Thursday, March 19, 2015

Are new insulins better or just better promoted?

Today I saw this frustrating article on my Facebook feed:

Why Is Insulin So Expensive In The U.S.?

The article talks about how the older kinds of insulins -- and we're talking about really old, back when insulin used to be harvested from animals -- is still available in other countries, and provides a more affordable alternative to the more modern insulins.

Although this doesn't me (I understand why people would want a cheaper alternative available, even though there is a very good reason we went away from these insulins), there are also things in this article that infuriate me.

For instance, this statement:

But newer drugs aren't always better, says Dr. Adriane Fugh-Berman, a professor of medicine and pharmacology at Georgetown University. That's partly because drug companies don't have to prove that a new drug is better than what is already on the market — they just have to prove that it's not worse.
"In government-funded studies that have compared older drugs to newer drugs, often older drugs come out looking better or equal to newer drugs," Fugh-Berman says.
As someone who has been on older insulins (not the animal-derived insulins, but insulins that aren't regularly used anymore) for some of the studies I've done, I can tell you that this is just not true.  There are clear benefits to the newer ones.  I've also been on insulins that are currently going through the FDA approval process, and WOW -- they were just amazing, even compared to the newer, routinely prescribed insulins.

As for the article, just a few paragraphs before the above excerpt, the article made this statement:

But for some, the early forms of the medicine weren't ideal. Many people required multiple injections every day, and some developed minor allergic reactions.
I don't think the reactions were that minor, actually.  There is a reason why people tried to avoid taking too much of it, even if they had to half-starve themselves to do it.

Diabetics live much longer now than they used to, and I think that ought to be a clear argument in favor of new insulin, too.

The old method of treating diabetes was to take your insulin, and only eat what you needed, when you needed, in order no to crash.  It was a miserable way to live, to be constantly in fear of crashing or going high.  And, oh yeah, you determined whether or not you were successfully managing your sugars by peeing on a scrap of paper.  Even though these test strips only showed an approximate blood sugar from hours ago (when your urine was made), they are cheaper than the ones for glucose meters, so maybe we should switch to using those too?!

Don't get me wrong, I am sympathetic to the choices that poor diabetics must make: Buy insulin, or pay rent?  But I think this article is barking up the wrong tree.  The answer is providing health care to all American citizens, not making substandard insulins available for people who can't afford the ones that will actually be able to control their disease effectively.

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