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Comment by argonaut | Hacker News Reader

A lot of people seem to be confused about insulin every time it comes up. There are many different forms of insulin. Regular human insulin has been around for decades and is fairly cheap without insurance but difficult/inconvenient to use because it requires planning out your eating schedule.

The extremely expensive insulin that articles are talking about is usually a brand name like Humalog which is an altered form of insulin that is far more convenient to use. It is possible (but rather convoluted) to bring these eye-popping prices down to $99/month without insurance (https://www.admelog.com/savings), or $43-73/vial (https://www.goodrx.com/insulin-lispro or Walmart Novolog). Of course, this is all basically a way for pharma companies to price discriminate to extract as much $$$ from insurance.

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Yet this price goes down to eg 8£ if you’re living in UK, or nothing in many places in Europe. The exact same Humalog.

Source for UK pricing:

https://bnf.nice.org.uk/drugs/insulin-lispro/medicinal-forms...

But also note that in the UK:

> If you use insulin or medicine to manage your diabetes, you're entitled to free prescriptions

I think (though not 100% sure) that covers all prescriptions too, not just those to manage diabetes.

But do they talk about that expensive form of brand insulin the article is taking about?

I don't understand your question.

Yes, the exact same stuff

Humalog 100units/ml solution for injection 10ml vials - £16/each

All NHS prescription drugs are free in the UK. Some people have to pay prescription fee (currently £9.35 per item) but diabetics get an exemption for that too (for all NHS prescriptions).

The price you see is the cost to the NHS, not the patient.

Indeed, and I think it's important to show those prices because otherwise you'll find people saying "It's not free you still have to pay loads through taxes".

So I find it best to ignore that and show them that the whole system is still only paying a tiny fraction of what they're paying.

Central NHS negotiations for the whole country also saves a lot of money by reducing expenses related to insurance, administration, pharmacy benefit managers etc.

On the other hand, it may take away some choice people have in selecting health care provider. For example, some people are not happy that they don't get semaglutide (which really helps diabetics to lose weight) because they don't qualify according to the NHS criteria (not obese enough). Of course, they always have a chance to go to private health care providers and pay full price (or private insurance) but not many can afford that. Although I suspect that even in the US many insurers will have similar criteria whether they reimburse the drug or not.

And the idea of this is that it is time/need release, so you don't have to inject it as frequently and you don't have to keep testing?

Assuming you cannot afford it, can you just get 'normal' insulin instead?

Sorry to pepper you with Questions :)

this is a really interesting article that explains how diabetics use insulin, and different types of insulin.

https://maori.geek.nz/the-unreasonable-math-of-type-1-diabet...

The tl;dr: is that there are longer+shorter acting insulins, and you want to mix and match them to roughly match your blood glucose levels (so taking short acting insulin shortly before meals when your blood glucose levels spike)

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