# The High Price of Insulin Is Killing US Citizens **URL:** \ **Category:** The BBQ Pit\ **Created:** [June 18, 2019, 1:12pm UTC](https://boards.straightdope.com/t/the-high-price-of-insulin-is-killing-us-citizens/835676 "2019-06-18T13:12:47Z")\ **Posts on this page:** 20\ **Page:** 2
**Author:** ![Slash1972](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/slash1972/32/6461_2.png) [@Slash1972](https://boards.straightdope.com/u/Slash1972)\ **Post date:** [June 18, 2019, 7:36pm UTC](https://boards.straightdope.com/t/the-high-price-of-insulin-is-killing-us-citizens/835676/21 "2019-06-18T19:36:17Z")
Sorry, but either I’m not reading your post correctly, or I’m just not understanding it, or something else, but I don’t see how what you wrote explains why people don’t want to use the $25 Walmart insulin as their primary insulin. Unless it is “the $25 Walmart stuff doesn’t maximize productivity”. Is that it? ---
**Author:** ![Ruken](https://avatars.discourse-cdn.com/v4/letter/r/f475e1/32.png) [@Ruken](https://boards.straightdope.com/u/Ruken)\ **Post date:** [June 18, 2019, 7:40pm UTC](https://boards.straightdope.com/t/the-high-price-of-insulin-is-killing-us-citizens/835676/22 "2019-06-18T19:40:25Z")
> [@Slash1972](#): > > Sorry, but either I’m not reading your post correctly, or I’m just not understanding it, or something else, but I don’t see how what you wrote explains why people don’t want to use the $25 Walmart insulin as their primary insulin. Unless it is “the $25 Walmart stuff doesn’t maximize productivity”. Is that it? It’s human insulin, not modified insulin. Different drug, and less likely to prevent hospitalization/organ damage/death. ---
**Author:** ![Nava](https://avatars.discourse-cdn.com/v4/letter/n/da6949/32.png) [@Nava](https://boards.straightdope.com/u/Nava)\ **Post date:** [June 18, 2019, 7:49pm UTC](https://boards.straightdope.com/t/the-high-price-of-insulin-is-killing-us-citizens/835676/23 "2019-06-18T19:49:11Z")
As to why that happens: modified insulins can include functionality such as longer lifes than human insulin, or being able to activate decreased-sensitivity insulin receptors (insulin resistance). The specific mechanisms and benefits will vary from insulin to insulin; which benefits are needed will vary from patient to patient. For someone who isn’t producing enough insulin but whose receptors work just fine, human insulin works just fine; for someone with insulin resistance, it won’t work well whether it’s from their own pancreas or from a needle. ---
**Author:** ![Slash1972](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/slash1972/32/6461_2.png) [@Slash1972](https://boards.straightdope.com/u/Slash1972)\ **Post date:** [June 18, 2019, 7:49pm UTC](https://boards.straightdope.com/t/the-high-price-of-insulin-is-killing-us-citizens/835676/24 "2019-06-18T19:49:51Z")
> [@Ruken](#): > > It’s human insulin, not modified insulin. Different drug, and less likely to prevent hospitalization/organ damage/death. I’m thinking that not taking insulin because you are too poor to buy the expensive kind would be worse than using the Walmart insulin. ---
**Author:** ![Hilarity\_N.Suze](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/hilarity_n.suze/32/6223_2.png) [@Hilarity\_N.Suze](https://boards.straightdope.com/u/Hilarity_N.Suze)\ **Post date:** [June 18, 2019, 7:52pm UTC](https://boards.straightdope.com/t/the-high-price-of-insulin-is-killing-us-citizens/835676/25 "2019-06-18T19:52:20Z")
Colorado has a cap on how much of a co-pay can be charged for insulin. It’s new. And there are people–conservatives, natch–who deride this as a slippery slope. Oh, what will happen next? Will we all have to pay for everybody’s eyeglasses? To fix their broken legs from skiing? How about plastic surgery, surely that’s next! Sheesh. I really don’t know how these people function, I honestly don’t. ---
**Author:** ![Treppenwitz](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/treppenwitz/32/3445_2.png) [@Treppenwitz](https://boards.straightdope.com/u/Treppenwitz)\ **Post date:** [June 18, 2019, 7:55pm UTC](https://boards.straightdope.com/t/the-high-price-of-insulin-is-killing-us-citizens/835676/26 "2019-06-18T19:55:19Z")
It’s not a quick (enough) fix, but the FDA are in the process of closing what amounts to a loophole that Pharma companies have been exploiting. For historical reasons insulins, which are biological drugs, have been regulated as if they were chemical drugs (because, I think, they are so damn old and predate the rules under which modern biological drugs are regulated). This has had the effect of keeping biosimilars (loosely