I’m not diabetic and the situation with insulin fills me with a white hot rage.
Same
the OOC might be TYPE 1 which is even more dependant on insulin than type 2, because you’re pancreas cant make any insulin at all. plus there also other expenses that comes with being type 1. CGM, INSULIN pumps(which are often regularly replaced because they wear out). you can sometimes tell when someones type 1, if they have a device attached to thier arm, its usually a circular button, thats the sensor(its another cost)
The sensor is no guarantee. Quite a few low carb dieters use constant glucose monitors (CGMs) to identify which foods they should avoid
I’m sure they’re Type 1. At least with Type 2 you can kind of manage it a little without the meds. The insurance company should be firebombed for refusing to replace the damaged meds.
How is it even possible to afford $800 for insulin? It boggles the mind
In Canada it is still considered expensive, but not even close to $800/month. It’s only considered expensive because most shit like that is free or a very nominal fee, but repeated need is what it is.
I genuinely think that in some third world countries, as part of the middle class, you can have a better life than in the USA.
Something I’ve noticed is when untraveled people in the USA try to contextualize themselves with other countries they pick the worst examples they can think of. Favelas in Brazil or slums in South Africa for example. We do this to the point where our entire conception of countries (or in the case of Africa, continents) is the worst imagery we can think of. I think they genuinely don’t believe that, for all their troubles India, Brazil, Mexico, Nigeria, etc also have smartphones and big buildings and libraries and universities and laboratories, and educated people living decent lives.
They also can’t see how the overcrowded jails full of pretrial prisoners, the barefoot children carrying buckets for water in Appalachia, the rundown schools full of illiterate kids, the impunity of rich private interests, the corrupt sheriffs and judges, and on and on, puts us in the company of the “third world countries”. Yes we have nice places too, but SO DO THEY. A broken society in the 21st century isn’t people living in mud huts, it’s children shitting in the street next to a glass skyscraper with LEED Platinum certification.
And it’s not just “overcrowded jails full of pretrial prisoners, the barefoot children carrying buckets for water in Appalachia” but the grad students in LA living out of their cars, or grandpa sleeping on a bus stop, or people in the Rockies surviving off roadkill and forage.
Seattle tent cities/tiny homes make some Favelas look real swanky.
It’s also much harder to become a middle class in those countries.
Not really. Poverty rates are higher, yes, but many middle income third world countries do have sizeable and growing middle classes. They’re called developing countries for a reason. The image of war-torn African countries where everyone works in mines isn’t really representative.
There’s a reason countries like Vietnam are so popular with digital nomads.
My dream would be to get a remote nightshift job and live in a house by the beaches of south Thailand
Logically, it’s not about how much money you make, it’s about purchasing power. It is irrelevant if you earn only $400 a month when you can eat well for $1 and pay $100 for your housing, you have free health care and education. That is the reality in some third world countries.
Third world doesn’t mean poor, it just means not aligned with US or Russia
Spain isn’t third world, it already had shown the middle finger to Trump and also has few to do with Rusia. Third world countries don’t certainly mean people starving, the people there often have all what they need, but this, you’ll see few Ferraries there and chalets with swimming pool. Someone is rich, not necesarly because a lot of money, but because he need only few. We often enter in a rabbit hole of the consumism, spending a lot of money in things we really don’t need, we work like a dog to have enough money to pay a journey to Hawaii to recover us from the burnout, which we wouldn’t have working less, no needing this journey.
Have you been to Spain? I’m not saying it is not better than where the US is headed to, but it’s a “western” country in Europe, with all the issues that come with it. Somewhat social market economy, but still suffering from the usual issues, including people driving Ferraris while others sleep on the street.
Also, at least since Franco I don’t think anyone genuinely thinks of Spain as third world.
Well, I’m from Spain, also in Spain there are People with Ferraries (few) and also poor people, but there is nobody without food, because Spain has a strong social system and free healthcare for everyone. Nothing, absolute nothing to do with the US, it’s the opposite in almost everything. Luckily Spain has also little dependency on the US or Rusia, so it is also not much affected by Trumps Tariffs or Rusian Gaspolicy. Trump hates Spain.
If you can eat well for $1 then it is definitely a poor country relative to the US. Differences in purchasing power are a direct result of differences in wealth.
