I think it means at first they will contract a drug company to make it and then sell it cheaper. Then they will make it in their own factory.
Good for them. Wonder if anybody else will follow suit.
Good. Routine healthcare is a part of the public weal. The state needs to provide it, either directly or through non-profit organizations.
Sounds like a disaster in the making.
You said “making their own”*
Does that mean only Californians can get it?
If it’s like Walmart insulin I wouldn’t want it. (YMMV)
*Edited to add: you yourself didn’t say it, Gavin Newsom said it.
Recall that South Africa dealt with high prices of patented antiretroviral drugs by authorizing compulsory licensing and parallel imports of drugs from countries where they were cheaper, thus undermining drug companies’ ability to profit from artificially high prices. The dozens of lawsuits were dropped after a few years of an increasing public relations nightmare for the pharmaceutical companies.
So, insulin could also be sold cheaply without necessarily having to imperfectly clone whatever is the good insulin.
What do you think, they’re going to make bad insulin? It’s not rocket science, the insulin they make will be of perfectly good quality. Are you aware of what factories make your other drugs?
I think it’s a great idea. I hope they make enough for all the states to buy what they need.
- Insulin is a drug that lots of people need.
- No one wants to take more than they need
- It’s far cheaper to treat diabetics who get the insulin they need than to treat those who don’t get enough.
- It’s an old drug, and hasn’t been under patent forever.
- It’s absolutely an example of market failure. The price keeps going up basically because drug companies want to profit as much as possible. Which is fine, in theory, but in practice it’s led to people not being able to afford as much insulin as they need.
I’m guessing it will be available to people on Medi-Cal? I wonder if they can supply pharmacies for everyone else, without getting into a huge fight with drugmakers over ‘unfair’ competition.
What would be the pharmaceutical industry’s basis for the claim of “unfair” competition? (I’m genuinely curious, not critical of the statement.)
‘Unfair’ (in my opinion) means ‘They’re hurting our profits!’ According to the article, insulin costs between $300 and $500 per month. I’ve seen proposals to cap the cost of insulin at $35 per month. I don’t know how much insulin people need, but a quick google search says that one vial costs between $2 and $6 to produce. So in my opinion, pharmaceutical companies will scream that California is competing unfairly because California will sell the drug for one-tenth or less than the companies sell it for.
I’d speculate that the accusation would be something analogous to “dumping”, saturating a market with a commodity at a price point that makes all other seller’s offerings uncompetitive at the “required” profitable price.
When you can’t compete, you litigate
Thanks, both of you. Very illuminating.
I use Lantus pens for my diabetic cat and they come in 300 units per pen. My cat is 18 lbs and uses 4 units per day so the cost is not terribly prohibitive but each pen runs around $80. Insulin dosage is variable–weight, type of diabetes and diet all figure into the equation but WebMD says a range of 80-130 units per day is a good starting point. Lantus is a stabilized, controlled release form of insulin so you only have to take it every 12 hours–if I were using, say, Vetsulin which is about $50 a vial I’d have to be testing the cat’s glucose several times a day and dosing accordingly. This would not be fun, trust me.
So we can see here than insulin is extremely overpriced, especially considering the person who first synthesized it released the patent for one dollar with the understanding that the drug would be readily available and affordable. This has NOT happened, the drug companies have had 100 years to batten off of helpless people who MUST have their product in order not to die and it needs to end NOW.
Good for California, I hope Oregon and Washington jump on this bandwagon as well. Now they need to manufacture their own birth control because I can see that becoming problematical in the near future as well.
Yes they can.
There’s a big disparity between human and analog insulin.
It matters which type they are manufacturing.
In it’s basest form, yes, it’s been out of patent forever. However, what has become “standard” in the US are modified. Using SA’s cat as an example, Lantus as a controlled release, meaning a new patent; Vetsulin is more base. “Insulin” seems to be very brand-reliant - people react differently to each of the different brands; this makes creating generics much more difficult. From the American Action Forum,
So, while insulin might be old and the production well understood, manufacturing a generic is going to be a pain, and getting doctors and patients to use the new generic properly will be difficult.
@Qadgop_the_Mercotan once claimed there wasn’t a lot of patient benefit to the fancier versions.