speaking, generics) off the market. The FDA issued a [statement](https://www.fda.gov/news-events/press-announcements/statement-fda-commissioner-scott-gottlieb-md-agencys-continued-efforts-bring-competition-insulin) in April: > [@](#): > > …Transitioning biological products currently regulated as drugs to being regulated as biologics will enable – for the first time – products that are biosimilar to, or interchangeable with, these products to come to market… > > …This transition is particularly important for insulin > > Although they are biologics, insulin products have historically been regulated under the FD&C Act rather than the PHS Act, which governs the FDA approval of most biologics. Biologics are typically isolated from a variety of natural sources – human, animal or microorganism – and may be produced by biotechnology methods and other cutting-edge technologies. Due in part to the complexities of these products, it has been hard to bring a substitutable generic insulin to the market under the FD&C Act. > > The transition of insulin from the drug to the biologics pathway will open up these products to biosimilar competition. We’re already seeing robust activity among sponsors seeking to bring forward biosimilar copies of insulin… So hopefully there’s a medium-term partial solution. But as has been noted above, basically you need a better healthcare system. j ---
**Author:** ![thorny\_locust](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/thorny_locust/32/431_2.png) [@thorny\_locust](https://boards.straightdope.com/u/thorny_locust)\ **Post date:** [June 18, 2019, 8:20pm UTC](https://boards.straightdope.com/t/the-high-price-of-insulin-is-killing-us-citizens/835676/27 "2019-06-18T20:20:49Z")
manson1972, you can die of the Walmart insulin, too. Insulin’s funny that way: if you’ve got too much in your system for the state of your system at that particular moment, it can kill you, even if it’s also going to kill you if you get too little. And unless you’re running a more or less continuous blood test, it’s very difficult to be sure exactly how much you need at a given moment (for your conscious brain, anyway; a properly functioning pancreas is very good at this, but a properly functioning pancreas is what a lot of diabetics haven’t got.) If the newer versions of insulin are less susceptible to that problem, then they’re a lot safer to take. – my father was on the old style insulin for many years when that was all that was available. We all had to be aware of early signs of insulin shock; and the accummulated damage which was part of the reason why he died at 69 was in large part due to poor control that was less drastic in the short run but did long term damage even though it didn’t kill him right off. At the time, of course, that was the best that could be done. I’ve had a dog on the $25 Walmart insulin – and it was only $25 if you could get to Walmart. The local pharmacy, which is a lot closer to me than Walmart (which is in a different village entirely, and difficult for anyone who can’t drive to get to) advised I go to Walmart because they had to charge $150 per vial for it; apparently Walmart had struck some sort of special deal. The dog was unlikely to live more than another couple of years in any case, so it was less crucial to have her on something with better long term results. ---
**Author:** ![Slash1972](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/slash1972/32/6461_2.png) [@Slash1972](https://boards.straightdope.com/u/Slash1972)\ **Post date:** [June 18, 2019, 8:26pm UTC](https://boards.straightdope.com/t/the-high-price-of-insulin-is-killing-us-citizens/835676/28 "2019-06-18T20:26:50Z")
Oh, i get it. Newer stuff = better. I just don’t get dying because you can’t afford insulin when there is cheaper, but not as good, insulin you can buy. And I still don’t get how someone on Medicare dies because they can’t afford insulin at the same time that someone else on Medicare gets insulin for $8.50 a month. ---
**Author:** ![cochrane](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/cochrane/32/10441_2.png) [@cochrane](https://boards.straightdope.com/u/cochrane)\ **Post date:** [June 18, 2019, 8:46pm UTC](https://boards.straightdope.com/t/the-high-price-of-insulin-is-killing-us-citizens/835676/29 "2019-06-18T20:46:04Z")
> [@Slash1972](#): > > Oh, i get it. Newer stuff = better. I just don’t get dying because you can’t afford insulin when there is cheaper, but not as good, insulin you can buy. > > And I still don’t get how someone on Medicare dies because they can’t afford insulin at the same time that someone else on Medicare gets insulin for $8.50 a month. They may not be aware that Extra Help exists or not be eligible. There are income requirements. To be eligible in 2019, your income must be below $18,735 for an individual or $25,365 for a married couple living together. ---