I think that the US is a third world country, it’s rich but most money is used for weapons and to make richer the billonairs and big corporations, in the social and cultural sphere, it is one of the most backward in the world. Now with Trump the US is turning in a running gag for the most countries. A country where 40 milloncof citizen don’t have enough to eat at least 2 times a day, isn’t a rich country.
Usa is the hub of first world. Russia is the second. Thirds is everyone else.
USA is an total dystopic country, any Banana Republic has more culture. US is only powerfull because use all the money for weapons, developed by foreigner scientifics. First world is anything else.
You will say that the US is a first world country, it’s better for your health
I really should just put a full block on lemmy.ml. Thanks for the reminder!
It used to mean that. First World was US aligned (or at least US friendly), Second World was Soviet aligned, Third World was not aligned
Now though, First World means developed nations, Third World means poor nations, Second World has fallen out of use
Only to those ignorant of it’s meaning. Developing nations is what people mean. Like people say third world, third to what? What’s first and second?
Espousing an old no longer relevant definition to sound smarter and be “right” is peak lemmy/reddit behavior. Third world does mean poor now.
It doesn’t. It never did.
It does. Strictly it does. Why do you think china is no longer considered third world?
Strictly, technically every other way China is still third world. This concept of third world being poor seems to have originated from the common charity ads in the 90s and 2000s who loved the phrase, and from the American exceptionalism that thinks everything not American is dirty and poor.
Being poor is the only way a country is third world or not. Being politically related to America is not relevant to the present definition. So no, it is not “technically in every other way”. It just is not a third world country, period.
No one really uses that word in its Cold War context anymore. It’s the common term for “developing countries” and the like.
People believe that only because they haven’t learned what it actually means.
You’re right that they either never learned what 1st-2nd-3rd world really means, or they forgot what they were taught in history class. Unfortunately it still is the main term to refer to poor countries even though it’s incorrect. Language seems to be biased towards the common meaning over the technically correct meaning.
Is there any reason a diabetic has to get the newer patented formulas instead of the old one that the pic talks about which is regularly sold for around $25 a vial in the US without insurance?
I know the new stuff works faster and you don’t have to worry about your diet as much so I’m sure it’s much easier, but why would you have to die instead of just managing your diet and using the $25 stuff for a month in this emergency situation?
Don’t get me wrong all medicine should be free and stuff but like, why die instead of switching to the cheap stuff and dietary management for a month?
People respond wildly differently to different types of insulin and it isn’t just a matter of switching and watching your diet. Too much and too little insulin can be deadly and it makes you feel like absolute shit.
Ah, so you’d need to know your dosage for that type beforehand, and if you didn’t know it you can’t just wing it. Still though, might be beneficial to know that for emergencies like this because it sounds preferable to certain death.
There should be a little chart your doc gives you at diagnosis (or something, spitballing here) that lays out the dosages you’d need for X, Y, and Z brands so that if say you use X and they’re out (or your kid freezes it or something) you can just consult the dosage chart and get Y for now.
I don’t think it’s a thing because even the same insulin analogue from different manufacturer can have different dosing
A unit is a unit, so the dosages are the same. What varies is onset curve and length of action, so timing.
Insulin is not permanently shelf stable, and will still expire in the fridge.
Diabetics usually start with a long-acting insulin to keep blood sugar from naturally rising plus a fast-acting insulin for corrections and to compensate for food.
The old style of just giving 2 long-acting shots of mixed insulin is mostly obsolete, except for legacy patients, some pregnant patients, and other special cases I can only theorize.
A good number of diabetics only use fast acting insulin in a pump, receiving microdoses every minute.
To switch brands of insulin, much less therapies in any circumstance requires a doctor’s visit.
With all that said, the insurance company will often replace a medication in the event of an accident, typically only once a year.
Without that, a patient might be able to find a charity they will assist them.
You also may be able to travel to the next state over where the cost of insulin is regulated.
Failing all other options, it is better to check yourself in to the hospital as your sugar begins to rise and tell them that you cannot control your blood sugar.
The subs would be R and NPH, not the old mixed formulas like 70/30.
Ah well that’s good, at least there appears to be some options.
I’ve heard of clandestine labs making patented insulin and selling it cheap too, and I’m all for a good grey market.
Not sure about that, and not sure if I could trust that.
Another option is to have the doctor prescribe insulin pens or another brand of the same kind of insulin. It’s technically a different prescription and the insurance company usually covers it.