I’m not knowledgeable about the details, but we are currently in an environment where it’s fairly common for Americans to lose access to insulin. Like, not get the wrong type, but have none. If CA can address even part of that problem, it’s a win.
The original insulin marketed was from cow or pig. It was a Godsend for Diabetics, because before that, Diabetics had NOTHING. The cow or pig insulin had major problems for some people.
Later, scientists tinkered with the chemical structure of the E. coli bacteria, to make a product more like human insulin than the cow/pig variety. This was marketed in 1978.
More studies and tinkerings on the modified cow/pig insulin using recombinant DNA, to make it more closely resemble human insulin. This was marketed in 1983.
When the early insulin was a byproduct of slaughtering cows and pigs, the cost was low. Once the tinkering began, each new product fell under the patent laws. I’m guessing that the mad scientist in the cluttered laboratory was constantly trying new ways to closer approximate human insulin. Each new formula, once approved and then marketed started the “patent clock” again.
This is frustrating to patients, and it can make necessary-to-live drugs prohibitively expensive.
I remember having a tantrum in the pharmacy when the cost of my asthma inhaler went up. It was the same damned medication! But the Federal government required a different propellant to be used. The drug manufacturer decided “different stuff in the inhaler = new formulation = higher price.”
~VOW
Note: if my paraphrasing of insulin manufacturing confuzzled the whole process, please forgive and correct me.
I think the differences today aren’t so much between human insulin and “close enough, probably” insulin, but between plain old human insulin and stabilized, slow release human insulin.
My understanding is that human insulin has been standard for decades, and is long off patent.
Fun fact–there are things called “compounding pharmacies” which, if you need some version of a drug that has something extra or that has changed and you can’t handle the something extra the pharma company has put in (usually as a means to create a new patent, the goniffs) or if you need a pediatric dosage the regular company doesn’t supply–the compounding pharmacy can specifically make you a tailored version of a drug and the patents are thereby sidestepped. Insulin was first synthesized in 1921 and you cannot persuade me that there is enough of a difference in current stabilized, time released versions that is different enough to continually warrant new patents–those patents are purely there to provide price supports. I think that California intends to put this theory to the test by using out of patent versions of the time release insulin. I find it difficult to believe that insulin formulations from the year 2000 are so radically different that patients can’t currently use and benefit from them. I’d like to see widespread empirical testing of this hypothesis, and a state with a population of 40 million seems like an excellent place to give it a shot.
There are private efforts afoot to reduce the cost of insulin, too.
And prices have skyrocketed for unchanged drugs.
Insulin surged in list price more than 250 percent over a recent 10-year span.
That’s for the same formulation. From the linked journal article:
Almost 100 years ago, the discovery of insulin, derived from animal sources, literally began to save human lives. The advent of genetic engineering brought human insulin formulations to patients with diabetes in the 1980s. Rapid-acting and long-acting human insulin analogs were introduced in the 1990s. The patents for many of the human insulin and human insulin analog formulations in current clinical use have expired.
They slice the market into different types of insulin products, and document steep price increases within each type.
Much of the public discussion regarding insulin affordability and accessibility has focused on the rapidly increasing average list prices of insulin over the past two decades, which nearly tripled between 2002 and 2013 ([3](javascript:;)). The list price is defined as the price manufacturers set for their medication ([Table 2](javascript:;)). Along with yearly increases, the published data also suggest that when one insulin manufacturer increases the price for a given insulin formulation, the other insulin manufacturers often increase their prices by a similar amount shortly thereafter ([15](javascript:;),[16](javascript:;)) ([Fig. 4](javascript:;)).
There has also been a shift away from cheaper human insulin to more expensive insulin analogs
Another important trend affecting overall costs for insulin in the last decade is the shift in insulin utilization from the less expensive human insulins to more expensive human insulin analogs ([14](javascript:;),[17](javascript:;)–[19](javascript:;)) ([Fig. 5](javascript:;)). While the prices of both types of insulin have increased, the difference in pricing between them has substantially added to insulin costs—both to the health care system and to many patients ([17](JavaScript:;),[18](javascript:;)) (human insulins are available at the pharmacy for $25 to $100 per vial compared with human insulin analogs at $174 to $300 per vial [[19](javascript:;)]).
There are a lot of other problems with the market, including a complex system of discounts and formulary rules.
I applaud CA for trying to address this.