|
|
| Price Check! Are analogue insulins worth their hefty price? |
| By Jeffrey E. Keller MD |
| Published: 01/21/2019 |
The analogue insulins were introduced into the United States in the late 1990s and early 2000s. They are called “analogue” insulins because their chemical structure is subtlety different than native human insulin, which gives them different, advantageous properties. Analogue insulins include the short acting insulins Humalog (insulin lispro) and Novolog (insulin aspart) and the long acting insulins Lantus (insulin glargine) and Levemir (insulin detemir). Since their introduction, the insulin analogues have pretty much taken over the insulin market in the US. That is why I only mentioned human insulins in passing in the JailMedicine post “Insulin Dosing Made Simple.” It is unusual to see patients show up at the jail on any other insulin regimen than analogue insulins, usually Humalog and Lantus. And I have to admit; the analogue insulins are easier to use than human insulins. I like them. But here is the problem: the analogue insulins have become insanely expensive! When they were first introduced, the price of Humalog and Lantus was around $20.00 per vial of 100 units. That compared to the price of human insulins like Humulin R and NPH of around $5.00 per vial. So the analogues were expensive, but doable. However, since around 2006, analogue insulins have dramatically increased in price—whereas the price for most other diabetic therapies has actually decreased over time. So where are we now? Using the Idaho Medicaid Actual Average Acquisition Cost as of August 29, 2017 (found here), here is the current price of one vial of each of the analogue insulins. Lantus (insulin glargine) $242.29 Levemir (insulin detemir) $262.16 Humalog (insulin lispro) $267.67 Novolog (insulin aspart) $262.16 Let’s compare that to human insulins: After checking various sources, I found regular insulin and NPH available for between $15.00 to $50.00 a vial. The reason that the analogue insulins continue to be used despite their hefty price tag is that they are perceived to be better than regular insulin and NPH. But is that true? And if they are better, are they ten times better? Well, if we limit the discussion to Type 2 diabetics on insulin, the answer appears to be “Well . . . no.” Here, for example, is a study of Type 2 diabetics that compared those prescribed long acting analogue insulins with those prescribed NPH. It found “no consistent difference in long-term health outcomes when comparing use of long-acting insulin analogues and NPH insulin.” The study authors went on to say in their “Take-Away Points” summary: “The higher cost of analogue insulin without demonstrable clinical benefit raises questions of its cost-effectiveness in the treatment of patients with diabetes.” A recent JAMA editorial came to the same conclusion. It is titled “Human Insulin for Type 2 Diabetes: An Effective, Less-Expensive Option,” This editorial is so good that I think it should be required reading for all correctional practitioners, who are always under the gun to practice cost-effective medicine! The authors begin by noting “Affordability of insulin has become a major issue for patients with diabetes in the united States.” Their estimate of the cost of analogue insulins, around $170.00, actually underestimates the actual cost by about $100.00 a vial! They rightly point out that the overall cost of analogue insulins is much higher for Type 2 diabetics compared to Type 1 diabetics because, since they are insulin resistant, Type 2 diabetics often require much higher insulin doses. The article then makes the point that the analogue insulins do not improve glycemic control or reduce the risk of severe hypoglycemia in Type 2 diabetics when compared to human insulin. After reviewing the physiologic differences in action between human insulin and analogue insulins, the article then states “Patients can safely switch from insulin analogues to human insulin.” Generally, they recommend that the total dosage of insulin be reduced by about 20% when making the switch. I love it when the less expensive medication performs as well as the pricy option! What type of insulin do you use at your facility to treat Type 2 Diabetes? Please comment! Corrections.com author, Jeffrey E. Keller is a Board Certified Emergency Physician with 25 years of practice experience before moving full time into the practice of Correctional Medicine. He is the Chief Medical Officer of Centurion. He is also the author of the "Jail Medicine" blog Other articles by Keller |
Comments:
Login to let us know what you think
MARKETPLACE search vendors | advanced search
IN CASE YOU MISSED IT
|
i read a lot of stuff and i found that the way of writing to clearifing that exactly want to say was very good so i am impressed and ilike to come again in future.. Buy Vape cart online
As we have said, usually KSEEB Do not share the Results data with third-party websites like IndiaResults, Manabadi etc, usually, they are hosted on karresults.nic.in official website or www.jeemain.nic.in, but if somebody want to check name wise or college wise or state wise Results then they may if the board allows to do so, usually there are so fewer chances for this, so be ready with your hall ticket or roll number and other details to get Results whenever it’s declared Click Here and wait till the ranks are allotted to the students. Karnataka PUC Results is the subject combination is Physics, Chemistry, and Mathematics. The Department of Pre-University Education announced its Second Pre-University results. Results can be checked online through Register number or Name wise. Results will be made available through the following Links which we will provide after the declaration of results.
Apply New PAN card online Apply Pan India.uti pan card apply You can apply just PAN Card Apply for Rs.155, PAN Card Online, PAN Card. Apply PAN Card Application Online 2020. Pan Card Apply: How to apply for PAN (Permanent Account. You can apply through alankith centers also. How to Apply for PAN Card Online in 5 minutes. Aadhaar card holders can now get a free PAN card in just 10 minutes.
I have been struggling to add wet ink signature to my documents but I can not seem to do that well. But thanks to the platform of the www.signnow.com/features/add-wet-ink-signature-online, I get to do that easily. It really saved me a lot of time.
Hamilton loves his family of five and badminton. His favorite sports ball team is the McGregor Dodgeballers. He has worked as a foreman on a chain gang, and later in life he was an architect of skyscrapers and tunnels. He was forced to give up his career because he was terrible at math. Hamilton has a keen attention to detail. He enjoyed watching bowling on TV and spent most every weekend on the couch falling asleep. He was a demon at croquet. He also enjoyed war movies and baking shows. Hamilton Lindley is constantly helping others less fortunate and lending a helping hand for relatives and friends in need of encouraging words. He coaches different sports and provided guidance for people who needed it, and a few who didn’t want it.
I don't think so that analog insulins worth their hefty price. Because i think there are many people who are ill and they need this insulin. And not all people are financially strong but here assignmentman.co.uk here you can get more latest work for the students. So it's the price should be low.
We are a full scope, family practice that SCLERAL CONTACT LENSE caters for all people, young and old. All our equipment is state of art- automated refractor, fundus camera, topographer, oct; and provide a more thorough eye examination, with a more accurate diagnosis of problem. The ease and speed of doing things the modern way also make the visit a more pleasant one.
Positive site, where did u come up with the information on this posting?I have read a few of the articles on your website now, and I really like your style. Thanks a million and please keep up the effective work. width of navien tankless water heaters
its a nice infomation for me. because insuline is use for becteria protecteion.i have a Wedding venues South Africa
wow.. its a nice information for me. i get a lot of information about insuline, a lot of thanks for transfering these information, i have Wedding venues South Africa
The estimation of age or time capability does not depend on the time zone of the person as the yield is the refinement of the time. This age littler than normal PC is made reliant on the most standard age framework, with the objective that it stays basic for most of the general open. Age Calculator Wala
Just one a single click here this site and learn more about for this game how to find clipboard history basically some users can't played this game.
Great article. Thanks to your post, I just know there are many different insulins. Great article. fnaf
The usage of Insulin is increased. But the analog insulin chemical structure and its different property are different from normal insulins. It has advantages and disadvantages. Now, most of the diabetics patients prepare insulin.clipping path company