Walmart releases more affordable analog insulin
corporate.walmart.com
corporate.walmart.com
As a type 1 diabetic myself, Walmart's offerings on R or Regular insulin saved me a few times. Once when I was simply out of insulin and did not have insurance. Then when I was caught in another city for work and ran out due to needing to extend my stay. I am slightly disappointed to see that one, the price is not the same as their human insulin which is around 25 dollars per vial I believe. Two, it will require a prescription. The times I bought their cheapest insulin, this was not required. However, I hope this is the right direction.
I wish more people knew about Walmart's $25/vial regular insulin. Like you said, it's available without a prescription at any Walmart (except in Indiana). Dosing needs to be adjusted relative to insulin analogs, but it's a viable option for anyone in a money pinch who hasn't yet gone through the process of signing up for patient assistance programs for their analog.
The GP was bemoaning that Walmart is selling the analogs for $70+ instead of the $25 they sell human insulin for.
Just... die?
Out of pocket, Fiasp costs 7.50 euro per 3ml, Novorapid costs 6.50, Novomix 30 is 7 euro, Triseba 12 euro, even the ridiculously pricy Xultophy is only 30 euro. The idea that "We halved the price" when the price is literally ten times too high, and not presenting it as "a start, we intend to bring the price down far more over the next few years" but as "and then we stopped, we're undercutting and that's all we're interested in" is... insane?
Walmart is also famous for selling regular insulin for $25/vial for many years now. Regular insulin isn't always as easy to dose as the modern insulin analogs, but it's a viable option for most people who are cost-constrained who don't otherwise have access to insurance.
A vial of analog insulin costs something like $6-7 to produce, probably less at Walmart scale. The distribution costs probably make the net cost somewhere still in the $7-10 range.
That’s a $60-65 or ~90% margin per Vial.
5-10 million or so insulin users in the US, let’s assume Walmart captures 3 million, at 3 vials per month.
$180 * 12 * 3mil ~~ 6.5 Billion.
Current market cap 400B
Lots of assumptions, but Walmart may have just added 2% of market cap per annum by insulin sales?
> A vial of analog insulin costs something like $6-7 to produce, probably less at Walmart scale. The distribution costs probably make the net cost somewhere still in the $7-10 range.
Don't forget the R&D costs of getting a generic drug approved and setting up the manufacturing. It may cost <$10 to produce at scale, but getting there isn't free.
Hopefully Walmart's pricing trends downward toward the $25/vial price of regular insulin.
Actually, I hope this move spurs more chain pharmacies to start developing their own analogs, furthering competition in the space. Race to the bottom would be great.
Sure, OTC stuff may differ given the different markets, but I’m highly skeptical of this spurring any sort of race to the bottom that doesn’t also come with large asterisks around quality, qualification to purchase, etc.
Benevolent? It's not exactly hard to be more benevolent than the medical establishment.
Where are you getting the $6-7 figure from? Artisan insulin makers? Feels like every insulin maker out there operates at walmart's scale, if not bigger. If that's where we're getting the $6-7 figure from, then it's not reasonable to expect it to drop any further.
$5.32-8.87 cost of production depending on the insulin analog.
As noted above, I did not account for R&D and manufacturing capacity.
Regardless, I tried to estimate conservatively at a $12-13 per vial overall cost. My napkin math is certainly wrong.
The point is that Walmart still stands to generate a multi-billion dollar per year profit on the sale of this insulin. (Unless my market capture estimate is wrong by an order of 6+, which it could be)
To be clear, I’m not opposed (in fact grateful) that Walmart is competing in the insulin market. However, I still find it unfortunate that we in the United States pay more for Insulin than any other country in the world, even with this competition.
I would like to live in a world where we can both be sensitive about certain topics, but also be able start hard discussions - for example "don't live an unhealthy lifestyle, exercise, eat better, or you're going to be the only one to blame if you get sick from X, Y, Z".
If nothing else, this may cause something foreign to the medical industry- Competition.
This is an insulin analog, which is a more modern patented drug.
Regular insulin is available for $25/vial at Walmart already. Could be cheaper, yes, but at that price it's already approaching their costs of production, distribution, and sales.
I hope the price of this insulin analog trends downward toward the $25 price of regular insulin.
Instead of figuring out what you're going to eat, taking insulin for that, and waiting 30-60 minutes before you can eat; you can take them pretty much right as you eat.
Instead of your blood sugar rising or dropping "randomly" over the course of the day, it tends to stay more consistent (though your body may decide otherwise).
