Tag Archives: Novolog

What has to happen?

I’ve wanted to ask this question, and know the answer to it, for a long time, even before I started blogging:

Why does the cost of insulin continue to skyrocket?

What I’ve found out so far is very little. At least very little that allows me to point my finger in a definite direction and say “this is why”. It’s complicated, and if I were to begin to point a finger in a particular direction, that’s where I would start. We can’t find the forest of cash for the trees.

The information on drug research, side effects, production costs, costs to file with regulatory authorities like the U.S. Food and Drug Administration, efforts to build marketing campaigns and pay sales reps to visit endocrinology practices is…. Non-existent. Nobody knows how much it costs to bring a new insulin onto the market (and keep it selling), and depending on how each phase of research, development, and rollout goes, the costs might vary.

Let’s not forget about the rest of the overhead. In Novo Nordisk’s latest financial results, 11.2 percent of their 4 billion dollars in revenue from January through June went to administrative costs, which includes things like pay and benefits, but not only pay and benefits. That’s 448 million dollars.

That seems excessive. And maybe it is. Maybe it’s not. The point is, we don’t know what’s excessive and what’s not in a financial statement for a company that grossed 4 billion dollars in the first six months of the year and published all of its financial line items in a one page document.

Eli Lilly did a much better job, I thought, of detailing their latest quarterly financial statement, but then again, they’re on the other end of the spectrum, and I had to search a little to find Humalog sales listed in the 28 page statement. In case you’re wondering, it was $1.3 billion year-to-date. For a drug that’s nearly 20 years old. Even if it cost a billion dollars or more to develop and produce these drugs, they have certainly more than paid for themselves by now.

But let me back off here. Maybe I shouldn’t point at Lilly and Novo. It’s not just about how much money is being made.

Actually, it’s about the right of a patient to get medication they need to survive, at a price that won’t have to make them have to choose between staying healthy and putting food on the table. Make no mistake: As insulin gets more expensive, this type of decision is already being forced upon a growing number of People With Diabetes here in the USA.

How companies (by companies, I mean drug makers, insurance, hospitals, etc.) reach the point where they charge as much as they do, and we get closer to the breaking point budget-wise, is a matter of great confusion. I really don’t know if this is by design, or if I just don’t have a good handle on the numbers. Here’s what I know:

Insulin should be more affordable.

When I’m tasked with solving a problem like this, I often think back to when The Great Spousal Unit and I bought our house. We knew we were ready to buy, but we didn’t even know if we could even get a mortgage, let alone whether we could afford one. So my solution was to find out what needed to be done to buy a home, and complete each step along the way, until we either moved into our house or knew where we didn’t qualify.

So in this case, I begin with the overarching statement: Insulin should be more affordable. Now the idea is, what needs to be done to make insulin more affordable? What are the steps? Can they all be accomplished? If they can’t all be done, what can’t be done? Why? How do we break down the barriers? What would have to happen to make insulin more affordable?

Why is a drug discovered nearly a century ago more expensive than ever?

Why is a drug approved in 1996 more expensive today than it was when it was approved?

I don’t know if I will get anywhere. But I really want to have a better working knowledge on this subject. I don’t know how long it will take, but I’m going to try to find out as much as I can.

In the meantime, feel free to give me your knowledge, if any, on why the cost of insulin is getting farther and farther out of reach. I’ll let you know if I find out anything.
There are programs dedicated to helping those who have difficulty meeting the cost of insulin and other diabetes drugs and supplies. Including programs run by Novo Nordisk and Eli Lilly & Co. Rather than re-inventing the wheel, I’ll refer you to this helpful post on the subject from Christel at The Perfect D:
Need Help with U.S. Diabetes Supplies and Medications?

Stay cool, my friends.

Okay, so obviously, I need to post this. If only to remind myself that insulin becomes useless once it reaches a certain temperature.

About a week and a half back, I had to toss out my reservoir with something like 65 units of insulin left. My site was working well for a few days; then allofasudden, my glucose kept climbing up. Over the 300 mg/dL mark. In the middle of the day, which is very odd for me. When I got home from work, I changed out my set, and wouldn’t you know it, before long, my BG came down into the upper 90s – low 100s.

This sequence of events didn’t surprise me too much: It is summer in Baltimore, and baby, does it ever get hot and humid here. Add to that the fact that our air conditioning unit finally gave out about a week earlier, and it’s no wonder I couldn’t keep the insulin in my reservoir cold.

Fast forward to this week. Again, I have a site that’s working very well, for about 5 days (yes, I often go longer than 3 days… so sue me). And we had a new A/C unit installed about a week ago. I go to bed overnight sitting at a pretty good 96, and I had a granola bar for a snack right before turning in, so I wasn’t worried about going low. I got up for a minute about two hours later, and a quick check of the Dexcom unit showed 124. About what I expected.

Then, about 3 a.m., the Dexcom starts beeping. That loud, “you’re high, you’re high” beep. Now it says 224 mg/dL. Great.

By morning, I was at 266 mg/dL. I took the reservoir out of the pump, and it certainly felt warm to me. I must have been sleeping right on it all night. Those reservoirs aren’t always the easiest things to look through, but what was inside didn’t look like normal insulin to me anymore. So I decided to throw out 70-plus units of insulin this time and change everything over. Today was a sensor change day too, so it was a double blessing while I was trying to get out the door to work.

Novolog, the insulin I’m using right now, has a tolerance up to 86 degrees farenheit (according to their website). By the way, Glucagon is only good up to 77 degrees farenheit. Above those temperatures, bacteria living in our insulin start to break down the protein inside our vials, insulin pens, and yes, pump reservoirs. Also, according to a Mayo Clinic blog post, “Heat can make proteins like insulin harden, which increases the potential for infusion set occlusions”. They also recommend tucking in the tubing instead of leaving it out and exposed to the heat (which is what I’ve been doing).

Man, I used to love summer. Now the hot weather gives me one more thing to consider. I know I will be much more careful through the next few months.

Wordless Wednesday. Multi-Purpose Packaging.

This little package has three important uses:


First… If you freeze these little guys, they’re great for keeping your lunch cold:

Second… Best.Stress.Reliever.Ever.

…And I simply couldn’t live without what comes in these little boxes:

Happy Hump Day!

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