In reply to Curtis73 (Forum Supporter) :
The chart is pretty stunning, until you look further down and see that they selected a filter for countries that supported their hypothesis of the US being most expensive.
Later in the article they break down the most expensive countries for each type of insulin, and the US is not the highest cost for most types, and the prices don't match the more dramatic chart.
Humalog insulin debuted in 1996 at a cost of $23/vile out of pocket. 2 years ago I adjusted for inflation. That vile should have cost $43. It cost $380 last time I checked. They have changed nothing. It is EXACTLY the same.
In 1996, a half ton Chevy pickup cost $18,500. Imagine they never changed it? Same 350 V8, same 4 speed transmission, same radio with a tape deck. If you used the same math as the Humalog increase, that pickup truck would cost you $260,000.
You don't need a pickup truck to live
Diabetics NEED insulin into live.
Don't make the article political, but it seems the price is being driven by insurance as well as manufacturers.
No Time said:Don't make the article political, but it seems the price is being driven by insurance as well as manufacturers.
Didn't read the article, but PBMs determine our out of pocket costs for most meds.
GoodRX is another one ,
someone. On TikTok said ther e was $800 for 3 months and dropped to $300 with GoodRX
Do not take TikToks word for anything but check it out and see if it's true ,
Hope that helps
californiamilleghia said:GoodRX is another one ,
someone. On TikTok said ther e was $800 for 3 months and dropped to $300 with GoodRX
Do not take TikToks word for anything but check it out and see if it's true ,
Hope that helps
I've used GoodRx in the past, and it was definitely cheaper than the copay with insurance. It requires some searching to figure out which pharmacy to have the Rx sent to, but the savings was significant.
I believe frenchy was asking why he was experiencing a shortage of insulin, not a money/insurance, government concern.
Sorry if I missed something but the only answer I saw as to the cause was from jthw8 which would make sense to me. My best friends son has severe diabetes and I am interested if this could be an issue for him in the future.
In reply to Lobsterpennies :
You are right. But as always, we end up on tangent. All I might suggest is too call the pharmacy 10 days before and have them order it.
Not to make light of the situation at hand, but am I the only one who keeps reading this and thinking of Jerry Seinfeld going "and whaats the deal with pharmacies? There's no farm! There's no sea! It's just Colgate and chap stick!"
No Time said:Don't make the article political
Not to break rules... but this is inherently political, since at the end of the day a big part of why these necessary for life hormones are expensive is because they're heavily monopolized, have strict manufacturing guidelines, have every reason to keep the current course, and bribe politicians millions to keep it that way. You either band-aid one issue through price-fixing or individual mandate or you ground-up alter the system, and honestly I think insurance would kill intentionally to keep their moneymaking scheme going.
In reply to GIRTHQUAKE :
I understand the root cause of the problem gets down to profit and politics. I just didn't want to see a thread with some interesting discussion shut down because the article mentioned a politician.
Appleseed said:In reply to Lobsterpennies :
You are right. But as always, we end up on tangent. All I might suggest is too call the pharmacy 10 days before and have them order it.
That won't work. Pharmacies simply do not stock certain Insulins. " They have to be "ordered" by a prescription. And the insurance company won't let you "inventory " excess drugs. You can get your prescription filled on the 30th day.
My wife's blood sugar was at 322 before I was able to finally get it filled 7 days after we requested it.
Lobsterpennies said:I believe frenchy was asking why he was experiencing a shortage of insulin, not a money/insurance, government concern.
Sorry if I missed something but the only answer I saw as to the cause was from jthw8 which would make sense to me. My best friends son has severe diabetes and I am interested if this could be an issue for him in the future.
I finally think I've found a solution to our problem. ( yet to be proven) After visiting 54 pharmacies in the surrounding area. ( metro. Population of 3 million 700 thousand). One pharmacist checked his available medication availability list and both insulin's were on it. That means he will have it in stock once we start to order in 21 days from today. ( insurance limits reorders to 30 days).
No Time said:Don't make the article political, but it seems the price is being driven by insurance as well as manufacturers.
ding ding ding, winner. One only needs to look at the numbers above to see that manufacturers DO sell insulin at reasonable rates, just not in the US. So what is different. Insurance. The insurance companies drive the pricing in the US and if the manufacturer does not go along with their decision they are removed from the list of "acceptable" drugs for that insurance plan.