I don’t think I ever had insurance in the US where checking into the hospital for any amount of time would cost less than $800 out of pocket.
Unless I had already reached my annual deductible, that is.
It’s no longer about saving money at that point.
Unless I had already reached my annual deductible, that is.
“Hey good news! After about 35% of your annual income is spent on medical bills on top of your triple digit monthly premiums… That health insurance starts to kick in!”
(Until it resets at the end of the year. Teehee!)
The deductible system is ridiculous.
It truly is amazing how an entire industry makes billions by literally avoiding delivering the most basic service it’s paid for at every possible turn.
This is not even good capitalism. Capitalism was intended to provide efficient solutions through competition. This is an oligopol secured by generous bribes
The extra ridiculous thing is how they deny services that a doctor says are medically necessary… and not even in a reasonable way, in an abusive way. Like the system that automatically denies 60,000 things an hour or whatever, and count on people wasting tons of time to challenge it. Or when they have an ophthalmologist review your kidney disease and say that some treatment isn’t warranted. And that’s even after you’ve paid your stupid deductible costs for the year.
The old formulas you can buy OTC for $25 are more inconvenient to use, but will indeed keep you from dying. The main difference between the R insulin and Novolog/Humalog are how quickly they act. Novolog starts lowering your glucose in about 60 minutes while the R takes 2 hours. Dietary management is not related to which insulin you’re using, at least for type 1. The long acting substitute, NPH, is a lot more difficult to use than Lantus though. It still works. I ran out of good insulin on a trip last year and had to sub the R and NPH and did have some issues with hypoglycemia. I’m more qualified to swap them on my own than many people though (lots of people are not informed enough to change their dosage without professional medical advice).
So yes, the claim that OOP’s only alternative to paying $800 was to die is not true.
We should be thankful for those of us not born in a third world country like the USA. 😌🙏
as an American I’m offended. how dare you compare third world countries to the US.
they may be small and unsuccessful but damn it they’re trying.
No no this is a “there are starving kids in America” thing; for a good chunk of the third world this shit would be literally unthinkable.
At least you can buy a human for only $85.21!
Lots of missing data in there, but gotta love Turkey’s $2.56.
I can confirm, as a insured I am paying $0.00 for Insulin in Macedonia. Now I am receiving 6 Novo Nordisk Tresiba pens per month. How much is that in US?
it is difficult to find out (by design) but i have found this for uninsured people
and this for insured people who qualify for a savings card(?)
I couldn’t find the answer easily myself and ended up asking AI, so take this with a significant grain of salt, but supposedly a 3mL pen would be around $145 without insurance. If anyone can find a better source, I’d be all ears.
Is it free in grey countries?
Either that, or maybe they don’t have diabetes there. (Lol joking)
1/5th cost just by driving to Canada.
California is contracting its own insulin supply and it’ll be available for $11 a pen starting Jan 1, 2026. I know not every state can or are willing to do this but just throwing out some examples and hopefully optimism to somehow fight the American decline from within it. We’re in a unique position as our state economy is larger than most countries but I am hopeful we will throw our weight around to counter the bs. https://www.chhs.ca.gov/blog/2025/10/17/governor-newsom-announces-affordable-calrx-insulin-11-a-pen-will-soon-be-available-for-purchase/
Seems like something other states should get in on. Now that the program is established seems like it would not be as hard to pay into it and get a share of the product.
But that’s socialism! /s
contracting is an interesting choice of word since it could mean decreasing
That’s called a homophone.
Well typically it’s said “contracting out” when they mean making contracts
I know not every state can or are willing to do this
this kind of thing scales well, i see no reason why after california has it set up, other states couldn’t get insulin from them, or chip in
I would think Big Pharma will aggressively fight against it.
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theres only 3 companies that produce it , Eli Lily, sanofi aventis and novo nordisk, they have fought aggressively through litigation in the past to prevent any insulin generic, or biosimilar to reach the market. they agreed amongst themselves to have whatever the cost they want without competing with each other.
Civica is launching insulin glargine in early 2026 specifically because of that bullshit.
good. generic biosimilars cost like 1/5 of the on-patent thing price
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Naive question from a european: Aren’t there companies on the market who can offer a cheaper price and therefore beat greedy competitors?
