I’m a freshman in college. This semester in my Composition II class, we’re doing basically one large research project. We started with an annotated bibliography, then moved to a literature review. After that we wrote a presentation proposal. Now we’re making a presentation of our topics. I chose to research type 1 diabetes (cost, mental health, statistics, signs/symptoms, history, etc.). I’m struggling to find super reliable references to use in my presentation on cost of diabetes (mainly insulin). If anyone could share links or other references to help, I would really appreciate it.
Thanks
Hi @Jesslauren9 and welcome to the forum. There is an app/website called Goodrx that provides out of pocket costs for medications in pharmacies based on the user’s area. Given that the numbers are location based (and can vary greatly by pharmacy) they may not give you an overall average cost. On the other hand, if you’re looking at showing a range of costs it might be helpful. The prices also vary based on type of insulin and whether you select pens or vials; and may represent the price with one of their coupons so you may need to consider that vs. without.
Also, the analog insulins that are mostly used now are more expensive than their counterparts from “the mid to late late 1900s.” I started taking insulin in the 1960s and they were animal based; followed by ones made via recombinant DNA technology; and now we have analogs such as Humalog and Novolog.
I did not excel at science (believe me) and my memory of older insulins has faded. I’m droning on though to say keep in mind that some older insulins are so available and are much less expensive, but may or may not work as well.
https://www.diabetes.org/ should be able to direct you to sources for your research, and publications such as https://www.diabeteshealth.com/ may have articles in their archives that might be helpful.
Wishing you the best with your research!
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Diagnosed in 1969. On parents’ insurance through college. Thereafter paid about $35 per 10 mL vial from about 1984 to 1988. In my youth I used Lente & Semi Lente from the Eli Lilly Company, harvested from slaughtered beef & pork.
The cost was around $85 to 90 per vial in 1998, it seems recombinant DNA (man-made) insulin were all that were available by that time.
Currently I have insurance and only pay a tiny copay on my insulin.
A few things I want to mention here. The original insulins were made from anima pancreases, usually beef or pork sources. Seems there was no recombinant DNA in 1921, of course. Anyway in about 1983 they found a way to use recombinant DNA to modify e. coli bacteria cells so that it will produce insulin.
So the so-called “human insulin” became the most popular insulin while animal based insulins were phased out over several years. Since this kind of insulin is exactly the same as a normal body’s insulin it avoids various problem, such as inflammation at injection sites or reduced results per unit of insulin.
The costs were kept moderate, generally rising with inflation factors. The price was determined based on the manufacturer’s promise to the Dr.s Banting and Best when they sold the Patent rights soon after discovery for a total of $3, $1 each for the two of them and another doctor involved in development. Maker’s promised that insulin would ALWAYS be sold at a reasonable cost, available at any pharmacy without prescription.
Then in 1996 Eli Lily found a way to change the structure of the insulin molecule made by the modified germs to create Humalog, which is not “insulin” anymore, but an “Insulin Analog”. The prices remained low for a while but then Lily ran into an expensive problem with a different medicine for a different condition, and lost a LOT of money since they had to take it off the market.
At that point somebody there realized that diabetics could save them from financial difficulties, sine we are TOTALLY dependent on our insulins and have no choice about using it, and the “Insulin Analog” works better than the earlier “Human insulins”. So they proceeded to use the Patent on Humalog as an excuse to make it necessary to have a prescription, at least in the USA. That doesn’t apply in other countries BTW.
So then the complicated system of making it impossible to tell WHY and WHERE the higher prices stem from was developed, so now we (at least those with good Medical Insurance) in the USA are “paying” around $300 per vial and rising, though of course the insurance companies don’t actually pay that, but our co-insurance price is set by that, usually at 20%.
The question arises of how it’s allowed that the Professional Benefit Managers (PBMs), separate businesses that “negotiate” prices for their particular insurance company(s)? If they negotiate the price the co-pay needs to be for the price the insurance company pays for the insulin (or any drug for that matter), which would actually do diabetics (or whoever) ANY good on what we pay. They are paid by the health insurance company in an external process, so it’s hard to make a case against them.
Of course the other problem is for those diabetics with no or poor insurance. They are forced to pay full price, which they may not be able to afford. So what’s the result? Type 1, and some Type 2m diabetics that can only try to ration insulin to stretch the budget until they need another vial. This has killed a fair number of diabetics in recent years.
