A Plan To Cap Insulin Prices May Not Be Helpful

IRA FLATOW: This is Science Friday. I’m Ira Flatow. Later in the hour, a master course on monkeypox. Debunking some common misconceptions about the virus. And meet the all knowing galaxy we live in, the Milky Way, in a sassy new tell all.

But first 30 million people in the US live with diabetes and access to insulin can be very expensive. More than one in five people with private insurance pay more than $35 a month for this necessary medication. The US Senate has a plan to cap insulin prices for some seniors, but critics say this plan would not help make insulin affordable for a majority of people. Joining me to talk about this and other science stories of the week is Katherine Wu, staff writer for The Atlantic based in New Haven, Connecticut. Welcome back to Science Friday, Katie.

KATHERINE WU: Hello. It’s good to be here again.

IRA FLATOW: Nice to have you. OK, let’s start with this insulin story. What’s the current status of insulin access for diabetics in the US?

KATHERINE WU: Yeah. So insulin is very, very, very expensive, which is very unfortunate. As you’ve pointed out, this can be a life or death drug for some people, especially those with type 1 diabetes who can’t make insulin on their own. And as you pointed out, there are some people paying way more than $35 a month for this medication. Some people are paying into the hundreds per month, which can be a huge portion of their paycheck. That is massive. That’s on par with what they may be paying for food, even part of their housing.

IRA FLATOW: And this is much more than people elsewhere in the world pay.

KATHERINE WU: Absolutely. So there was a study I believe it was last year by the Rand Corporation that found that average prices for a vial of insulin in the US exceed prices in any other country and is about 10 times more than the global average, which is a huge gap.

IRA FLATOW: So the Senate plan for insulin access doesn’t quite solve this problem, does it?

KATHERINE WU: No. So obviously this bill is still kind of working its way through all of the legislative red tape, but it has cleared the Senate in kind of a mixed bag form. So people with Medicare are slated to get a copay cap of $35 per month. But people with private insurance don’t get that benefit. People who are uninsured and paying out of pocket aren’t getting that benefit. And people on Medicaid are not getting that benefit, which is, as you pointed out, a lot of people.

IRA FLATOW: Is this just an instance of companies getting as much as they can?

KATHERINE WU: I certainly think that plays a role, though the companies that have sort of a monopoly on the insulin market have pushed back on that characterization. But the reality is insulin, it’s not the most expensive drug in the world, but it’s not necessarily cheap to make. We don’t have a generic version available. And really three big, big companies dominate the market. And so they get to sort of put prices wherever they like.

IRA FLATOW: All right. Let’s move on to something that was a little surprising I think to most people about COVID-19. And that is the CDC releasing new guidance on COVID-19 protocols in schools just this week, right? What are the new guidelines?

KATHERINE WU: Yeah. So there are several things that are rolling out this week from the CDC. Basically it is kind of a massive loosening of protocols. So there is going to be no more routine testing recommended in schools and workplaces. So this is very, very precisely timed. A lot of kids are about to go back to school and that may be a huge change for them.

Before there were a lot of places that had policies in place that if you are a kid and you are exposed to someone who has presumed COVID, has symptoms, has recently tested positive, you either have to quarantine or you have to take tests and make sure that you’re testing negative to come back to school. A sort of test to stay policy. That is no longer being recommended. And more generally for everyone else, no one needs to quarantine anymore after they’ve been exposed to the virus even if they’re unvaccinated or not up to date on their vaccines. And there’s no more recommendation of staying six feet away from each other.

IRA FLATOW: Is there a general feeling of why they’re doing this?

KATHERINE WU: It’s a little complicated, and I certainly can’t speak for the CDC. But the general sense seems to be the CDC has taken a look at the situation. Cases are quite high still in this country. But the proportion of cases that are preceding to hospitalization or death has stayed thankfully very, very low. On a press call yesterday, the CDC was saying a lot of people have some form of immunity, whether it’s through vaccination or prior infection. The virus is just finding fewer ways to cause severe disease. And so the CDC is saying maybe it’s time to loosen up a little bit. And this is kind of a way to quote unquote “live more sustainably” with the virus.

IRA FLATOW: All right, let’s loosen up a bit ourselves for a moment and move to space for our next story. Many of us have been following the discoveries from the James Webb Space Telescope, JWST, with a good form of shock and awe. And it seems astronomers may have found the youngest exoplanet we know of. Tell us about that.

KATHERINE WU: Yeah, so I do want to highlight that Rob and George Andrews had a great story on this in the New York Times. With this amazing new James Webb telescope, we are seeing our universe in unprecedented detail. And scientists have found evidence that there is an exoplanet orbiting a star about 395 light years away from us. And that star is just 1.5 million years old, which means that planet is probably about the same age. Now, you may be thinking 1.5 million years sounds like a really, really long time. That sounds kind of old. But for perspective here, Earth is 4.5 billion years old. So this is like a little baby exoplanet.

IRA FLATOW: Wow. So we might learn something about how planets form from watching this.

