insulin vials and syringe

Amid Skyrocketing Insulin Prices, Americans Head to Canada

Insulin has become so unaffordable in the U.S. that many American diabetics and their caretakers are seeking alternative ways to procure the medication, including traveling across the Canadian border, where it can be purchased over-the-counter for a fraction of the price.

According to the American Diabetes Association, of the more than 30 million Americans living with diabetes, approximately 7.4 million take insulin every day to either partially supplement (in the case of type 2 diabetes) or entirely replace (type 1) the blood sugar regulation hormone ordinarily produced by the pancreas. Without daily injections of insulin, diabetics face serious — and often fatal — health complications, including kidney failure, heart disease, and stroke. But a complicated web of factors have been driving up prices for years, making the medication prohibitively expensive for many consumers, even with health insurance.

According to a 2018 study in the journal Diabetes Care, the average list price of insulin in the U.S. nearly tripled between 2002 and 2013. An analysis published this year by the Health Care Cost Institute found the average annual cost of insulin for treating type 1 diabetes almost doubled over a five-year period, from $2,864 in 2012 to $5,705 in 2016.

These surging prices have pushed some individuals to start taking smaller or less frequent doses of insulin than recommended, which can lead to dangerous complications. Others have taken to stockpiling vials of the drug — even after they’ve expired.

As reported in this week in The Washington Post, other desperate patients have begun making runs across the border to purchase insulin in Canada. Despite the dubious legality of the mission, “rule-abiding Minnesota mom” Lija Greenseid led a self-dubbed “caravan” of families to Fort Francis, Ontario, to purchase insulin at one-tenth of the U.S. cost for her 13-year-old-daughter.

“When you have a bad health-care system,” Greenseid told the Post, “it makes good people feel like outlaws.”

Insulin’s soaring prices in recent years are tied to a highly concentrated market and a complex — and often cozy — relationship between manufacturers, pharmacies, and insurance companies. In the U.S., three pharmaceutical giants, Sanofi, Eli Lilly, and Novo Nordisk, have long maintained a virtual monopoly on insulin’s manufacturing and sale. By making small tweaks to their formulations and devices, critic say, the companies have extended their patents and limited competition in the space.

Also in the news:

• Permafrost — ground that remains at or below freezing for two years straight — is thawing much faster than originally anticipated at a remote site in the Canadian Arctic, researchers from the University of Alaska Fairbanks reported this week. “What we saw was amazing,” Vladimir E. Romanovsky, a professor of geophysics at the university, told Reuters. “It’s an indication that the climate is now warmer than at any time in the last 5,000 or more years.” The team visited the site several times between 2003 and 2016 to collect data. Over that time, the icy landscape was visibly transformed by new thermokarst — small ponds and depressions — rich with vegetation. The team’s findings, published recently in Geophysical Research Letters, reveal that at their test sites, the maximum thaw depths have already surpassed those projected by their models to occur by 2090. Scientists worry that such rapidly thawing permafrost will accelerate the effects of climate change by releasing more heat-trapping gases, contributing to a feedback loop of even faster warming. “It’s a canary in the coalmine,” said Louise Farquharson, a post-doctoral researcher in arctic geology and co-author of the study. “It’s very likely that this phenomenon is affecting a much more extensive region and that’s what we’re going to look at next.” (Reuters)

• As India continues to weather a deadly heatwave, the nation’s sixth largest city, Chennai, is rapidly running out of water. The four reservoirs upon which Chennai typically relies for its water supply have simultaneously run dry, leading to government-mandated rationing, the temporary shutdown of many local businesses, and long lines for water trucked in from out of town. Many citizens put the blame on city officials for failing to take appropriate measures to prevent the crisis — like harvesting rainwater, proactively managing groundwater usage, and preventing the development of land near the reservoirs, which may have contributed to their depletion. The situation in Chennai could be a preview of the hotter, drier, and thirstier future India will face as the climate continues to change, according to a 2018 report by the National Institution for Transforming India, a government think tank, which estimates that by 2030 the country’s water demand will twice exceed the available supply. (CNN)