**Author:** ![The\_Devil\_s\_Grandmother](https://avatars.discourse-cdn.com/v4/letter/t/74df32/32.png) [@The\_Devil\_s\_Grandmother](https://boards.straightdope.com/u/The_Devil_s_Grandmother)\ **Post date:** [June 18, 2019, 8:57pm UTC](https://boards.straightdope.com/t/the-high-price-of-insulin-is-killing-us-citizens/835676/30 "2019-06-18T20:57:03Z")
> [@Slash1972](#): > > And I still don’t get how someone on Medicare dies because they can’t afford insulin at the same time that someone else on Medicare gets insulin for $8.50 a month. Medicare is done state-by-state. The federal government gives a block of money to the state and they choose how to use it. In some states, the governors have resisted [Medicare Expansion](https://www.healthinsurance.org/medicaid/), leaving the citizens of that state with less coverage than other states. You can check what type of medicare your state has at the link above. ---
**Author:** ![Slash1972](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/slash1972/32/6461_2.png) [@Slash1972](https://boards.straightdope.com/u/Slash1972)\ **Post date:** [June 18, 2019, 9:01pm UTC](https://boards.straightdope.com/t/the-high-price-of-insulin-is-killing-us-citizens/835676/31 "2019-06-18T21:01:14Z")
> [@The\_Devil\_s\_Grandmother](#): > > Medicare is done state-by-state. The federal government gives a block of money to the state and they choose how to use it. In some states, the governors have resisted [Medicare Expansion](https://www.healthinsurance.org/medicaid/), leaving the citizens of that state with less coverage than other states. You can check what type of medicare your state has at the link above. Isn’t that MediCAID? ---
**Author:** ![Euphonious\_Polemic](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/euphonious_polemic/32/3002_2.png) [@Euphonious\_Polemic](https://boards.straightdope.com/u/Euphonious_Polemic)\ **Post date:** [June 18, 2019, 9:37pm UTC](https://boards.straightdope.com/t/the-high-price-of-insulin-is-killing-us-citizens/835676/32 "2019-06-18T21:37:17Z")
I’ve been told that this is all OK, because in Canada, we are all socialists, and that is bad. You see, Insulin may cost you Americans a lot more, and some of you may die because you can’t afford it, but you have FREEDOM. And we are just damned dirty socialists. So there ya go. ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [June 18, 2019, 11:21pm UTC](https://boards.straightdope.com/t/the-high-price-of-insulin-is-killing-us-citizens/835676/33 "2019-06-18T23:21:34Z")
> [@Ruken](#): > > It’s human insulin, not modified insulin. Different drug, and less likely to prevent hospitalization/organ damage/death. I’ve been managing diabetics for decades, and am an insulin-taking diabetic myself. NPH and Regular are very good tools for managing diabetes. The ultra-long and ultra-short acting insulins have not been shown to be significantly better for the _typical_ diabetic’s health. With usual use, they result in A1C levels about the same as with the older insulins. But those new insulins sure have been marketed like they’re truly superior. THAT is a problem. And yes, the jacking up of the price of insulin ought to be a crime. ---
**Author:** ![slumtrimpet](https://avatars.discourse-cdn.com/v4/letter/s/b5e925/32.png) [@slumtrimpet](https://boards.straightdope.com/u/slumtrimpet)\ **Post date:** [June 18, 2019, 11:28pm UTC](https://boards.straightdope.com/t/the-high-price-of-insulin-is-killing-us-citizens/835676/34 "2019-06-18T23:28:18Z")
Dayum. I pay $44 for a vial of Lantus insulin. From the Vet. For the CAT. ---
**Author:** ![thorny\_locust](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/thorny_locust/32/431_2.png) [@thorny\_locust](https://boards.straightdope.com/u/thorny_locust)\ **Post date:** [June 18, 2019, 11:32pm UTC](https://boards.straightdope.com/t/the-high-price-of-insulin-is-killing-us-citizens/835676/35 "2019-06-18T23:32:17Z")
> [@Slash1972](#): > > Oh, i get it. Newer stuff = better. I just don’t get dying because you can’t afford insulin when there is cheaper, but not as good, insulin you can buy. Would they know what the dose was? They’d have been given instructions for how much to take based on the medication the doctor ordered. A different form of insulin might need a different dose. Guessing it wrong might mean dying right now. Not taking it means dying but not as fast. Qadgop? I might have that wrong; but I can readily imagine that thought process. (And I was told by the vet. that using a slightly different form for the dog would require recalculating her dose.) Personally, I think I’d call the doctor; but either being very broke or significantly sick can screw up your thinking. Both at once is a double whammy. (Both at once, or even one on its own, could also make it hard to get to Walmart. Will they mail order without a significant charge?) ---