Correct, but when it’s already been established that people will pay those prices, they keep them high. So instead of going from $800 to $5 out of the goodness of their hearts, they go from $800 to $650 (number made up) to get more business but still make massive profits.
You’d THINK capitalism would cause that to happen, wouldn’t you?
Doesn’t work when people don’t get to choose not to take it when it gets too expensive! That thing that capitalists always forget about: necessities.
Every time someone talks about you being supposedly free to choose where to work they should get instant diarrhea. Let alone medicine of course, that’s a hard dependence.
Nobody is truly free without proper UBI and free healthcare and good public transport. Only then true freedom can exist.
instant diarrhea, haha, but yeah, it carries the point across quite well. some people can’t work wherever they want, at whatever job they want, because they have health conditions limiting their range.
Amen!
Capitalists don’t forget. They exploit.
Yes, correction noted
What USA is experiencing is feral Capitalism.
Crony capitalism
it’s just capitalism, that’s what capitalism is
A lot of the benefits people associate with capitalism require a free market. The US problem is that the megacorps have gotten sufficiently powerful to abolish that free market through regularory (and legal) capture, enabling entrenched monopolies.
Sectors like pharma require enormous R&D budgets. If you have a free market with many companies, each company will have only a tiny marketshare, and therefore only a tiny budget. So you can’t do without the megacorps. The solution is for the megacorps to be run by the government / non-profits / trusts, or, if that is not possible, for prices to be fixed by an independent regulatory body.
Look, mate, Intellectual Property Laws are literally the government creating and giving somebody an artificial monopoly on something which would not naturally exist if it wasn’t for artificial limitations on “doing the same thing” being forced on everybody thanks to legislation and the coercive powers of the Legal system, and this was purposefully written in Law to do exactly that, so it’s not an unexpected legislative side effect.
So anywhere were Intellectual Property legislation can apply the market is not free, on purpose and by policy.
Now, a good argument can be done about how IP law incentivises the creation of things with a high utility value which would otherwise not be created, but that doesn’t alter the fact that the whole thing is a giant legislative sledgehammer with massive destructive capability for both the Economy and people’s lives, which needs to be handled very carefully in order not to do more harm than good.
As it so happens IP has gone completelly out of control in the US because Corruption there is incredibly high, more some when it comes to the property of ideas since holding a piece of such property can yield billions of dollars in profits - the profits from owning ideas can be far vaster than of merelly owning land - and this shit has been copied around the world by almost as corrupt politicians (for example, the thoroughly corrupt crooks in the EU commission pretty much copy every single “this will make me personally lots of money from thankful corporations” pieces of legislation from the US).
So Copyrights now last an insanelly long period - about 1.5 times the average human lifetime - before things covered by it go into the Public Domain, whilst lots of Patent Offices (most notably the ones in the US and Japan) will just accept patents on everything no matter how obvious without even a proper search for prior art, hence things like the “round corner button” patent that Apple has as well as countless business patents for “solutions” which are obvious to any domain specialist (many such patents literaly the product of paying a domain expert for an hour of their time by a patent troll to just “think up a solution for this” as no actual implementation is needed to get a patent, just the idea of how it could be done).
All this to say that this fucked up situation of insane government-given monopolies all over the place for shit that’s obvious to domain experts or derivative (a common trick in patents for medicine is to just do a small tweak in the formulation to get another 25 years of patent protection on pretty much the same thing) was created ON PURPOSE by the very politicians who claim to want a Free Market.
The entire thing should be reviewed and ajusted in exactly the opposite direction it is going (so we should have shorter protection periods, no “ideas only” patents, proper prior art searches rather than relying on expensive court cases to nullify patents on things somebody else already did or which are common practice in that industry, no business patents, properly funded Patent Offices, no transnational recognition of patents - so that countries *cough* Japan *cough* can’t just use their Patent Office as some sort of commercial weapon to benefit their local companies in other markets - and so on) but given that Intellectual Property is an area worth trillions (and, remember, it’s entirelly artificial, so without that legislation such property would be worth nothing at all) and politicians are incredibly corrupt nowadays, this shit is getting worse rather than better (and, IMHO, severely slowing down the speed of progress in the current Era versus a Free Ideas system)
Yup, but their products don’t work as well, don’t work for everyone, or have other downsides. Banting’s original insulin would be dirt cheap today, but it’s shit compared to what we have now, so the best products on the market today charge a premium for either efficacy or convenience.