• A new report from the U.S. Government Accountability Office (GAO) warns of further delays in the National Aeronautics and Space Administration’s ambitious project to redevelop human space flight programs to the moon. It faults the agency for cost overruns, secrecy, and a devotion to one of its major contractors, Boeing, which contributed to problems dogging the program. In the highly critical report, the GAO estimates that the cost of a primary rocket in the Space Launch System is now almost $2 billion over budget and unlikely to be ready until 2021. The original launch date was expected to be 2017. Further, the report warns that additional cost overruns are likely and accused NASA of hiding the problem with an accounting method that deliberately charged some of those overruns to other rocket programs. William Gerstenmaier, NASA’s Associate Administrator for Human Exploration and Operations, pushed back against the report, accusing the GAO of adopting worst-case scenarios and of failing to understand the technological challenges involved. (Ars Technica)

• In arguments against vaccine safety, skeptics and opponents often cite data from the U.S. National Vaccine Injury Compensation Program (NVIC), which has paid out more than $4 billion to families over the past 30 years. But put into context, public health experts say, the data simply proves how rare vaccine injuries really are. Between 2006 and 2017, for example, 3.4 billion doses of vaccines were given, in comparison to just 4,311 claims that were awarded compensation. In other words, for every million doses, one individual received compensation. Prior to the measles vaccination, in contrast, 3 to 4 million people were infected each year, resulting in 400 to 500 deaths. Long-debunked autism claims have not been considered by the program for years and recently, a larger fraction of claims have been related to shoulder injuries caused during injection, rather than the vaccine’s contents themselves. (The New York Times)

• The Environmental Protection Agency has released the final version of its Affordable Clean Energy rule, repealing a stricter carbon dioxide emissions plan proposed during the Obama administration. EPA Administrator Andrew Wheeler announced the new policy on Wednesday morning in front of a crowd that included coal miners in hard hats. The rule replaces Obama’s Clean Power Plan, which set state-by-state emissions reductions targets but had yet to go into effect due to legal challenges. The replacement policy, lauded by the coal industry, will instead require modest efficiency gains for power plants — a measure that’s expected to yield only minor emissions reductions, if any. The change may allow some coal plants to survive longer than they would have under the Clean Power Plan, though experts predict that coal’s share of electricity generation will nonetheless continue to decline. Wheeler touted estimates that the new rule could eventually produce up to $100 million annually in environmental benefits. But, already, some reports are calling that analysis into question. E&E News, for example, reports that, excluding gains from ancillary cuts to ozone and fine particles, the rule’s compliance costs could exceed its environmental benefits by $980 million over 15 years. (E&E News)

• And finally: In the clickbait derby that is our modern digital newsfeed, The Washington Post emerged as a clear winner this week with a headline that seemed to yoke modern technology, human biomechanics, and Greek mythology: “Horns are growing on young people’s skulls,” the newspaper declared. “Phone use is to blame, research suggests.” The story is based largely on a narrow and limited 2016 study out of Australia, which found that, among a sample of 218 X-rays of subjects aged 18 to 30, 41 percent showed evidence of atypical bone spurs at the base of the skull. In follow-up analyses published last year, the same researchers focused on just four boys, coming to the conclusion that the spurs were likely a response to posture and mechanical loading, rather than genetics. Twitter enthusiasts, of course, had a field day with the news, but some media and science critics raised questions about both the studies, and the Post’s handling of the coverage. John Hawks, a paleoanthropologist and professor at the University of Wisconsin-Madison, called the story “deplorable” and the research “nonsense.” Other Twitter users noted that one of the researchers — and an oft-quoted source in the Post piece — is a chiropractor. And at Vice’s Motherboard, Caroline Haskins broke down the studies at length, noting that while the bony growths were indeed observed, the attribution to phone use was pure speculation on the researchers’ part. The idea that phones are causing teens to grow horns, Vice’s headline declared “is a dumb tech moral panic.” (The Washington Post, Vice)