KATHERINE WU: The way that I’ve been thinking about this is it’s like we’re getting baby pictures of this planet. And if we sort of keep at it with James Webb or other telescopes that come out in the future, we could sort of watch this planet get older and older. I certainly don’t know if we’ll be following it in this much detail 4 billion years from now. But at the very least, we can sort of look into our own past. If all planets form the same way, this could be the closest we come to watching our own planet’s early development.

IRA FLATOW: So we’re not actually seeing a finished planet yet, right? It’s sort of in a stage of development?

KATHERINE WU: Right, right. So when planets are born, it’s less a fully formed tiny planet being birthed out of a bigger planet. It’s not like an animal. But basically the idea here is we have this star and there’s a lot of dust and gas orbiting around and it looks like they are clumping together to form a planet. Imagine a ball of dough coming together. And that dough is going to get cooked from something raw and battery into a finished cake-like product. This planet is in the very early stages of that.

IRA FLATOW: Well, I’m glad you made this food analogy with the planet, because it’s a great segue into this other story. A bit of hubbub in the space community about an image that looked beautiful, like a beautiful star deep in space. And it turns out that the photo is actually something much closer to home, a slice of chorizo. Tell us about this.

KATHERINE WU: Yeah. This may be the biggest womp womp story of the past week. But last week a physicist posted this chorizo photo to Twitter except he did not say it was a chorizo. He said it was a James Webb photo of this beautiful reddish star elsewhere in the universe. And a lot of people fell for it. The tweet totally went viral. And maybe it’s not shocking that they did. This was an established physicist. He had a blue checkmark, tons of followers. But he later admitted, yeah no, that is cured meat, not a star.

IRA FLATOW: And why were people so fooled? I mean, well maybe it’s because we’re so used to seeing some incredible pictures coming back from the JWST, we didn’t question this thing.

KATHERINE WU: Yeah. I mean, there was probably little reason to question it. All the photos we’ve been seeing so far have been beautiful and showing us unprecedented detail. Why not something chorizo-like? And as we were just kind of hinting at, a lot of things in space look delicious.

[LAUGHS]

My colleague Marina Koren at The Atlantic wrote a great piece basically making that argument. This is not going to be the only meat-like thing we see on space Twitter. And hopefully the next things we do see are going to be more legit. We’re definitely already seeing things out there that look like tomatoes and meatballs, delicious savory red things that just also happen to be stars.

IRA FLATOW: I’m getting hungry. Let’s move away from space quickly. Let’s go back to Earth to tackle a very serious medical story. We are no strangers to infectious diseases, of course, at this point. And in the New York City area, a few cases of polio have been detected. It turns out additional cases have been detected in wastewater. Tell us what’s happening here.

KATHERINE WU: Yeah. So this has been an unfolding story for a few weeks now. And it starts a couple of weeks ago when health authorities in Rockland County, New York found that a man in his 20’s had been paralyzed from a polio virus that had actually come from a type of vaccine that is not used in the US but is used in other countries to vaccinate people against polio. So this is a weakened form of the virus. It can replicate in people and does not generally cause any form of disease, but if it spreads to a ton of unvaccinated people, it can mutate back into a form that can be pretty dangerous and can in rare cases cause paralysis.

So I will point out here that the man who got paralyzed was unvaccinated. And so this is not going to be a massive threat to people who do have the polio vaccine. But this is worrisome. The fact that this paralysis occurred means that there probably is transmission in the community. And the wastewater detection means that it’s probably ongoing.

IRA FLATOW: All right. We’re going to keep our eye on that one. Let’s talk about our last story, another infectious disease on many people’s minds, monkeypox. You wrote a story about vaccine splitting. Tell us what that is.

KATHERINE WU: Right. So it’s quite clear that at this point we do not have enough of the monkeypox vaccine here in the US. We’ve been using a brand called JYNNEOS. And there are more than a million people at very high risk of monkeypox right now, most of them men who have sex with men, many of them who are living with HIV.

And so to really stretch the resources we have, the government this week decided we’re going to split the JYNNEOS doses we have into five. And instead of injecting a full dose under the skin into the layer of fat that sits underneath, we’re going to use 1/5 of the dose and use a special needle to inject it between the layers of skin. So it’s a more shallow shot. It’s more difficult to administer. But the hope is that this will stretch our supply.

The tricky thing here is that procedure, making that switch from so-called subcutaneous dosing to intradermal dosing, is really just based on a single study that was done in 2015 in mostly young healthy adults. We don’t quite know exactly how it’s going to perform as it rolls out into the public in the context of this outbreak.

IRA FLATOW: So it’s going to be like a little bit of an experiment to find out.

KATHERINE WU: Definitely. A real world experiment.

IRA FLATOW: Yeah, well, we’re going to be talking about monkeypox in our next segment. Everything you wanted to know about it with some experts. So we’ll cover that also. I want to thank you for taking time to be with us today.

KATHERINE WU: Absolutely. Thank you so much for having me.

IRA FLATOW: Katherine Wu, staff writer for The Atlantic based in New Haven, Connecticut.

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