That being said, with enough testing (or a CGM, but that can be costly too), the older insulins work just fine; they're just annoying to use. You see your blood sugar going up, you exercise some; you see it going down, you drink some OJ. I tend to have to do the same with the newer insulins AND a CGM; just a lot less so.
I wonder if every company was like this, what would happen to the world.
Not meaning to cast any shade at this insulin product; it looks like a substantial improvement over what the US "market" for insulin was offering before.
>Regular Human Insulin which has an onset of action of 1/2 hour to 1 hour, peak effect in 2 to 4 hours, and duration of action of 6 to 8 hours.
The insulin they're offering:
>starts to work about 15 minutes after injection, peaks in about 1 hour, and keeps working for 2 to 4 hours.
For example, if you have maybe 15 grams more of carbohydrates than you planned and you did R (old insulin), then you will either have to wait or, what they did for me in school back at that time, send em to P.E for awhile (since exercise _mostly_ and _usually_ lowers blood sugars) ;-).
Insulins are interesting.
Also, they are likely to sue walmart for whatever BS reason. But, walmart probably figures they can get through it unscathed.
... but wow, just woooow. It's so incredibly depressing that I'm calling this "good." Sometimes the sheer insanity of the United States health care system overwhelms me. The fact insulin isn't a few dollars or free is beyond disheartening. It's like the system itself saying the Sackler's just didn't have enough imagination exploiting people, and destroying lives, for profit. "Oh? You don't need to get them addicted if they'll die without it... silly, Sacklers. #BusinessMASTER"
I keep hoping one day folks in the US will get tired of being screwed on their healthcare and living in fear of getting sick... shrug
Medicine, such as FIASP...
Just look at the difference in taxes on salary between France and the US. Half of what is payed by employers to workers goes to social protection (this is in addition to the company taxes). If you add VAT and income taxes the amount of disposable money is a fraction of what you would get in the US, nothing magic.
20 euros per 10ml (about 2 weeks of use for me) is still kind of a good money for a product I cannot stop using...
The important thing is that insulin prices haven't been going up. You can continue to get the same insulin as 50 years ago for pretty much the same price modulo inflation.
And anyway, the Netherlands getting cheap stuff is a side-effect of innovation here. America builds for America, driven by American needs, and you guys benefit as a result. There's a reason recombinant DNA tech (which backs modern insulin) came from the Bay Area and not the Netherlands. NL has twice the pop of the Bay and a fraction of the inventions. A single university here has like 5x as many Nobel Prize winners as that entire country.
I mean, I'm glad you're able to buy insulin cheap but we're richer and we're the ones driving progress, so we'll keep at it because we want a better life for ourselves (and if you benefit, it's fine). You're not capable of making that for us, yourselves, or anyone really.
Legal hostage taking in this way is uniquely US.
They have? According to testimony by Sanofi, even though list price have went up 126%, net price has actually gone down 25%.
https://www.finance.senate.gov/imo/media/doc/26FEB2019BRANDI...
Good thing it's covered in the report
>What about revenue?
Surely your accounting class tell you that rising revenue doesn't necessarily mean that "margins just keep climbing"
net price =/= profit. The report also covers what exactly goes into the difference between gross and net price. If you can point out what the accounting tricks are, that'll be great.
It’s particularly gross and brazen, even by pharmaceutical rent-seeking standards, to justify cocaine-like profit margins because large buyers can negotiate.
Insulin prices are driven by anticompetitive behavior. If you look at metformin, a generic drug treating the same disease, profit margins are tight, driven by competitive economics. A 90-day supply is < $10 retail.
This is a government problem, not a healthcare system problem.
To maintain this standard of living you're always going to be dependent on someone, it's not a government problem.
90-95% of type diabetics have type 2 diabetes. Of those, around 95% can completely eliminate insulin dependency by straightforward dietary modifications. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6104272/
Under what moral framework should these people (around 90% of diabetics) receive insulin at others’ expense? I can see at least a first-order argument for having everyone else pay for obligate insulin dependents’ medication, but I struggle to see an argument for foisting the cost of an entirely preventable dependency on everyone else.
> Forty percent (31/78) of CCI participants who began the study with insulin prescriptions … eliminated the medication
The idea is that if you worked through your life, then shit hits the fan, you shouldn't be knocked down below your contribution to society as measured by your level of success under capitalism.
There's a second-order argument of the form "We will all be better off if we invest in healthcare. Society is not zero-sum."