So, you ask, why would it be in the insurance companies interest to have higher prices? Rebates, which is a kind way of saying kickbacks. Its not unknown to your lawmakers, but insurance companies have deep pockets and lots of political influence and again, any manufacturer who really dared to speak out about it would just be blacklisted.
In reply to JThw8 :
Do we need HMO's or is it simply a way to get money for management? They certainly haven't made things cheaper.
Then Management can leverage that money into rules that increase costs to cash paying customers. How much of that $800 is used as Kick backs and rebates? My wife's Co-pay is $45. Which is what I believe they should cost (IMHO).
Can someone explain to me how things are done in the rest of the world? I mean. Where people are assumed to have a right to health care?
Do they have expensive insurance? Or have to pay outrageous medical bills?
Some companies have special programs to help reduce cost for medication. If you are paying out of pocket it can be beneficial to check the pharma company's website for rebate programs that help the consumer.
In reply to frenchyd :
Higher taxes.
frenchyd said:In reply to JThw8 :
Do we need HMO's or is it simply a way to get money for management? They certainly haven't made things cheaper.
Then Management can leverage that money into rules that increase costs to cash paying customers. How much of that $800 is used as Kick backs and rebates? My wife's Co-pay is $45. Which is what I believe they should cost (IMHO).
Can someone explain to me how things are done in the rest of the world? I mean. Where people are assumed to have a right to health care?
Do they have expensive insurance? Or have to pay outrageous medical bills?
HMOs are still insurance. The insurance industry in america is corrupt and that sadly wont change any time soon.
As to other countries, as others have noted, higher taxes. I spend a bit of time in Denmark and have many friends there. They do have socialized medicine. They also have what we would consider insane taxes. One particularly relevant to us car folks for example. The tax on registering a car is 180%. Think about that for a minute. They do have a great public transit system and honestly if I lived there I probably wouldn't own a car. On top of that the socialized medicine isnt all its cracked up to be according to my friends who live there. And there's no dental included in that, all that comes out of pocket.
JThw8 said:I spend a bit of time in Denmark and have many friends there. They do have socialized medicine. They also have what we would consider insane taxes. One particularly relevant to us car folks for example. The tax on registering a car is 180%. Think about that for a minute.
That is incorrect ... they have tiered taxes depending on purchase price. They are high(may end up being 50 to 60% for low end to 150%+ for high end) but its not as simple as saying its 180% of the purchase price, and it also depends on whether they are gas/hybrid/electric.
Streetwiseguy said:In reply to frenchyd :
Higher taxes.
Exponentially higher taxes.
Sad thing about here, at least on my life, when the amount of money I am not allowed to keep goes up, I always get less for it.
From there, the discussion goes down hill.
Slippery said:JThw8 said:I spend a bit of time in Denmark and have many friends there. They do have socialized medicine. They also have what we would consider insane taxes. One particularly relevant to us car folks for example. The tax on registering a car is 180%. Think about that for a minute.That is incorrect ... they have tiered taxes depending on purchase price. They are high(may end up being 50 to 60% for low end to 150%+ for high end) but its not as simple as saying its 180% of the purchase price, and it also depends on whether they are gas/hybrid/electric.
Sorry for simplifying it, sure I could have given the entire breakdown but the bottom line is it is stupid expensive to own a car in DK. The rest of the taxes are in line with it as well. Most of my colleages in DK find excuses for US business trips in Oct/Nov to do some christmas shopping :)
Amusing side note on Danish culture, I once asked some of my colleages there why DK was consistently ranked one of the happiest places when they were all so decidedly unhappy with much of their situation. The answer was that Danes dont like to complain so when polled they give high marks. Its an interesting culture but a beautiful country and I do enjoy my time there when the opportunity arises.
If we wish to be pedantic about it here's the full breakdown
Vehicle
Vehicle registration tax
Private cars
25% of DKK 65,800
85% of DKK 65,800-204,600
150% of the rest.
Motorbikes
25% of DKK 20,300
85% of DKK 20,300-68,800
150% of the rest.
Vans and lorries (up to 4,000 kg)
DKK 0 of the first DKK 75,900
50% of the rest.
Exemption: For open vans and trucks (pick-ups) and box vans with no window on the left-hand side behind the driver, with a permitted total weight of more than 3,000 kg, the tax may not exceed DKK 47,000.
