# Why Isn't insulin a Generic Drug Yet? **URL:** \ **Category:** Factual Questions\ **Created:** [December 22, 2014, 7:23pm UTC](https://boards.straightdope.com/t/why-isnt-insulin-a-generic-drug-yet/707940 "2014-12-22T19:23:01Z")\ **Posts on this page:** 20\ **Page:** 1
**Author:** ![Jinx](https://avatars.discourse-cdn.com/v4/letter/j/c6cbf5/32.png) [@Jinx](https://boards.straightdope.com/u/Jinx)\ **Post date:** [December 22, 2014, 7:23pm UTC](https://boards.straightdope.com/t/why-isnt-insulin-a-generic-drug-yet/707940/1 "2014-12-22T19:23:01Z")
Boy, someone’s sure milking a sacred cow here…if you know the price of insulin! Insulin has been known about since the 1950’s. So why the heck is it still so expensive, and most important: Why is there no generic equal for insulin? And, for extra credit, I should ask this: Since insulin is such a common drug, why isn’t there extreme competition driving down the price? My doctor just told me how there are several companies vying for you to purchase their insulin supplement-like drugs that control blood sugar by cheating (in my opinion) i.e., promoting the body’s ability to spill excess sugar in their urine. In fact, in many cases, these NEW drugs can be gotten for free via some game the pharmas are playing by signing up on some innocuous plan just calling their toll free number (if you have commercial insurance). So, what’s the deal with insulin? Another open and shut case of price gouging? ---
**Author:** ![VunderBob](https://avatars.discourse-cdn.com/v4/letter/v/839c29/32.png) [@VunderBob](https://boards.straightdope.com/u/VunderBob)\ **Post date:** [December 22, 2014, 7:31pm UTC](https://boards.straightdope.com/t/why-isnt-insulin-a-generic-drug-yet/707940/2 "2014-12-22T19:31:39Z")
> [@Jinx](#): > > Boy, someone’s sure milking a sacred cow here…if you know the price of insulin! Insulin has been known about since the 1950’s. So why the heck is it still so expensive, and most important: Why is there no generic equal for insulin? > > And, for extra credit, I should ask this: Since insulin is such a common drug, why isn’t there extreme competition driving down the price? My doctor just told me how there are several companies vying for you to purchase their insulin supplement-like drugs that control blood sugar by cheating (in my opinion) i.e., promoting the body’s ability to spill excess sugar in their urine. In fact, in many cases, these NEW drugs can be gotten for free via some game the pharmas are playing by signing up on some innocuous plan just calling their toll free number (if you have commercial insurance). > > So, what’s the deal with insulin? Another open and shut case of price gouging? Well, the common insulin used today is human insulin, produced by recombinant DNA processes. Those are all new, and within the 20 year window for a pharmaceutical process. The older stuff was horse insulin, and I have no idea how it was produced/extracted. As long as the patent is valid, the patent owner can charge what they damned well please. ETA: User of Lantus and Humulin, for reference. ---
**Author:** ![USCDiver](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/uscdiver/32/354_2.png) [@USCDiver](https://boards.straightdope.com/u/USCDiver)\ **Post date:** [December 22, 2014, 7:35pm UTC](https://boards.straightdope.com/t/why-isnt-insulin-a-generic-drug-yet/707940/3 "2014-12-22T19:35:24Z")
Walmart sells vials of regular insulin for something like $20. ---
**Author:** ![boffking](https://avatars.discourse-cdn.com/v4/letter/b/858c86/32.png) [@boffking](https://boards.straightdope.com/u/boffking)\ **Post date:** [December 22, 2014, 7:49pm UTC](https://boards.straightdope.com/t/why-isnt-insulin-a-generic-drug-yet/707940/4 "2014-12-22T19:49:04Z")
> [@Jinx](#): > > My doctor just told me how there are several companies vying for you to purchase their insulin supplement-like drugs that control blood sugar by cheating (in my opinion) i.e., promoting the body’s ability to spill excess sugar in their urine. How exactly is this cheating? It _does_ reduce blood sugar. ---
**Author:** ![Ethilrist](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ethilrist/32/4604_2.png) [@Ethilrist](https://boards.straightdope.com/u/Ethilrist)\ **Post date:** [December 22, 2014, 8:14pm UTC](https://boards.straightdope.com/t/why-isnt-insulin-a-generic-drug-yet/707940/5 "2014-12-22T20:14:46Z")
> [@USCDiver](#): > > Walmart sells vials of regular insulin for something like $20. A box of five Humalog pens cost me $400 at CVS a few months ago. I’ll have to check out Walmart… particularly since now I have to refill my Lantus, which is about $120 a bottle. ---
