The artificially inflated price of insulin

Over time, there have been different formulations of insulin, slow acting, fast acting, newer types that better mimic human insulin, and varieties which some work better for certain people than others. Each of those has been patented by the company that developed it because well... patent law itself is complex even in basic principal. The idea is that you wouldn’t spend the millions or billions of dollars to figure out some complex problem if you knew some other guy could just copy your work and you might not even make back what you spent.

Isn’t that what people say about few internships and “exposure” for artists and the like? Expecting someone to do work for MAYBE some money isn’t really right is it? On the other hand- patents also allow companies to stifle the work of others, every gene is owned by someone and if you need to research on it as part of your project- you’re going to have to pay for the privilege. So patents are a good idea but that system is broken too. Regardless- we an hopefully agree researchers need SOME kind of protection so the decades and multi millions spent on an answer to a problem can’t just be copied by someone else before they can make back what they spent and make enough to research the next problem.

Unless we want all that to be publicly funded and also government controlled. They do such a fine job with everything else like our school system and DMV and public assistance that I can’t see any problems come from that.... our last few wars have also been well planned and troops have had the support, information, and supplies they needed on and off the battlefield in a timely fashion... so what could go wrong with government control of the research and intellectual property of private citizens?

But here’s the kicker- so the 4th insulin company? The only generic in America, the “Walmart” insulin? It’s an old type of insulin that isn’t without problems and won’t work safely for all people. Older insulin’s like that are no longer protected by IP. Companies CAN copy them, doctors CAN prescribe them... but they generally don’t.

Doctors are reluctant to prescribe older, cheaper insulin even when it will work for a patient. There are many factors. It’s more work for them- making sure the patient tolerates that insulin and adjusting and trying until they find the right one and dose etc. with medical malpractice and the ability of patients to sue- even if the patient loses this can cost a doctor tons of money and time away from their practice, drive up their insurance, block promotions and even hurt their reputation with patients (when a potential new doctors name comes up on google search for malpractice suits, win or lose most people are hesitant if there are other comparable doctors without...) and other doctors who may not want to be associated with them or have their name on the practice.

There’s also the fact that many doctors just... well... to be frank they are kind of in bed with the drug companies for the most part. Not all are sinister or immoral, being “bribed.” Many doctors just don’t have time to do all the research and they are doctors not chemical engineers. Your GP probably knows next to shit about nutrition and little more than shit about you endocrine system or how your brain works. It takes over 8 years to teach the “basics” of medicine and no human could master it all and every aspect from nuclear physics to chemistry and genetics and psychology etc etc.

The doctors more or less rely on the drug companies to tell them what to prescribe. If Company A makes a heart medication and they reach the doctor and convince them it’s awesome- if the doctor prescribes it and it works they will likely keep doing that. The longer they’ve been doing it the more likely they are to keep doing it because that drug hasn’t killed any patients. They know the side effects and warning signs- a different drug, even if it is better... they often balk because it’s an unknown to them. Likewise some doctors just think newer is always better. And some are basically chummy with certain companies or reps who either do right by them in incentives and gifts, or they have a good working relationship.

Either way a doctor just doesn’t have time or honestly the skillset to dissect every drug at a molecular level and figure it out. They have to take a specialists word often times. They get ads and basically “commercials” just like you and that’s a big part of how they chose drugs along with what colleagues and mentors or organizations prefer.

So do we make it a law a doctor has to prescribe the cheapest version of something? I mean... like I said... it’s really complex and we haven’t even gotten into the part the FDA plays in the whole thing. From putting a hard deadline of early 2020 after which they would reject any pending application for a new insulin supplier and force a lengthy and costly re application- to the road blocks they put in the way of those trying to create new insulin or market cheaper insulin; and of course the corruption and complicity of the agency which is also beholden to the very companies it is supposed to police. That doesn’t mention politicians- who not only set laws and oversee the FDA or even sit on the FDA BUT also have personal financial interests and often they or family or friends also have ownership stake in the companies they are supposed to regulate.

THERE’S EVEN MORE! But this is long enough. As said originally- it’s a nice idea and I suppose outrage is often the starting point of change- but we need to get to the next step which is discussing an actual actionable idea for it. We all see the problem- or almost all anyway. But seeing a problem is usually easier than solving a problem- especially if you aren’t seeing the whole problem. Drug companies play their part- but we already have government agencies that are supposed to protect us from them and look out for our interests. Why is this a problem? It’s tempting to get mad at the “rich evil villains” but the big companies are only a part of this.

