Tuesday, September 03, 2019

Insulin: A Dilemma

As with "surprise billing," coverage for insulin is currently a major shanda in the news:

"Diabetic, 27, dies after taking cheaper insulin as he lost private health insurance."

Josh Wilkerson had recently come off of his stepfather's health insurance (he had reached that magical age of 26) and had elected not to buy his own. As usual, the reporter doesn't bother to ask why Mr Wilkerson chose to "go bare;" at his age a catastrophic ACA plan would have cost about $300 a month (assuming he didn't use tobacco). At least one plan appears to cover insulin.

Be that as it may, the high cost of "regular" versions of the med have become quite expensive, which is a problem for any number of reasons, not the least of which is this:

"Remember those guys who actually discovered insulin back in 1921? Dr. Frederick Banting and Charles Best were the main two, along with Dr. James Collip -- all three had their names attached to the patent awarded in January 1923 to their method of making insulin.Well, did you know that their original intellectual property rights were sold for just $3 in Canadian money?"

(It's more now)

How we got here is outside the scope of this post, but there appears to be more than enough blame to spread around.

So what is the point of this post, you ask?

Well, it's actually quite simple (for certain values of "simple"):

Regardless of how we got here, it's a big problem, so how do we fix it?

Of course, many folks would have the government wave its magic wand and legislate that it be covered at little or no expense (for those who are insured) or provided at little or no cost (to those who are not).

Which seems reasonable on its face, until one considers this:

It would also likely have a chilling effect in development of other vital medications: how does the manufacturer know that his expensive, hard-won work won't be confiscated by the government?

One possible ray of sunshine is the possibility of importing less expensive versions from Canada, but then, that also creats (unintended?) side-effects.

As I said, there don't seem to be any easy answers.

[Hat Tip: FoIB Sam B]
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