**Author:** ![Ethilrist](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ethilrist/32/4604_2.png) [@Ethilrist](https://boards.straightdope.com/u/Ethilrist)\ **Post date:** [December 22, 2014, 8:16pm UTC](https://boards.straightdope.com/t/why-isnt-insulin-a-generic-drug-yet/707940/6 "2014-12-22T20:16:40Z")
> [@boffking](#): > > How exactly is this cheating? It _does_ reduce blood sugar. Well, on the one hand, it’s harder on the kidneys if they have to make all that urine. On the other hand, unlike actual insulin, it’s not convincing your body to store all that glucose, usually after converting it to fat. ---
**Author:** ![barbitu8](https://avatars.discourse-cdn.com/v4/letter/b/839c29/32.png) [@barbitu8](https://boards.straightdope.com/u/barbitu8)\ **Post date:** [December 22, 2014, 9:25pm UTC](https://boards.straightdope.com/t/why-isnt-insulin-a-generic-drug-yet/707940/7 "2014-12-22T21:25:49Z")
> [@USCDiver](#): > > Walmart sells vials of regular insulin for something like $20. Is the brand name Equate? Equate is distributed solely by Walmart and the products are all drug related. I suspect that they are actually made by the patented brand but allows Equate to sell them. For example, Equate makes a mouthwash exactly the same ingredients and same proportions as Listerine, made by Johnson & Johnson. ---
**Author:** ![USCDiver](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/uscdiver/32/354_2.png) [@USCDiver](https://boards.straightdope.com/u/USCDiver)\ **Post date:** [December 22, 2014, 9:32pm UTC](https://boards.straightdope.com/t/why-isnt-insulin-a-generic-drug-yet/707940/8 "2014-12-22T21:32:21Z")
> [@barbitu8](#): > > Is the brand name Equate? Equate is distributed solely by Walmart and the products are all drug related. I suspect that they are actually made by the patented brand but allows Equate to sell them. For example, Equate makes a mouthwash exactly the same ingredients and same proportions as Listerine, made by Johnson & Johnson. It is a [Novolin N](http://relion.com/products/relionnovolin-human-insulin-n-inj) manufactured by Novo-Nordisk. Sells for $25. I found out about this not because I’m a physician, but because my dearly departed dog was diabetic and the Vet told me about it. Now I tell my diabetic patients as well. ---
**Author:** ![USCDiver](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/uscdiver/32/354_2.png) [@USCDiver](https://boards.straightdope.com/u/USCDiver)\ **Post date:** [December 22, 2014, 9:34pm UTC](https://boards.straightdope.com/t/why-isnt-insulin-a-generic-drug-yet/707940/9 "2014-12-22T21:34:59Z")
> [@Ethilrist](#): > > A box of five Humalog pens cost me $400 at CVS a few months ago. I’ll have to check out Walmart… particularly since now I have to refill my Lantus, which is about $120 a bottle. You’ll still have to buy needles to go back to using vials of insulin but overall should be less than the cost of the Pens. ---
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [December 22, 2014, 10:59pm UTC](https://boards.straightdope.com/t/why-isnt-insulin-a-generic-drug-yet/707940/10 "2014-12-22T22:59:20Z")
Here is some info. > **[Why Isn't There A Generic Insulin?](https://hubpages.com/health/Why-Isnt-There-A-Generic-Insulin)** > > Many patents on insulin have run out years ago, and more will be expiring soon. Does this mean that a generic form of insulin is on the horizon? As others have said, walmart has some kinds of insulin (I believe only 1 formulation though) pretty cheap. ---
**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:** [December 22, 2014, 11:38pm UTC](https://boards.straightdope.com/t/why-isnt-insulin-a-generic-drug-yet/707940/11 "2014-12-22T23:38:06Z")
If you’re going to go with the pricey ultra-long or ultra-short brand name insulins like Lantus and Humalog and others, it’s gonna cost you a lot. Especially in fancy pre-filled syringes. Use generic NPH and Regular vials, load up your own syringes, and the price plummets tremendously. A vial of Lantus was costing our institutional pharmacy something like $120, while a vial of NPH could be had for about $10. Granted, NPH has to be dosed twice a day, but a lot of folks are taking their Lantus twice a day too. ---
