$1300/month is absolutely crazy. In Sweden, a whole year’s worth of injection insulin is about $600 (actual cost to the government, including the disposable injectors) and $0 to the end user.
Another person commented on a different thread that he was buying some kind of auto-injection pen that fetched a premium to the bottled stuff. It seems he was not aware that he could’ve used the regular bottle stuff and saved a LOT of money.
The pharmacist should’ve given him a better consult and told him options for cheaper stuff. I had a pharmacist and a tech search for 30 mins several times for a rebate that brought my cost to $0. They will suggest another medication if the one you are getting isn’t covered. They will even call you doctors to get a new script.
It seems there were failures on multiple levels. He should’ve been aware of better options. The pharmacist shouldnt have let him leave when he couldn’t afford it.
The primary failure is that healthcare is considered an "industry" in the US and that health "insurance" is incentivized to keep prices (and profits) high.
Health insurance by private companies is just a scam. In combination with "not-for-profit" hospitals, medical practicioners loaded with college debt, lobbying to government to enforce ongoing rent-seeking (eg "Medicare D is specifically not allowed to negotiate drug prices").
The entire US health system needs an enema.
It should not be up to the patient to "be aware of better options". It should not be up to the pharmacist to stop him leaving when he couldn't afford it.
What should have happened is that a doctor prescribed the appropriate medication, and a pharmacist supplied that medication, both ensuring the best outcome for the patient.
The cost of the medication should be absorbed (not totally perhaps, but within the bounds of reality and the minimum wage) by the government.
That forces the government to negotiate the best possible price with the suppliers and to remove inappropriate IP "rights" when they no longer "promote the progress of science and the useful arts".
Still, auto-injection pens are not rocket science. In Sweden, maybe they'd double the cost to $1200/year, though I doubt they'd do that if mass-produced.
Here in the Netherlands my insulin costs including all other medical necessities are about 1600 euro/year. Do note, this can differ substantially per person.
edit: the cost to the end user is the required 385 euro.
Here it is happening as well: Novo Nordic set the cost of the - the new - Tresiba insulin higher than the covered amount, it simply wasn't offered as there were fortunately enough alternatives available though the stuff actually works better. A few years back they finally gave in and now it is still sold at the premium price but the apothecaries get back the amount not covered by insurance from the distributor (and I guess thus Novo). Which basically tells me they can offer it for that price but don't want to and hope the covered price goes up (not likely).
And the crazy thing is you also need strips at least, many of us pumps and CGMs because of being super sensitive to insulin. That is easily 100k per year even in Europe. And due to the mandatory insurance, not that much for the user.
I'm not sure where in Europe you are, but it's nowhere near that in the UK - testing strips are around 0.20 each, (which TBH I think is expensive, but plainly no going to cost 100k/year!).
For CGM, if you're lucky enough to get the NHS to pay for it (unlikely), it costs them around 1k for the monitor, and around £1,500/year for sensors.
Finally, insulin costs the NHS around £400/year for a T1 diabetic.
Pump, insulin, Dexcom sensors and transmitters, pump infusion sets with the tubing separately, pump cartridges, strips and so on. It'll add up quite fast. Depending where you are it can be very expensive or not. In many European countries paid by the insurance.
In areas the mafia doesn't exist (an analogy the title makes by calling it a racket), the cost of paying the mafia is $0. So it might be £30/vial no mafia fee in the U.K., and the same + $10,000 mafia fee in America.
However, doesn't some of that mafia fee go toward R&D? (Developing new drugs)? Why isn't the price to the NHS slightly higher, also in part to fund research?
It's hard to imagine $10,000 just gets pocketed by Don Carleone, without any of it going back to the laboratory.
> Why isn't the price to the NHS slightly higher, also in part to fund research?
The NHS (via NICE) sets a standard amount that it is prepared to pay for any treatment based on the QALYs (Quality Adjusted Life Years) it results in. So really a non-generic manufacturer can charge whatever they like, so long as the end result is worth it. In a sense we don't eliminate the mafia, just set the terms of engagement under which they have to justify their pricing. Whether they take that money and spend it on R&D or dividends is the vendor's decision.
I'm trying to figure out if the cost in Sweden (or UK NHS) is using the older recipe so the a valid comparison. If so the US Walmart product isn't so different. I'm trying to compare like with like.