The big companies themselves aren’t necessarily evil- that is to say, if you topple their evil empires any empire that replaces it is almost certain to become just as evil because it is the system the companies are operating in that allows this- and in a profit driven economy, companies will make profits. Stopping that isn’t really compatible with the idea of freedom unless you use the government to compete in the private sector- which itself opens up all kinds of potential problems. But beyond that- if it was effective to use the government to combat corporate abuse why haven’t the agencies responsible for that done so? It’s a big mess and it’s easiest to point at the guys selling the product- but they aren’t the only ones gaining here.

Ok Boomer

Insulin should be affordable end of story. It shouldnt have to be “go into debt or die”

We are in agreement, as I said above. The system is broken, the system should be fixed so that people don’t have to choose surviving but not being able to live while they survive. I’m just saying that if you want to “fix” something it is about identifying and correcting the problem and not about finding a simple and easy totem to make a symbolic effigy of so we can burn it and appease invisible spirits and hope that fixes it.

Simply put- how cheap and easy has it been historically for people to get their insulin under communism? Communism doesn’t have mega corporations- it’s state industry and controlled economics- yet often you’d find the choice there isn’t go broke or die- it’s commit crime or die; or, commit crime and die. Unless you know the right people. We also know that in developed countries with socialized medicine- they have big corporations and capitalism- but they don’t pay what the US does for insulin. So.... we can more or less rule out “big corporations greed” as the primary factor in the spike in price seen by the end user.

A single vile of Humalog is 10x less in Canada. It’s made by the same company. Same drug. 10x less to the consumer. So... there’s obviously more to it because Canada is a free market capitalism too. Funny enough- even at 10x less a vile Canada is second only to the US in consumer drug prices and its a big issue. Canada DOES have a series of regulations to control costs of prescription drugs- and they obviously do something to help since they pay less- but they don’t solve the problem either since Canada still is the second highest costs and is still looking for solutions to lower their prescription costs.

So I am not saying that we don’t have a problem and don’t need to fix it @sassyllamaesuwire- I’m saying we have a huge problem and we should fix it- by doing things that will, not things we know won’t but will still take years or decades of high cost legislation and legal battles to not work. And @unklethan- if it makes me a boomer in your eyes to disagree with reactionary herd mentality- to say “yes, we have a gaping wound, yes we need to act, but no. Rubbing sand in it and asking the sand gods for help because it will make us feel better and we are panicked chickens is not a good idea and we should use our logic and our brains to identify the problem and the best solution...” then I am sad for you.

@guest_ its not everyday i agree with you but i think you did a very good job explaining the complexities of this issue. Ignore all the downvotes, you did well.

Thanks puma. Usually the DV’s just egg me on. I appreciate your kind words and your opinion. Even when our opinions do not match up. Lol.

@guest_ I didn't read most of what you wrote, so no criticism from my end, but how do you have the confidence to write out huge paragraphs of info and then get downvoted into Oblivion half the time?

Given the choice, I’m not going to let the social pressures or disapproval’s of others stop me from living my life and saying what I have to say. That’s a dangerous mentality if one has a closed mind- it can justify bigotry and resistance to change- but I’m open to discussing things with people and getting their side of things when they have worthwhile things to say and respectful discourse. So I can, will, and have changed my opinions or admitted wrongs where people have shown me sound reasoning- and at the least we can agree to disagree. But I’m more interesting in learning and growing and sharing my own thoughts and perspectives with others than I am concerned with being popular.

Unless a person has the power to overcome our own- then the only power anyone has over is is what we give them. Some people’s only source of feeling power comes from being able to get others to do what they want. They get upset when someone else won’t give them that power over them. From presidents to billionaires there are plenty of people who are often more hated than loved- but with principals and a job- on the practical side you just have to ask if you’re getting what you want out of life- and on the philosophical side you just need to know you’re always trying to be the best you and you’ll never get all the way there. So people will of course be critical of a work in progress- but you’re the one shaping what you are- so if you are what you want to be then let the critics enjoy themselves and you just enjoy what you’re making.