**Author:** ![nearwildheaven](https://avatars.discourse-cdn.com/v4/letter/n/90db22/32.png) [@nearwildheaven](https://boards.straightdope.com/u/nearwildheaven)\ **Post date:** [December 22, 2014, 11:54pm UTC](https://boards.straightdope.com/t/why-isnt-insulin-a-generic-drug-yet/707940/12 "2014-12-22T23:54:03Z")
> [@VunderBob](#): > > Well, the common insulin used today is human insulin, produced by recombinant DNA processes. Those are all new, and within the 20 year window for a pharmaceutical process. The older stuff was horse insulin, and I have no idea how it was produced/extracted. > > As long as the patent is valid, the patent owner can charge what they damned well please. > > ETA: User of Lantus and Humulin, for reference. Humulin N, the first recombinant insulin, was launched in 1983. And insulin itself has been on the market since 1922, not the 1950s. I’ll never forget the first time I ever rung up insulin. I was a 16-year-old Target cashier in 1980, years away from becoming a pharmacist but I did know what it was, and I thought the $6.28 was a misprint - that something this important would be, oh, like, $300 or something. BTW, where do you live that they sold horse insulin? I’ve seen beef and pork insulin, and heard about fish insulin in Japan. ---
**Author:** ![Athena](https://avatars.discourse-cdn.com/v4/letter/a/35a633/32.png) [@Athena](https://boards.straightdope.com/u/Athena)\ **Post date:** [December 23, 2014, 2:59am UTC](https://boards.straightdope.com/t/why-isnt-insulin-a-generic-drug-yet/707940/13 "2014-12-23T02:59:28Z")
I just filled a prescription for 3 vials of Novolog, which is one of those new-fangled fast-acting insulins. Retail price was $768 for 3 vials, about a 3 month supply for me. Regular insulin, as others have noted, is in fact, generic and cheap. And nobody who has a choice uses it. It’s the stuff that gave a bad name to insulin; it’s slow-acting, hard to detect lows, and has weird peaks and valleys. I don’t think it can be used if you’re doing MDI (multiple daily injections), basically tailoring your insulin use to your daily life, taking into account what you’re eating and how active you are. You take a shot in the morning, eat it on a schedule, and avoid much activity. It was a wonderful, life-saving thing in its day, but nowadays, there are many better choices. From what I gather, the reason the newer insulins are more expensive is that they are difficult to manufacture, and only a few places around the world make them. The type I use has two makers globally, for example. Expensive, yes, but I have good insurance, it has far fewer side-effects, and it lets me live a normal life. ---
**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:** [December 23, 2014, 3:06am UTC](https://boards.straightdope.com/t/why-isnt-insulin-a-generic-drug-yet/707940/14 "2014-12-23T03:06:54Z")
I’d disagree that the new insulins are _that_ much better than the older ones, at least as regards long acting NPH vs. very long acting Lantus. Recent (non drug company sponsored) studies have shown that Lantus doesn’t result in better control than NPH for most diabetics, and since it can’t be mixed with regular (or the ultra-fast acting insulins) it doesn’t reduce the number of needle pokes needed either. Theoretically, its zero-order kinetics are nifty, but they don’t translate into clinical differences for most folks. Nor is the Lantus turning out to be a true 24 insulin for a LOT of patients, necessitating two shots of it a day anyway. And if you take the ultra-fast acting varieties, you need to be able to eat within 15 minutes of injecting, or you could run into trouble. I’ve a number of type I DMs and insulin-using type II DM patients under pretty damn good control using a 3 x a day shot regimen of NPH + Regular in the AM, Regular in the PM, and NPH at bedtime. ---
**Author:** ![Athena](https://avatars.discourse-cdn.com/v4/letter/a/35a633/32.png) [@Athena](https://boards.straightdope.com/u/Athena)\ **Post date:** [December 23, 2014, 3:11am UTC](https://boards.straightdope.com/t/why-isnt-insulin-a-generic-drug-yet/707940/15 "2014-12-23T03:11:42Z")
> [@USCDiver](#): > > You’ll still have to buy needles to go back to using vials of insulin but overall should be less than the cost of the Pens. > [@Qadgop\_the\_Mercotan](#): > > If you’re going to go with the pricey ultra-long or ultra-short brand name insulins like Lantus and Humalog and others, it’s gonna cost you a lot. Especially in fancy pre-filled syringes. > > Use generic NPH and Regular vials, load up your own syringes, and the price plummets tremendously. > > A vial of Lantus was costing our institutional pharmacy something like $120, while a vial of NPH could be had for about $10. Granted, NPH has to be dosed twice a day, but a lot of folks are taking their Lantus twice a day too. Yeah, but guys, come on. The difference between Regular and Humalog/Novolog and Lantus/Levemir is a heck of a lot more than ‘you have to fill a syringe yourself.’ It’s a whole different type of therapy, one that I’d venture to say most insulin-dependent diabetics would agree is very much worth the price. ---
