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by dragontamer 1315 days ago
Patients seem to trust that Eli Lilly's drugs work. The price point may not be trusted, but its efficacy is trusted.
1 comments

Patients don't have real choice. Options are either you die or spend hundreds* of dollars on a drug that everywhere else on the planet costs few bucks.
Why is there no black market for insulin? Like build capacity in Mexico/Canada and smuggle the product in the US? Seems like the multiplier would still be pretty good.
Why do you assume there isn't one already? The "War on Drugs" was never just about illegal drugs across borders, and US Customs will try to stop many legal ones too, especially at volume.
There is plenty of gray market for insulin near both borders. No large players (just individuals going over the border to buy).
The Bush admin basically made a point of ending crossing the boarder to buy cheap drugs.
That doesn't contradict the point above
Patients seldom have a choice in any aspect of their care. We could flood the market with dirt cheap insulin using an older formulation but surprise you can’t actually do that without one of the oligarchs buying your company just to stop you.
Or the dirt cheap insulin does not work as well as the newer patented insulin that a private company paid to do R&D for.

There is nothing stopping Congress from passing a bill to fund insulin R&D that provides the newest insulin technology without being patented, but the fact that they do not and would rather sit in their pulpit and “grill” private company representatives proves that it is all a show.

We (sufficient voters) want to pay for nothing, but expect everything.

The patents on lispro (the stuff that costs $300/vial) expired several years ago.

The fact is, Lilly isn't even the largest profiteer. The insane margins of insulin are actually split between Lilly, PBMs (like optumRX and CareMark) and insurance companies, through an incredibly complex system of rebates and vouchers. Turning over that rock reveals more writhing maggots than anyone cares to see.

> The insane margins of insulin are actually split between Lilly, PBMs (like optumRX and CareMark) and insurance companies, through an incredibly complex system of rebates and vouchers. Turning over that rock reveals more writhing maggots than anyone cares to see.

Health insurance companies (parent companies of PBMs) have low single digit profit margins, and medicine manufacturers like Eli Lilly have 20%+ profit margins. If health insurance companies are getting any piece of the "insane" profit margin, then it is being eaten up by losses of other healthcare spend.

Health insurance company profit margins:

https://www.macrotrends.net/stocks/charts/UNH/unitedhealth-g...

https://www.macrotrends.net/stocks/charts/ELV/elevance-healt...

https://www.macrotrends.net/stocks/charts/CVS/cvs-health/pro...

https://www.macrotrends.net/stocks/charts/CI/cigna/profit-ma...

https://www.macrotrends.net/stocks/charts/HUM/humana/profit-...

Versus medicine manufacturers' profit margins:

https://www.macrotrends.net/stocks/charts/JNJ/johnson-johnso...

https://www.macrotrends.net/stocks/charts/LLY/eli-lilly/prof...

https://www.macrotrends.net/stocks/charts/PFE/pfizer/profit-...

https://www.macrotrends.net/stocks/charts/NVO/novo-nordisk/p...

https://www.macrotrends.net/stocks/charts/ABBV/abbvie/profit...

Which still doesn’t mean that patients aren’t trusting Eli Lilly. Given the fact that they are choosing to spend a lot of dollars buying its drugs indicates that they do trust the efficacy of the drugs.

Also, the fact that the drug costs a few bucks everywhere else on the planet but not in the U.S. suggests this isn’t as much of an Eli Lilly problem as it is a USA problem.

Not true. You can buy generic insulin in the US for a reasonable price, it's the new stuff that lasts longer that is expensive.
I looked it up and a fifty percent savings is pretty good, but that is still a pretty high price for something that has to be taken forever and is twice as expensive as non generic in every other country. https://www.fda.gov/news-events/press-announcements/fda-appr...
I believe Walmart is the only place that does this, and there is some state this is not true in (thinking Indiana, but I'd have to look it up).
The patients also aren't actually paying for it, so mostly don't care. Insurance, Medicaid, or Medicare is paying.
And insurance companies get that money from thin air? Isn't this "Exhibit A" for why health insurance in the US is unaffordable to many?
I think insurance companies don't actually pay the "sticker price" but negotiate for substantial discounts.