**Author:** ![Slash1972](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/slash1972/32/6461_2.png) [@Slash1972](https://boards.straightdope.com/u/Slash1972)\ **Post date:** [June 19, 2019, 12:44am UTC](https://boards.straightdope.com/t/the-high-price-of-insulin-is-killing-us-citizens/835676/36 "2019-06-19T00:44:58Z")
> [@thorny\_locust](#): > > Would they know what the dose was? > > They’d have been given instructions for how much to take based on the medication the doctor ordered. A different form of insulin might need a different dose. Guessing it wrong might mean dying right now. Not taking it means dying but not as fast. Not sure, but I’m guessing they could ask their doctor. ---
**Author:** ![Helena330](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/helena330/32/531_2.png) [@Helena330](https://boards.straightdope.com/u/Helena330)\ **Post date:** [June 19, 2019, 12:46am UTC](https://boards.straightdope.com/t/the-high-price-of-insulin-is-killing-us-citizens/835676/37 "2019-06-19T00:46:03Z")
I completely agree with this pit. Also, if a diabetic vet hasn’t considered using the VA: They suck in SO MANY ways, but they’re excellent at providing insulin. Well, at least the one in Seattle is. Consider it, anyway. ---
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [June 19, 2019, 1:58am UTC](https://boards.straightdope.com/t/the-high-price-of-insulin-is-killing-us-citizens/835676/38 "2019-06-19T01:58:35Z")
> [@Slash1972](#): > > Not sure, but I’m guessing they could ask their doctor. You’re assuming they have a regular doctor. I know too many poor people who go to a clinic and get whomever happens to be there that day. Also, for the uninsured doctor visits start around $150 in my area. It’s more for a specialist like an endocrinologist who specializes in treating diabetes. Assuming said person can get an appointment in the first place. Otherwise - it’s wait until you’re dying and go to the ER. Or at least hope someone gets you to an ER when you get goofy/unconscious from blood sugar problems. ---
**Author:** ![Slash1972](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/slash1972/32/6461_2.png) [@Slash1972](https://boards.straightdope.com/u/Slash1972)\ **Post date:** [June 19, 2019, 2:13am UTC](https://boards.straightdope.com/t/the-high-price-of-insulin-is-killing-us-citizens/835676/39 "2019-06-19T02:13:55Z")
> [@Broomstick](#): > > You’re assuming they have a regular doctor. > > I know too many poor people who go to a clinic and get whomever happens to be there that day. > > Also, for the uninsured doctor visits start around $150 in my area. It’s more for a specialist like an endocrinologist who specializes in treating diabetes. Assuming said person can get an appointment in the first place. > > Otherwise - it’s wait until you’re dying and go to the ER. Or at least hope someone gets you to an ER when you get goofy/unconscious from blood sugar problems. You know poor people who go to a clinic, and the doctor there tells them “you have diabetes” and then there is no follow up or anything? ---
**Author:** ![Beckdawrek](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/beckdawrek/32/3647_2.png) [@Beckdawrek](https://boards.straightdope.com/u/Beckdawrek)\ **Post date:** [June 19, 2019, 2:17am UTC](https://boards.straightdope.com/t/the-high-price-of-insulin-is-killing-us-citizens/835676/40 "2019-06-19T02:17:34Z")
My insurance insists I am involved in a diabetic nutritional and lifestyle group. I go once a month get talked to, meal plans, monitor memory looked at. For my trouble I get some free insulin pens. And I grab all they’ll give me. Along with the insulins I need there are many essentials you have to have. My latest expense is the monitor patches. Very pricey. I write big checks every month. My insurance pays. But not enough. I’m lucky, I can afford to have this disease. I’ve been a diabetic my whole life and I’m still shocked about the cost. [Previous page](https://boards.straightdope.com/t/the-high-price-of-insulin-is-killing-us-citizens/835676.md?page=1) [Next page](https://boards.straightdope.com/t/the-high-price-of-insulin-is-killing-us-citizens/835676.md?page=3)