All this is for WHAT? Profits to all companies in any part of the supply chain insulin analogs anywhere in the USA. PBM have NO function except personal profit, and need to be made totally illegal in the USA. Chances of that with the current Federal administration? Almost certainly ZERO, since the only thing they care about is the businesses that pay them under the table for the privelege of killing diabetics!
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Thank you, THANK YOU, Ted! @tedquick
This is about the best description of insulin used during the recent 66 years. I hope you don’t mind if I add a couple of points - if you prefer I don’t, let me know and I will edit them out.
With the ability to develop Human Insulin in a laboratory in the early 1980’s [actually first made in the laboratory on the United States Space Station]] came the standardization for insulin “strength” set at 100 units per ml,; the U-100 and the need for purchase of new syringes. Prior to that, insulin was U-40 and U-80 - for which I used a two scale syringe when I needed both a long-acting and fast-acting insulin.
Your explanation of why Lilly NEEDED to place the $325 price on its rapid-acting Humalog is plausible. But why does Novo-Nordisk have a similar price on its “similar” acting Novolog? Novolog is made from brewers yeast and Humalog is made from virus.
Oh yes, I didn’t think about that. As I understand it the other 2 major insulin manufacturers saw what Lily did so they just set themselves in lockstep whenever Lily raised prices. Price fixing to match competitor’s prices is totally illegal, but they always mumble their way out of it. Since Lily is wrong to charge such outrageous prices why wouldn’t they be also.
Also didn’t mention that the excuse that the high price supports research into new products is totally false. Eli Lilly has NO research going into insulins at any level that needs such support. They’re just enjoying the benefits of government officials who support industry regardless of citizen’s needs, and/or they get paid off constantly.
Ted Quick
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@Jesslauren9 Hi Jessica, and Welcome to the JDRF TypeOneNation Forum! I hope that you will find some useful information here; as you know there is plenty on the open internet.
When looking at the “cost” of insulin for your paper, please take into consideration the different methods of paying, retail, insurance co-pay, etc. For instance, prior to this century there was NOT any insurance plan the paid for prescription medicines [Medicare Part D didn’t come about until about 2006] and most people paid whatever the drug store set as price. My price information is from the Boston area.
In the 1950’s, at a local independent Drug Store I paid $2.00 per vial for both U-40 Regular Insulin, and for U-80 NPH Insulin - pig & cow extracts; 10 ml. vials which is the same size as the present day U-100 vial. In the 1960’s when I began working in downtown Boston, a large chain drug store [Liggets] sold those same types insulin for $1.77 per vial.
In the 1980’s, the new U-100 Hunan Insulin, recombinant DNA, such as Humulin and Novolin, cost about $5.00 per vial. In 1996, the new analog “rapid-acting” Humalog cost me $35.00 for a package of 5 1.8 ml cartridges [total 9 ml insulin] for my insulin pen; I believe a 10 ml vial cost about the same. This was before the advent of the pre-filled pens, and as I recall, the pens I used were not cheep. Inflation, and as Ted said, other factors immediately pushed up the cost of Humalog; when Novolog was approved for use in 2004, the price matched Humalog [actually a dollar or two less] because that is what the market would bear.
Inflation and cost-of-living shoul also be considered for your parer. In the 1950’s. a loaf of bread cost 10 cents, a gallon of gasoline was less than 20 cents, etc. A “blood sugar test” at the hospital - the only place to have one done, and it took two days - cost $10.00 and very good health/medical insurance did not cover out-patient lab-tests.
[Now going off-topic]; Are you and your project-mates able to work effectively together during this COVID social-distancing? I certainly hope you are.
Good luck to you and the other students; my daughter teaches university chemistry classes and is hoping that her students continue to learn - her “trick” part is the hands-on lab from a-far.
Thank you for the great (accurate & depressing) overview of insulin manufacture and pricing in the USA. A recent special on PBS called Blood Sugar Rising is worth watching for all on these forums, and does touch on the insulin price gouging situation. A recent article in Consumers Reports places the Pharmacy Benefits Managers with their kickback (called rebate) schemes as the primary cause of high prescription prices in this country. The PBMs earn a fortune while contributing nothing.