Feline insulin costs
October 12, 2020 8:41 AM Subscribe
My wife's old cat (RIP) was diabetic and she used to have to give him insulin shots. This insulin came from a regular human pharmacy but was dirt cheap. Yet I hear stories about humans dying from rationing their insulin because they can't afford more. What's going on?
Just to be clear I absolutely believe that there are people out there who can't afford their insulin and that this situation is atrocious. Insulin literally saves lives and should be easily affordable.
It's been three years since our cat passed away but our memory is of going to Walmart, buying a 10ml vial, maybe of Novolin R, and paying $17. She said she must have had a prescription from the vet at some point because the employee at the pharmacy at Walmart was momentarily confused when she said "it's for a cat" but she doesn't remember using our insurance cards or anything.
Our cat was diabetic for years so I know that neither of us are wildly misremembering the cost of a vial - it's not like this was a one-time purchase. But I can't reconcile that with the info I find online that says a 10ml vial of Novolin R is almost $100 now.
Help me understand what's going on here. I can't understand how insulin for a cat should be cheaper than insulin for a human.
Just to be clear I absolutely believe that there are people out there who can't afford their insulin and that this situation is atrocious. Insulin literally saves lives and should be easily affordable.
It's been three years since our cat passed away but our memory is of going to Walmart, buying a 10ml vial, maybe of Novolin R, and paying $17. She said she must have had a prescription from the vet at some point because the employee at the pharmacy at Walmart was momentarily confused when she said "it's for a cat" but she doesn't remember using our insurance cards or anything.
Our cat was diabetic for years so I know that neither of us are wildly misremembering the cost of a vial - it's not like this was a one-time purchase. But I can't reconcile that with the info I find online that says a 10ml vial of Novolin R is almost $100 now.
Help me understand what's going on here. I can't understand how insulin for a cat should be cheaper than insulin for a human.
Could it have to do with the amount of insulin a 5 pound cat might need versus a 200 pound human?
"A patient with Type 1 diabetes incurred annual insulin costs of $5,705, on average, in 2016"
Just multiplying your cost 17 bucks might be 700 bucks a month to a human.
posted by beccaj at 8:57 AM on October 12, 2020 [2 favorites]
"A patient with Type 1 diabetes incurred annual insulin costs of $5,705, on average, in 2016"
Just multiplying your cost 17 bucks might be 700 bucks a month to a human.
posted by beccaj at 8:57 AM on October 12, 2020 [2 favorites]
There is veterinary insulin and human insulin. Walmart has a separate Pet RX site now, but even so the prices are higher than $17/vial.
I think this can be attributed to the rising cost of insulin, even over 3 years. Here's a 2017 article from Business Insider that details the cost of two insulin drugs. Just in a year, the cost rose by +7%. In a decade, list prices for the two drugs increased by 290%.
posted by pumpkinlatte at 8:59 AM on October 12, 2020 [1 favorite]
I think this can be attributed to the rising cost of insulin, even over 3 years. Here's a 2017 article from Business Insider that details the cost of two insulin drugs. Just in a year, the cost rose by +7%. In a decade, list prices for the two drugs increased by 290%.
posted by pumpkinlatte at 8:59 AM on October 12, 2020 [1 favorite]
Diabetes can mess with your energy mental wellbeing, making it hard to plan ahead and act in your best interest (to the point of avoiding small co-pays for no good reason.) Combine that with financial difficulty and living alone, and you can spiral into trouble, even though you technically had options available to you.
For anyone reading this who is trying to figure out how to get more insulin, if you have insurance and aren’t getting enough insulin from your prescription, talk to your doctor about upping your prescription (your prescription is supposed to provide a little extra for spills and overlap.) If you don’t have insurance, use the manufacturer’s patient assistance programs to get free or copay-equivalent costs.
posted by michaelh at 9:42 AM on October 12, 2020 [2 favorites]
For anyone reading this who is trying to figure out how to get more insulin, if you have insurance and aren’t getting enough insulin from your prescription, talk to your doctor about upping your prescription (your prescription is supposed to provide a little extra for spills and overlap.) If you don’t have insurance, use the manufacturer’s patient assistance programs to get free or copay-equivalent costs.
posted by michaelh at 9:42 AM on October 12, 2020 [2 favorites]
regular insulin (insulin R) or NPH insulin (insulin N) are old, not under patent, and cheap. It is also harder to manage your blood sugar in a fine-tuned way due to the time of onset.
Most people with Type 1 diabetes, and many people with Type 2 diabetes, are now managed with a mixture of long acting insulin (like glargine or detemir) that provides a basal level of action and rapid acting insulin (like aspart or lispro) with meals, OR with just rapid acting insulin via a pump that can be adjusted quickly. They result in more precise blood sugar regulation because people can more accurately match their insulin dose to their food intake and current glucose levels instead of having to extrapolate out several hours. Those are still under patent and $$$$$.
This chart shows the difference between insulins pretty clearly. It's likely that your cat had glucose levels that would be considered suboptimal in a human, but also most owners are not willing/able to do multiple blood tests a day or multiple injections for more tightly managed sugar, so the cheaper/older insulins are okay for pets. I think that it's likely that as the long-acting insulins fall off patent they'll make their way to the veterinary population as well because they're overall safer and require fewer injections than R or N.
posted by The Elusive Architeuthis at 10:52 AM on October 12, 2020 [7 favorites]
Most people with Type 1 diabetes, and many people with Type 2 diabetes, are now managed with a mixture of long acting insulin (like glargine or detemir) that provides a basal level of action and rapid acting insulin (like aspart or lispro) with meals, OR with just rapid acting insulin via a pump that can be adjusted quickly. They result in more precise blood sugar regulation because people can more accurately match their insulin dose to their food intake and current glucose levels instead of having to extrapolate out several hours. Those are still under patent and $$$$$.
This chart shows the difference between insulins pretty clearly. It's likely that your cat had glucose levels that would be considered suboptimal in a human, but also most owners are not willing/able to do multiple blood tests a day or multiple injections for more tightly managed sugar, so the cheaper/older insulins are okay for pets. I think that it's likely that as the long-acting insulins fall off patent they'll make their way to the veterinary population as well because they're overall safer and require fewer injections than R or N.
posted by The Elusive Architeuthis at 10:52 AM on October 12, 2020 [7 favorites]
I give my dog nph, I get it from wal-mart, it’s $32 vial and I do not need a prescription. I also do not need a prescription for the syringes but I do tell them specifically I’m getting this for my dog. They take literally no info from me, just give me the stuff and I leave. I’m in Nevada, it may be different in other states. I know nph isn’t as good as other insulins, but I’m also pretty sure lots of people do not realize they can go get insulin with no prescription.
posted by yodelingisfun at 12:33 PM on October 12, 2020
posted by yodelingisfun at 12:33 PM on October 12, 2020
Also, many type I diabetics have insulin pumps and those older forms of insulin simply don't work in pumps. My wife's insulin bill (if we didn't have insurance) would be $1500-$2000 a month of 4-5 vials.
posted by COD at 2:32 PM on October 12, 2020
posted by COD at 2:32 PM on October 12, 2020
This thread is closed to new comments.
posted by saeculorum at 8:55 AM on October 12, 2020 [4 favorites]