**Author:** ![Athena](https://avatars.discourse-cdn.com/v4/letter/a/35a633/32.png) [@Athena](https://boards.straightdope.com/u/Athena)\ **Post date:** [December 23, 2014, 3:21am UTC](https://boards.straightdope.com/t/why-isnt-insulin-a-generic-drug-yet/707940/16 "2014-12-23T03:21:31Z")
I wrote my last response before I saw **Qadgop’s** reply. I’ll give you NPH versus Lantus/Levemir; I’m not as much in the loop as you are on that one, but I know they’re both primarily used for basals, and I bow to your judgement that they’re similar enough to work. But Regular and Novolog/Humalog being equivalent? Really? I know you work primarily in a prison, where inmates may not be able to eat around the same time as they dose, and perhaps don’t have as varied of a life as someone who is not in prison. But for the rest of us? My daily dosage for bolus insulin can change as much as 20 units a day from one day to the next, depending on what I eat, whether I work out, whether or not I had a couple drinks, and the phase of the moon. Dosing within 15 minutes of eating isn’t a hardship for most diabetics (at least, I’ve never heard anyone complain about it on the various T1 boards I visit). And most of the time, it’s not at all that regimented. I know more than a few T1s who dose after they eat because they find it more convenient, and their A1cs are fine. Heck, I might dose several times over a night, if I’m grazing or otherwise not eating a set meal on a set schedule. I’ve no doubt you can achieve decent blood sugar control with what you describe, but would you _want_ that life if you didn’t have to have it? ---
**Author:** ![nearwildheaven](https://avatars.discourse-cdn.com/v4/letter/n/90db22/32.png) [@nearwildheaven](https://boards.straightdope.com/u/nearwildheaven)\ **Post date:** [December 23, 2014, 5:11am UTC](https://boards.straightdope.com/t/why-isnt-insulin-a-generic-drug-yet/707940/17 "2014-12-23T05:11:59Z")
Which begs the question: Does anyone here have an insulin pump, and what do you think of it? I’ve met a few people who had them, and all of them loved them. ---
**Author:** ![obbn](https://avatars.discourse-cdn.com/v4/letter/o/d6d6ee/32.png) [@obbn](https://boards.straightdope.com/u/obbn)\ **Post date:** [December 23, 2014, 7:11am UTC](https://boards.straightdope.com/t/why-isnt-insulin-a-generic-drug-yet/707940/18 "2014-12-23T07:11:13Z")
> [@USCDiver](#): > > You’ll still have to buy needles to go back to using vials of insulin but overall should be less than the cost of the Pens. Needles are incredibly cheap. I get them at Walgreens for about $0.30 each. ---
**Author:** ![Athena](https://avatars.discourse-cdn.com/v4/letter/a/35a633/32.png) [@Athena](https://boards.straightdope.com/u/Athena)\ **Post date:** [December 23, 2014, 1:01pm UTC](https://boards.straightdope.com/t/why-isnt-insulin-a-generic-drug-yet/707940/19 "2014-12-23T13:01:04Z")
> [@nearwildheaven](#): > > Which begs the question: Does anyone here have an insulin pump, and what do you think of it? > > I’ve met a few people who had them, and all of them loved them. I have one, and yes, it’s great. Could live without it, but not with the same level of blood sugar control and also live a fairly normal life. ---
**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:** [December 23, 2014, 1:33pm UTC](https://boards.straightdope.com/t/why-isnt-insulin-a-generic-drug-yet/707940/20 "2014-12-23T13:33:58Z")
> [@Athena](#): > > But Regular and Novolog/Humalog being equivalent? I never claimed that. But using fast acting insulins in prison has more risks, so we don’t use it. And as I said, we can get pretty good control with a 3 shot a day regimen. And by pretty good control, I mean HgbA1c under 7. That’s not a complicated regimen. Yes, for an active, informed diabetic needing insulin, using the fast acting insulins has benefits and makes more sense quite often. But I don’t see it as being so superior that using regular insulin ought to be considered a hardship. QtM Treater of thousands of insulin-requiring diabetics Past user of NPH, regular, Lantus, and novolog. Currently controlled with NPH and novolog. [Next page](https://boards.straightdope.com/t/why-isnt-insulin-a-generic-drug-yet/707940.md?page=2)