Comment by RPLong | Hacker News Reader

Comment by RPLong | Hacker News Reader

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I'm saying Novo Nordisk produces insulin, and in doing so causes downward pressure on insulin prices thanks to basic economics. (When the supply of a good increases at the same level of demand, price falls.) This is true for both type 1 and type 2 diabetics.

In Novo's case, they have two kinds of long-acting insulin analogue taken 1-2 times per day for both T1 and T2; they have to my knowledge the only ultra-long-acting insulin on the market, taken once every 2-3 days, most appropriate for T2, but also viable for some T1 lifestyles; they have very-rapid-acting insulin for T1 diabetics only, and they have older kinds of insulins appropriate for older patients.

They offer all of these products in good supplies. I've never seen or heard of a Novo product's being unavailable at the pharmacy. So, as far as I can tell, their only influence on insulin prices is downward pressure, not upward pressure. Every new product they produce lowers the price of insulin despite industry-wide changes.

There are really 2 major makers of insulin Norvo and Elli and another that isnt near as popular, Apidra. Each insurance company has a 'preferred' where you only have 1 choice.

So, with that I dont feel like there really is any competition. A good step forward might be to disallow insurance companies from having 'preferred' brands.

Not a bad idea at all. I'd prefer that insurance companies weren't involved at all, but as a second-best option, I'd prefer if the insurance companies allowed the pharma companies to compete with each other for my business!

Insulin prices have inflated by about 500% over the past two decades in the United States.

Novo Nordisk's profits have seen a similar rise.

Now, im no economitician, but I'd wager a vial of Fiasp® that there's more than just supply and demand going on here.

Yes, there is more than supply and demand going on here, which explains why one company's pricing policies can't account for a 500% industry-wide increase. Novo is not a monopolist.

A lot has changed in the last 20 years. A lot of regulatory and insurance law changes. When the law mandates that we pay for all our medicine via 3rd party intermediaries, you can expect a corresponding price increase as those 3rd parties add their intermediary markup.

Here's what an ADA working group[0] had to say about possible causes for Novo Nordisk's insulin price increase:

> Novo Nordisk also published data for two of their insulin products, NovoLog and NovoLog FlexPen. Since the early 2000s, the CAGRs for the list prices for NovoLog and NovoLog FlexPen (Fig. 7) have been in the range of 9.8–9.9% (22). This translated into large total increases in the list prices: 353% (2001–2016) for a NovoLog vial and 270% (2003–2016) for a FlexPen. In contrast, net prices received by the manufacturer increased at a more modest rate (3–36%) with CAGRs of 0.2–2.1%. Novo Nordisk, Eli Lilly, and Sanofi have reported that rebates have grown rapidly in recent years, representing more than 40% of U.S. gross sales in some cases

[0] - http://care.diabetesjournals.org/content/diacare/41/6/1299.f...

The price of Novo insulin in Denmark has not risen since 2005 for the products I checked.[0] So they haven't followed the price index and have thus become cheaper.

[0] https://www.medicinpriser.dk/?lng=2

You're missing the key part of the story. Yes, Novo's price went up, but so did their rebates. The price of insulin (net price) has actually be increasing less than inflation.

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