So your only option is to buy the modern day synthetic analogs - or illegally import the old stuff, which the FDA notes here it has the right to block, but may allow under exceptional circumstances.
When people complain about being forced to pay thousands a month for insulin, they're talking about the newest synthetic insulins that were developed very recently at substantial costs.
They could take the older insulins for $50 a month, no one is stopping them. It's just that those older products are less convenient.
Only the last one makes the distinction between modern synthetics and basic insulin.
Frankly the US pays for the cost of the research while the rest of the world just pays for the cost of production.
If you want to fix the cost of insulin products (and many other drugs) in the US you need to figure out how to make everybody else pay for the true costs.
Edit: also your last source there doesn't even know what it's talking about Novolin is a generic brand name for 3 distinct products that have distinct pricing.
The history of insulin shows a great deal of involvement and progress made by researchers in several countries, and the US would probably not even rank as first among them.
Novo Nordisk is based in Denmark and they did a lot of research. Of course, cherry picking the stuff Eli Lilly brought first makes it seem they are the ones driving the thing forward but it only makes sense in the wider contact and when compared with what other have done first as well.
Novo piggybacked on a ton of research especially with metformin done in the US. Let's not be delusional that Denmark is a bastion of cutting edge biological research
> Let's not be delusional that Denmark is a bastion of cutting edge biological research
Except in this case, it is? All I read seems to point they did push the envelope a lot of times. Do you have some other reason to say this except "psht, get real, it's Denmark"
That's a 10 year old article. Although if we rank by market cap top 6 are from the US these days (by revenue 5 out 10 seem to be European) so not much has seemingly changed (besides Novo Nordisk becoming the second most valuable pharma company out of nowhere)
> That's a 10 year old article. Although [the] top 6 are from the US these days […] so not much has seemingly changed
Well, thanks for the update. Correcting a citation an out-of-date article that is - as you admit - apparently still relevant as cited was definitely worth everyone’s time.
The very specific figures from that comment are obviously not really correct. e.g. Pfizer's profit margin in 2023 was ~3.5% which isn't that great (and that's the largest pharma company by revenue).
Keep in mind that marketing is a bit complicated - very few countries allow direct to consumer marketing. I think kits just the US and New Zealand. Obviously there would still be marketing in other countries, but a heavy US presence likely skews things.
Fun fact: the main reason it was legalized in New Zealand was heavy US pressure and lobbying over trade agreements and there’s been substantial pressure to get rid of it since then.
The argument that the US is paying for everyone else’s drugs is often made in defence of big pharma, but their profits make it hard to swallow. In recent times the US hasn’t really shown any other other signs of chasing socialist policy where it subsidises the rest of the world.
perhaps most of the research would not be incentivized in a socialist society? it's not like the talent doesn't exist elsewhere, but US embrace of capitalism is a factor in the research development research.
> Frankly the US pays for the cost of the research while the rest of the world just pays for the cost of production.
Oh come the fuck on, this has been the talking point since the early 2000's. Surely nobody still believes this horse shit. Phizer by itself raked in 50 billion last year alone.
It comes up here in NZ every few years, as there is frustration that we aren’t paying as much as the drug companies would like. The US leaned on us hard to scrap our single payer system.
This sympathy for these massive companies in this thread depressing. Big Agg and Big Tech don’t get this free pass.
It was depressing in 2008, now it's just pathetic. It's no wonder they feel so emboldened to continue fucking people raw for their medications, they have hordes of defenders in government and otherwise ready to offer page upon page of apologia for their rampant profiteering.
> One key limitation of this study is that most of our analyses used manufacturer gross prices,
not manufacturer net prices after rebates and other discounts are applied.16 Given the generally
competitive insulin market, rebates in the United States are substantial (Mulcahy, Schwam, et al.,
2021; Dickson et al., 2023). After applying a 76 percent manufacturer gross-to-net reduction,
U.S. prices were roughly twice as high as those in other countries (compared with nearly ten
times as high without the discount). We caution that these results likely underestimate the
magnitude of the price differential because we were unable to estimate similar gross-to-net
discounts in other countries. If manufacturer net prices in at least some non-U.S. OECD
countries are lower than their manufacturer gross prices, the ratio of U.S. to other-country prices
would be higher. In addition, because of data limitations, we applied a single U.S. gross-to-net
reduction across all insulins. Actual product-specific gross-to-net discounts likely vary along
product characteristics (for example, prescription versus over the counter and timing category).
As a result, our estimated ratios of U.S. to other countries’ prices for specific insulin categories
likely reflect measurement error.
As far as I can tell they also aren't attempting an apples to apples comparison, they're lumping all "long lasting" insulin drugs together. There is no such drug as "insulin", or even "long-lasting insulin". There are dozens of insulin analogs being sold at an incredible range of prices, easily over 10x from the most expensive to the cheapest.
My default take on this kind of analysis is that people in the US are wealthier and are therefore paying for the newer, more effective, more expensive insulin drugs than people in other countries. I'm happy to be proven wrong on this but I haven't ever seen that analysis, they always conspicuously avoid direct comparisons of the same drugs.
This falls into a greater pattern of behavior in the us that I have noticed where pricing for almost everything is completely opaque. The price on the menu for a burger is not what comes out on the bill (tax, gratuity).
The price for healthcare is beyond understanding for mortals. The price for drugs, again you and your neighbour could be paying something completely different for the same medication. The actual cost to your wallet for university? Who know, everyone seems to get different levels of subsidy and scholarship. Visa Cash App - you can make the same purchase on two different days and pay different prices, unique only to you.
I find it incredibly exhausting to visit the US and navigate all these pricing systems, I dont know how you have let this become a psychological status quo.
If you're not distinguishing between insulin extracted from a horse circa 1922 and a modern synthetic analog, well that's just not being honest.
There's good arguments that the modern synthetic analogs are overpriced, but that's a more subtle argument.