Lorries (over 4,000 kg)
As a general rule, no vehicle registration tax is payable.
Buses
DKK 0 for the first DKK 12,100 of the taxable value
60% of the rest.
Zero-emission vehicles (electric cars, etc.)
A zero-emission vehicle may be a zero-emission car (cars emitting 0 g of CO2 per km, typically electric cars) or an electric or fuel-cell powered motorbike.
For electric cars, a special deduction from the taxable value at DKK 1,300 per kWh of battery capacity used for propulsion is granted, up to a maximum of 45 kWh. The deduction is written down annually and amounts to DKK 900 in 2023 and DKK 500 in 2024, after which it will lapse as from and including 2025.
For zero-emission vehicles, the tax is first calculated according to the general rules applicable to private cars, motorbikes, vans and buses.
However, only 40% of the calculated tax will be payable if the vehicle is registered before 2026. The tax will then be phased in gradually until it has been fully phased in during 2035.
In addition, a special basic deduction is granted for the calculated tax on zero-emission vehicles.
On registration in 2022, zero-emission private cars are subject to a basic deduction of DKK 167,500 from the vehicle registration tax. Zero-emission vans are subject to a basic deduction of DKK 78,750 on registration in 2022, while the deduction for electric and fuel-cell powered motorbikes amounts to DKK 105,200 on registration in 2022. The deduction amounts are written down annually by specified amounts.
Low-emission cars (typically plug-in hybrid cars)
A low-emission car is a car that emits more than 0, but less than 50 g CO2 per kilometre. Motorbikes are not subject to these rules.
For low-emission cars, a special deduction from the taxable value of DKK 1,300 per kWh of battery capacity used for propulsion is granted, up to a maximum of 45 kWh. The deduction is written down annually and amounts to DKK 900 in 2023 and DKK 500 in 2024, after which it will lapse as from and including 2025.
For low-emission vehicles, the tax is first calculated according to the general rules applicable to private cars, motorbikes, vans and buses. However, only 50% of the calculated tax will be payable if the vehicle is registered in 2022, 55% in 2023, 60% in 2024 and 65% in 2025. After this, the tax is phased in at 3 percentage points per year until 2030, after which it is phased in at 4 percentage points per year until 2035, when it will be fully phased in.
On registration in 2022, low-emission cars are subject to a basic deduction of DKK 48,750 from the vehicle registration tax. The deduction is written down annually by specified amounts.
Motorhomes
Calculation of the vehicle registration tax is based on the rules for passenger cars:
25% of DKK 65,800
85% of DKK 65,800-204,600
150% of the rest.
For motorhomes with a maximum permitted weight of at least two tonnes which are designed with the possibility of making up of proper sleeping accommodation for at least two persons, the expense for design for habitation is not included in the taxable amount.
The vehicle registration tax must be at least 45% of the vehicle’s value over DKK 12,100, including the expense for design for habitation but excluding vehicle registration tax.
FWIW 204,000 DKK is about 27k USD so the average new car is over that threshold and into the 150% bracket
And we've now completely derailed the original post. Apologies to Frenchie
If you have a 10% copay and the medicine costs $40, just jack the price to $400 so the copay covers everything and they work out the rest on the back end.
Little different from hospitals making up huge numbers for out of pocket billing, because they figure if they can get even a quarter of it before the patient files for bankruptcy, they got their money back.
In reply to frenchyd :
That's what I was afraid of. I might suggest using the original insulins, N and R in the mean time. Not ideal in any respect, but 322 is brutal. Any inulin is better than no insulin. Anything her endocrinologist office can do? Like calling the pharmacy and explaining what's going on? Maybe try a different pharmacy that is more willing to work with you?
I hate to suggest this, but lie. Lie to the endocrinologist. Tell him/her that she's using 300 units a day instead of 200 (I'm only using those numbers as an example. I don't know what she actually uses. It is none of my business.) That way, there is a small surplus at the end of the month to carry her until supplies arrive. Its terrible, but it's a game I've had to play, too.
In reply to JThw8 :
You didn't really have to post all of that, just for one guy... the rest of us were fine.
The first paragraph explained it well enough.
The second paragraph was cute. Having some Danes in the family, pretty truthful.
In reply to Appleseed :
It's a shame we have to play that game, and does require some discipline; fortunately my wife has the patience for it. It does work.
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