Interesting Links for 21-10-2024

[andrewducker]

1. There's something terribly endearing about small children making delighted friends with hideous otherworldly monsters

(tags:monsters children video cute costumes )

2. Type 2 Diabetes: New Treatment Eliminates Insulin for 86% of Patients

(tags:diabetes insulin GoodNews )

3. COVID-19 linked to type 2 diabetes onset in children

(tags:pandemic diabetes children )

Comments

[calimac]

1) So what is that thing, actually? Computer-controlled, remote-controlled, or what?

2) "Following the procedure, participants adhered to a two-week isocaloric liquid diet." There's always a downside, isn't there?

[andrewducker]

Man with stilts I think.

And yes, don't fancy that much, although if necessary...

[armiphlage]

2) It involves duodenal ablation using electroporation, which means they shove a Tazer into your intestines and repeatedly zap you. So it would be really unwise to eat solids for quite some time afterwards.

[autopope]

Just noting that insulin is very much not the first-line treatment for Type II diabetes -- it's the last resort, after various other classes of antiglycemic meds have failed (starting with metformin and working up from there).

[andrewducker]

Oh yes. It's a useful step, but only for the few people who need it.

[danieldwilliam]

And a front line, so far as I can tell from my own recent experiences, of "have you tried eating better and drinking less?"

[channelpenguin]

I assume ozempic is much more expensive than insulin? Just being cynical here.

And yes, I think you have to be pretty far gone to need insulin anyway?

[andrewducker]

You do.

I think that Ozempic is easier to manage than insulin, because you don't have to calibrate it to the things that you're eating.

[armiphlage]

Plus once-a-week injection vs multiple injections per day! This will be amazing for people in developing countries without reliable or affordable electricity to keep their medication cold. A trip to a clinic with a refrigerator (with generator backup) once a week is achievable, but few people can hold down a job and go to a clinic several times a day.

[danieldwilliam]

My guess is that at the moment ozempic is probably several orders of magnitude more than insulin.

[andrewducker]

Best I can find, in the USA Ozempic is about $1,000 per month and insulin is about $100 per month.

[danieldwilliam]

I get the impression that insulin is retailed at a significant mark up over cost in the US.

[armiphlage]

There's about an order of magnitude difference between the US and Canada for exactly the same medication, produced by the same pharmaceutical company, with similar distribution and regulatory costs.

https://www.cbc.ca/radio/whitecoat/blog/the-soaring-cost-of-insulin-1.4995290

[magedragonfire]

Some types of insulin are much, much more than that in the states. You’re looking at maybe $100 a month for the oldest kinds with the worst activation curves (which are harder to both dose and time appropriately). If you want, say, one of the rapid types to help with mealtimes, depending on dosing requirements that’s going to cost anywhere from $200 out of pocket to… well, I calculated out my own usage, and that was approximately $1350 a month.

There is a cap of $35 out of pocket cost that has been introduced in some parts of the states very recently, but I don’t know if it applies everywhere.

[andrewducker]

In which case Ozempic will save you a significant amount!

[magedragonfire]

Not me in particular, since I a) have type 1 and b) am in Canada (:P), but, yeah, possibly.

I believe Ozempic-etc is prescribed as an alternative to metformin, however, which is usually given before a type 2 diabetic is at the point of requiring insulin.

[autopope]

That's the retail price to the customer.

In reality, Semaglutide (the drug in Ozempic, Rybelsus, Wegovy) is largely manufactured by fermentation of genetically modified yeast, then extraction, some minor chemical tweaking, and packaging. In bulk it shouldn't cost much more than insulin -- which is also produced in GM yeast, then extracted, somewhat modified, etc.

Whaty makes Ozempic/Wegovy expensive is the license fees because it's still under patent. Which also makes newer formulations of insulin more expensive, to about the same degree. Out of patent or in developing world markets it's more like $40 a month (and insulin is more like $10 a month).

In short, the cost is a function of actually-existing capitalism, not the drug itself.

[andrewducker]

Oh yes, but we were talking about prices now. I'm sure that once competitors are allowed the price will drop dramatically.

[hairyears]

Being a bit of a cynic, I'm expecting a media blitz to discredit Ozempic: it's not just the potential to significantly reduce the cost of Americans' diet-related health issues - damaging as that would be to their parasitic healthcare economy - it's the threat to all kinds of profitable addictions and addiction-adjacent behaviours in gambling, smoking, and drinking.

[autopope]

Yup: it's already undergoing clinical trials as an anti-addiction and anti-alcoholism drug. (It reduces cravings -- not just for food.)

However the 50% patient rejection rate due to persistent nausea, diarrhoea, and vomiting shows there's room for next-generation meds with fewer side-effects.

I reckon it'll be cheap as chips within 5 years, obsolete within 10, and off the market entirely within 15 (much like cimetidine, the first H2 antagonist for stomach ulcers in the late 1970s, which frequently caused gynocomastia in male patients).