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Comment by basch | Hacker News Reader

Insulin is cheap.

Long acting insulin is not.

They are different products, and the formers patent being free has nothing to do with the later innovations being locked down.

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The whole point of this is that insulin is more expensive in the US than elsewhere. So maybe it isn't "cheap", the point is the price is being inflated due to many factors, including through monopoly tactics such as paying off competitors to not compete.

Traditional insulin is cheap in the US. The price has not changed in a decade. Nobody wants it, it is a product of last resort.

Modern insulin is protected by moats, two of which are intellectual property and regulatory approval. Modern insulin being cheaper in other countries is because they are not following the same trade and approval laws. The way to match abroad prices would be to change protections and approvals, the latter of which is and has been happening over the last five years.

You are missing the point. Every kind of insulin is more expensive in the US than _every_ other country. It's not just old stuff is "cheap", new stuff is expensive. It's old stuff is more expensive in the US, new stuff is more expensive in the US.

Average prices per "standard unit"

  * Rapid acting: $120 (US) vs $13.50 (JP)

  * Rapid-int (?) acting: $107(US) vs. $13 (JP)

  * Short-acting: $87 (US) vs $19 (FR)

  * Short-int acting: $95 (US) vs $13 (JP)

  * Intermediate acting: $73 (US) vs $13 (JP)

  * Long acting: $88 (US) vs $15 (JP)

Based on https://www.rand.org/pubs/research_reports/RRA788-1.html

Novolin/ReliOn is nowhere near that expensive. I skimmed it, but report you are citing appears to be averaging the price of insulin types. So if there is a cheap rapid and an expensive rapid, it ignores that somebody can buy the cheap one. That averaging distorts the price of available traditional insulin dramatically.

https://www.goodrx.com/healthcare-access/research/how-much-d...

It is more expensive in the United States because the US is subsidizing the earnings requirements the companies who make the drug require to develop new variants. At a high level, everybody pays insurance, it gets funneled into high drug prices, high drug prices pay shareholders and fund R&D. It's capitalisms version of socialized drug creation, and the rest of the world benefits from the US overpaying.

Thank you for your informative comments on this thread.

Even the modern rapid acting insulin that doctors are prescribing (Humalog, Basaglar, etc.) can be very expensive.

CVS filled a month supply for me after my insurance number had changed and when I went to pick it up they kindly asked for $1300 before I gave them the new insurance info.

Rapid (minutes) being modern insulin. Short acting (takes 30 minutes) being traditional insulin. Rapid for the most part being an additional technology and convenience over short acting traditional.

But yes, I didn't leave a complete comment.

Hi even the long acting insulin has been quoted to cost around $10 to manufacture (at scale)!

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