If you want to opt out of taxation you should surely also be morally obliged to opt out of using roads, internet, mobile telephones, clean water, sewerage, police, fire brigades, etc.
I know that it is possible to opt out of fire services in rural US but most of the rest might put a bit of a crimp in your lifestyle.
Enabling unhealthy diets is not “investing in healthcare”.
If that argument strikes you as problematic, it might be because society is better when it's generally well educated and healthy.
As someone with good but very expensive health insurance, any time I bring up health insurance prices, the response from people who get cheap health insurance through their employers is basically, "F* you, got mine"
Unfortunately, the block of people with stable corporate jobs also tend to have a lot of political power and are in no hurry to see their perks upended.
Type 2 can pay for it themselves. Their condition was caused by themselves.
Regardless of obesity, Type 2 can be managed with a low carb diet.
Low card can be part of it, but it's not a panacea, once an individual has diabetes, the damage has been done.
--those are the people you feel comfortable shitting on for their circumstances?
(And there absolutely is a predisposition to Type 2 diabetes in some populations and not in others.)
If for some reason they still have diabetes with a BMI <25, then subsidize it.
With UHC, suddenly folks like this will try to deny me care because I'm taking on non-normative risk. Fine, do so if you want, but I want to be tax-exempt. You can have your UHC, but you pay for it.
But folks won't do this. Instead they want to take my money and then give it to themselves by denying me 'subsidies'. No thanks, I'll keep my money and give it to Anthem. No UHC in the USA.
I dunno, it just doesn't seem all that hard to have have some really simple baseline humanity for the grist in the mill trying to find a moment of respite in something bad for them--ingrained literally decades before and in plenty of cases before they had the personal automony to decide for themselves.
Even if their BMI is over 25, heaven forfend.
meanwhile there are people dying from lack of food in the richest nations on earth.
don't get me wrong, there is plenty wrong with healthcare.
I get that there are people who have to skip meals in the USA, but does anyone really get to the point of dying?
> severe addiction problems that prevent them from seeking it in the first place.
... and we're right back at health care.
https://www.feedingamerica.org/hunger-in-america/facts
(disclosure: food bank logistics and tech volunteer in the sunbelt)
Captured implies a change in behavior or an outside force acting on them, and that isn't accurate.
Only politicians that fall in line are given the support necessary to succeed.
To me, the term captured reduces the agency which is our responsibility to exercise as citizens (at least in the U.S. where I'm based.)
/steps off soap box.
The various medical cartels have lobbied to artificially decrease the supply of competitors, workers, and companies in the healthcare industry.
Single payer healthcare doesn't magically create more physicians, hospitals, or drug companies.
If republican voters aren't willing to replace their politicians with ones that are willing to vote and make a single payer solution, then they don't care about single payer healthcare that much. It has nothing to do with any specific implementation. Republican politicians have never put forward any sort of single payer healthcare implementation
Patents are the same. Residencies are the same. Hospitals are the same.
Do you think the physician cartel is going to stop living in Mansions?
>links to two hn comments
really?
Well if we apply your logic to this other thread: https://news.ycombinator.com/item?id=27860162, can we assume that "large segments" of the US population are knowledgeable in debating the merits of the rust programming language?
>and mirrors the comments from others in the US....
Mirrors what? I certainly didn't see any reference.
Falling back on individual responsibility might be popular but it is absolutely a cop out. We're playing a numbers game with public health in an adversarial environment. Relying absolutely on what individuals could or should do isn't going to help us win that game.
This is true even for those people who never question why they are purchasing food in boxes instead of actual food.
It is best to understand that people can make informed choices. It is very shortsighted to think that everyone is subject to the magical sway of marketing without a conscience or decision making abilities.
The existence of personal choice and individual responsibility don't make anything else that you mention disappear. Are you saying you want to increase behavior modification of people and somehow rob people of personal choice? That's what your words imply.
Of course, there are nearby supermarkets too, but you'll be paying like $10/lb for raw chicken and everything is "organic"
I frequently work at state fairs & arts and crafts festivals on the east coast. The amount of very overweight and obese people is simply astounding.
About half of one coke is the average adult’s recommended sugar intake. I know more people than I’d like who have at least one soda every day, and some who have multiple every day.
Nearly everything in our supermarkets has a lot of sugar. Including common things like bread and pasta sauce. Last time I checked at publix, I only found -one- type of bread that didn’t have a lot of sugar in it. Finding a protein bar without tons of sugar was rather difficult. Etc.