That’s certainly how capitalism is marketed, isn’t it?
the problem is that there is natural (as in, unmodified) cheap generic insulin available, it’s just that it sucks compared to everything else. you see, insulin is a peptide that is supposed to appear, do some signalling, then disappear and unmodified insulin copies this thing exactly. the problem is, most of the time when peptide is supposed to work as a pharmaceutical, you don’t want to do that, you’d like insulin to last longer than usual, which means changes to it that make breakdown slower, or adding something that makes it stick to albumin, which has similar effect because it hides insulin somewhere enzymes can’t reach it and also it makes it start acting slower. this means less frequent dosing and less changes in insulin activity over time. there are also other insulins that start acting faster than natural, and this is also due to a couple of modifications in its structure
for another example, ozempic was not the first drug in its class, it’s also a modified peptide, and it can be injected s.c. once a week, compared to previous iteration (liraglutide) that requires daily injections. if natural peptide is injected i.m. instead, its halflife is half an hour, and in serum it’s only two minutes (it gets released a bit slower than it is metabolized)
manufacturing costs are about the same for any variant, most of it is in purification. patents for a couple of these have expired anyway by now, but if manufacturing is limited then price can be set arbitrarily high (see daraprim)
thats why the big 3 companies make different version insulin so they are effective at certain times of the day, or when you eat/
there are multiple short-acting and long-acting insulins because you can’t patent other people’s things, but now it’s all off-patent. just take your stainless steel bioreactor and preparative HPLC, cook up a batch, wait ten years for biosimilar approval and you’re good to go
because unlike with small molecule drugs, when cooking up generic biopharmaceutical there’s extra approval process that amounts to a tiny clinical trial https://en.wikipedia.org/wiki/Biosimilar this and type of economics of scale that there is with biologicals makes manufacture at large scale way more preferable. these requirements were loosened a bit over time
very interesting!
Oh wow, an actual nuanced response and genuine answer!
Also today I learned!
Responses don’t need to be nuanced to be useful.
Yeah, alright buttnugget.
Alright Caroline
???
Since your comment was entirely superfluous, I just replied in that same spirit.
Costs aren’t just research and purification, it’s also good manufacturing practice and quality control.
i mean i don’t think about it as a separate budget line because if you don’t have that you get police raids and investigation instead of normal business, but yea. insulin is purified using HPLC, so at all times you get some of analytical data about fractions you just made, so some of QC, not all, but already something, already happens at this point
my point is that actual manufacturing costs will be low because biotech scalability logic is that you need to make yeast or something that makes peptide you like and then all you need to do is keep bioreactor alive and happy. lots of what is left is in purification
also it’s an injectable so it’s gonna be kept to some standards that non-injected drugs aren’t. whoever comes up with insulin pill will be printing money
US Healthcare = pay or die
Oh, it’s not that good.
It’s “Pay until you run out of money and can no longer take on more debt. Then die.”
Let yourself be captured by the ICE, so they expel you for free to a civilised country.
Civilized countries don’t run camps for ICE.
It’s yet another thing to force the riff-raff to work any job for any pay.
Can’t have people refusing to do disgusting or even life-long disabling jobs for peanuts.
See also “housing costs”.
US hEAlthcare.
Pay a monthly subscription fee, and additional microtransactions every time you get rejected.
You forgot the middle step, vote for republicans to perpetutate the situation, and then die.
Invented by a Canadian, exploited by an American.
'Murica, fuck yeahhhh!
If I’m remembering the original sysntesis for insulin used dogs, and it was harvest from them after being killed. It’s unjust that insulin is so expensive, but also modern production methods are not the problem here. It’s greed.
Shoutout to the uninsured cost of the medication I need to live
(90 tablets)
Does anyone really need to live? What you need is to be producing value for your company!
/S
Also I just remembered, I used to have United Healthcare and they didn’t cover this medicine so I had to switch. Had to pay ~$300 for that refill (i think it was fewer tablets and 75mg that time). $40 on my current insurance.
Anyway I’m a big Luigi fan
wahooyuck, did you use optum health? they are owned BY UHG.
Using Aetna currently. That is good to know though
A patient cured, a customer lost. A dead customer, just a cost of business.
^ Say “for profit medicine” (oxymoron btw), behind closed doors.
