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Diabetes drugs are too expensive in the U.S., and insulin is infamously six to 13 times more expensive here than in comparable high-income countries. And blockbuster GLP-1 drugs, too, could be a lot less expensive, according to an investigation published this week in JAMA Network Open, with a simple change: robust generic competition.

The study, led by Melissa Barber, a Yale postdoctoral fellow, and conducted in collaboration with Doctors Without Borders, a nonprofit medical organization working in low-resource and emergency settings, found that making a generic vial of insulin could cost $61 to $111 per year — 97% less than than the current market price in the U.S., based on an estimate that factors in a 10% to 50% profit margin.

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“The prices of insulin, in the United States in particular, are exceeding production,” Barber said, commenting on the stark contrast between sales price and production cost. “It’s up to policymakers to decide what to do about that.”

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