Combine this with sitting all day + driving everywhere and we’ve got a huge problem.
But only in the short term, right? Once you figured out what products are healthy and switched to them, you can rely on prior memory. It's not like you have to look at the labels of every item you're buying for years.
I eat pretty healthy, though I also like cheeseburgers so I'm not thin. But I make a very healthy income and have the time, and the resources, and the education to actually have the time and executive function to have an opinion about ingredients in food. It is difficult for me to know these things, let alone to in all cases exert the self-control to act on them--and I make north of five times the median personal income of the United States with which to do it.
I mean, let's think for a second. Blame an Amazon picker or a Wal-Mart cashier or blame the corporate entity with a marketing department designed to overwhelm your attention and to induce the specific action they test and refine for?
Gosh. I wonder.
Are the nutrition content for staples (eg. milk, bread, eggs, apples) likely going to change any time soon? As for the processed foods, they might change from time to time, but I doubt they undergo drastic changes that the nutrition profile is entirely different. On the off chance that it does happen, you'll likely notice it on your tongue, and can update your brain accordingly. If you do any sort of research, you'll probably start to notice such processed foods aren't healthy, so you shouldn't be buying them in the first place.
>Or the time in your day you have to prepare food may suddenly shrink; do you then have the time and spare cognitive cycles to make a good decision under stress? (You probably don't. Not, like, you specifically, but in aggregate.)
>[...]
>It is difficult for me to know these things, let alone to in all cases exert the self-control to act on them
People aren't getting diabetes because they accidentally ate mcdonalds one time. It's from bad diet over a long period of time. For that reason your objection doesn't really make sense.
Perhaps those of us who benefit inordinately from the output of the perpetually stretched class can show some grace in life and not second-guess the folks picking and delivering our consumer goods.
It probably is gradually done, but I recommend looking at the amount of sugar each brand of bread has next time you're at a supermarket. Or milk, lemonade. Or other common groceries. It really is crazy to see just how much of -everything- has added sugar. Including products that are branded as "healthy". AFAIK Naked juice is a great example of this.
As a remote worker with a great schedule, I have the time to do such research. But not everyone is in that situation, particularly if they have a job and have kids, etc. Brands can essentially lie through their teeth and get away with labeling as the regulation can be quite loose.
Many people "know" processed food isn't healthy, but to what extent it's bad for them, maybe not. And it comes down to time and cost. Also, some people don't really grow up knowing what "healthy" food is like.
> It's from bad diet over a long period of time.
It doesn't help that healthy foods are more expensive than food that's absolutely terrible for you.
I think Mexico's new laws around food labeling is the way to go, but time will tell if that's actually effective or not.
Ethical consumerism is a constant treadmill. Even knowing which brands are owned by which corporations is an absolutely exhausting affair.
You honestly expect people to keep up with this? It's as bad as a software dependency chart.
As mentioned in a sibling comment, while this is theoretically an issue, it doesn't happen often enough in practice that it causes a burden
>Ethical consumerism is a constant treadmill. Even knowing which brands are owned by which corporations is an absolutely exhausting affair.
Why are you mixing ethics into this? We were talking about making healthy purchasing decisions, not boycotting [insert brand here] because they punch kittens or whatever.
BTW, one advantage of the 'shop online for curbside pick up' trend is that it makes it so much easier to read labels and compare products.
It's still convenient, so I still do it, but it is not a reliable way of getting __exactly__ what you want.
Do we need intelligence licenses that allow to you to purchase unhealthy foods?
Now, it's a mix of societal and economical (and more) that's making people eat a certain way. Changing your eating behavior can be difficult, especially if you've eaten a certain way for the past 16-18 years.
I'm not saying it's Walmart's fault, but it's also not just an individual willingness to change that's in play here. The United States clearly has a problem of obesity, which is related to Type 2 diabetes.
As do all but specialized grocery stores because this is the majority of food produced. How about we go after the food producers instead? Or the subsidies that enable this?
https://economics21.org/html/sugar-subsidies-are-bitter-deal...
and of course the true scandal of sugar
(IMHO the war crime of anti-science)
https://www.npr.org/sections/thetwo-way/2016/09/13/493739074...
Sure it does. Maybe not to 5 decimal places, but you're not going to get that on an internet forum of non-specialists. You want more? I'm sure there's a dissertation from an economics student or a master's thesis out there for your digestion.
You can be a picture of health shopping at Walmart, just as you can be a danger to yourself shopping at whole foods.