Paying More With Insurance?

Just made an observation at the pharmacy the other day. It was the first time it had to buy insulin without insurance after switching jobs. Back in January when I had the insurance discount it was $295 for one bottle. Thursday the same bottle minus the insurance “discount” was $272 for the same bottle. So the difference is $23 a bottle LESS without insurance before the copay kicked in. I’m actually a little relieved as I’ve been hearing from other diabetics online that they pay as much as $380 a bottle for Humolog, an Eli Lilly insulin. I was FORCED by the insurance to switch to Novlog which is a very similar substitute made by Novo Nordisk, a Danish company. It just struck me as odd that the “discounts” talked about by insurance companies actually cost me an EXTRA $46 back in Jan (2 bottles). Granted I’d much rather pay the 20% copay which ends up at $65 a bottle. New insurance copay is higher, It’s either going to be 25% or 40% depending on how they catagorize the insulin, formulary or non-formulary.
Why do I bring this up? I read last week or earlier this week Trump was trying to get Canada to raise the price it pays for meds to lower USA prices. Huh? I’ve looked at Novo Nordisk and a while ago at Eli Lilly financial staements (publicly traded companies so those are online). Novo made $17.4 Bilion last year. In their statement diabetic meds make up about 81% of their sales world wide and the USA makes up 52% of the sales worldwide.
What made me look twice at it was that they list 2 sales regions, North American and International. Its obvious that the USA, Mexico and Canada are the North American region unless they have a different map than mine. Total sales in those 3 countries was about $9.1 billion and the REST of the world was only $8.4 billion. 3 countries had more money in sales than the other 188 countries they serve (190 in all according to them). Trump wants the one of other countries in our region to raise the profits for a company that makes over a billion more from us already? It does not makes sense to me other than more of my money going to keeping me alive, hence calling us a captive audience in this story. The companies will not reveal how much it costs to make any of the meds but they are required to list sales and cost of goods. Sales last year was again $17.4 billion and cost of goods was only $2.8 billion. So making the goods cost them less than $3 billion but they charged more than $17 billion for them. That means that there was about $15 BILLION more made than spent on these meds.
An insulin that is sold for $150 here in the states is sold for only $9 in the UK and only $2 in India (going off memory here so not sure if I have the right price with right country). They are still making a profit off it.
The argument that it will cut into research money is also not completely true. It will reduce the amount but if it is focused into the right areas it would help. Why create an insulin that is touted to stay in your system for 36 hours but you are still made to take it every 24 or once a day just like the other insulins? What is the advantage? That same insulin is also a newer version of an older insulin that would have lost its patent protection, gone generic, if not for them changing the chemical makeup enough to keep both the new and old under a new 20 year patent. They only spent $2.2 billion, 12.5 % of their sales, on research. Those are their listed numbers.
We need to have the government step in and do something to stop the price gouging going on in our health care system. People wanted it when gas was so high but this does not affect everyone like gas prices do, just us with chronic life threatening conditions.Trying to make other countries pay more for the same meds is not the way. I’m not a business genius but if everyone started paying more the only outcome I can see is deeper pockets to throw money at congress to get more corporate control in there.
I know a lot of people hate to see more about universal healthcare but it works for other countries. Make it a universal tax like Medicare, which we will not have anymore. Why would we? If there was a universal system in place, everyone with an income would be putting into it and getting out of it. You would think corporations would be on board for this system as they wouldn’t have to split the cost anymore. The amount of money saved could go into pay raises for the CEO or board members. The last tax break didn’t increase my income much if any. The only reason I can say my wages went up is I switched employers. Last year my weekly take home was about $415 a week and in January without overtime it was about $423. In 8 months I’ll have an extra tank of gas at current prices. Welfare, disability, social security, unemployment, and any other income would have the tax on it. My current situation would not be happening. I lost my insurance when switching jobs. A universal system you wouldn’t lose it going from one job to another. You wouldn’t lose getting laid off. I have not heard of any annual restart dates where you end up going back to deductibles or having high out of pocket expenses. Being a working class guy, I would want this system just for the fact of having a security blanket that is with you anywhere at anytime. No out of network worries or coming up with a copay to see the doctor. I just had another MRI done to be sure the “nodule” in my lung had not grown or moved. Haven’t seen the bill from the hospital yet but it will be around $170 plus the $18 bill I just got since the radiologist who looks at the film is not in the network. $18 dollars for a few minutes work.  I’ll have another one coming in another 6 months. My new job is going to be shut down in about 2 weeks for a planned upgrade/refit. I will once again be without insurance. It makes me wonder at times if the universe really hates me or just doesn’t care whether I live or not. Most of the time I go for the former but there are times that it seems like the latter.

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