income - and otherwise do whatever is required to prove that you are (un?)worthy enough as with any similar medical financial aid program.

https://www.lillycares.com/assets/pdf/lilly_cares_applicatio...

[dragonwriter]

Its not a financial aid program, its a market segmentation program.

[TheCoelacanth]

Exactly, they just want to suck you dry. They don't want to let a̶ ̶p̶o̶t̶e̶n̶t̶i̶a̶l̶ ̶s̶o̶u̶r̶c̶e̶ ̶o̶f̶ ̶r̶e̶v̶e̶n̶u̶e̶ you die from lack of medicine that costs them pennies.

[ramraj07]

Wow nitpicking much?

[GrinningFool]

Not at all.

I believe that regardless of whether someone is at a financial disadvantage, neither business nor government should have the ability force them to surrender both dignity and personal financial information in order to receive aid.

It's hard enough to ask for help without having to lay your life bare to strangers in order to receive it.