laos low price new river sand ultrafine mill sell

walmart unveils low-price analog insulin amid rising diabetes drug costs

walmart unveils low-price analog insulin amid rising diabetes drug costs

Walmart said Tuesday it will offer a less expensive version of insulin that could better fit into the budgets of millions of Americans who don't have health insurance or struggle to pay for the lifesaving diabetes drug.

Starting this week, the retailer will sell an exclusive private-label version of analog insulin, ReliOn NovoLog, to adults and children who have a prescription. The drug will be available at its membership-based Sam's Club in mid-July. The insulin will cost about $73 for a vial or about $86 for a package of prefilled insulin pens.

The insulin is the latest addition to Walmart's private brand of diabetes products, ReliOn. It already sells a low-price version of insulin for about $25 as part of the line, but that is an older formulation that some doctors and advocates say is not as effective at managing blood sugar swings as newer versions of insulin, called analogs.

With the move, Walmart will bring its longtime focus on "everyday low price" to a drug that is a medical necessity for a growing number of Americans. More than 34 million people in the U.S. or nearly 11% of the population have diabetes, and about 1.5 million Americans are diagnosed every year, according to the American Diabetes Association. That percentage is about 14% among Walmart shoppers, said Warren Moore, Walmart's vice president of health and wellness, on a call.

As the number of people with diabetes climbs, the cost of the 100-year-old drug has soared rather than fallen and drawn scrutiny from lawmakers. The annual cost of insulin for people with Type 1 diabetes in the U.S.nearly doubledfrom $2,900 in 2012 to $5,700 in 2016, according to the most recent data available from the Health Care Cost Institute. Some of the top manufacturers of insulin, including Sanofi and Eli Lilly, have been grilled by politicians during congressional hearings for hiking prices of the critical drug. In some cases, the companies have responded to criticism by rolling out limited, reduced price programs.

Dr. Cheryl Pegus, Walmart's executive vice president of health and wellness, said Walmart's version of the drug will expand access to care as it undercuts the typical price and puts analog insulin within reach of more people. She said Walmart worked directly with manufacturer Novo Nordisk to reduce costs. The price difference with branded competitors will be as much as $101 per vial of insulin or up to $251 per pack of prefilled insulin pens, Pegus said.

"This price point, we hope, will improve and hopefully revolutionize the accessibility and affordability of insulin," she said on a call with reporters. "We know that many people with diabetes struggle to manage this chronic condition because of its financial burden."

Walmart, already the nation's largest employer and grocer, has made a bigger push into health care as it tries to leverage its massive reach for other money-making opportunities. It has opened 20 clinics next to its stores with budget-friendly medical care, such as $30 annual checkups or $25 dental cleanings. It bought a telehealth company, MeMD, in May for an undisclosed amount as a way to provide care virtually. And it has pressured the pharmacy industry on price before by launching a prescription program that sells monthly supplies of many widely used generic drugs for $4.

Yet the retail giant is treading in a complex industry that has tripped up other large, influential corporate players. Haven, a joint venture of Amazon, Berkshire HathawayandJPMorgan Chase, disbanded early this year about three years after the companies heralded plans to disrupt health care with lower costs and improved outcomes.

Walmart has lost some of the key talent it recruited to lead and expand its health and wellness efforts, including Sean Slovenski, formerly senior vice president of Walmart health and wellness; and Dr. Tom Van Gilder, who had become its first full-time chief medical officer.

laos | history, flag, map, capital, population, & facts | britannica

laos | history, flag, map, capital, population, & facts | britannica

Laos, landlocked country of northeast-central mainland Southeast Asia. It consists of an irregularly round portion in the north that narrows into a peninsula-like region stretching to the southeast. Overall, the country extends about 650 miles (1,050 km) from northwest to southeast. The capital is Vientiane (Lao: Viangchan), located on the Mekong River in the northern portion of the country.

The geologically diverse landscape of Laos, with its forested mountains, upland plateaus and lowland plains, supports an equally diverse population that is united largely through agriculture, particularly the cultivation of rice. Interactionssometimes hostile, sometimes hospitablewith the neighbouring Khmer (Cambodian), Siamese (Thai), and Myanmar (Burmese) kingdoms between the 5th and the mid-19th century indirectly imbued Laos with elements of Indian culture, including Buddhism, the religion now practiced by most of the population. Both Buddhist and Hindu lores have shaped the visual, performing, and literary arts of the country. Many of the indigenous and minority peoples of the remote highland slopes and mountainous regions, however, have maintained their own idiosyncratic ritual and artistic traditions.

Colonization by the French from the late 19th to the mid-20th century infused Laos with a European cultural element, which intensified throughout the countrys embroilment in World War II and the Indochina wars, as well as a civil war of its own in the second half of the 20th century. Guided by Marxist-Leninist ideology, Laos emerged from the turmoil in 1975 as a communist country. Economic reforms of the late 20th and early 21st centuries, including the development of tourism, have strengthened Laoss economy, gradually shrinking the countrys debt and diminishing its dependence on international aid.

Dominating the landscape of Laos are its inhospitable forest-covered mountains, which in the north rise to a maximum elevation of 9,245 feet (2,818 metres) above sea level at Mount Bia and everywhere constitute an impediment to travel. The principal range lies along a northwest-southeast axis and forms part of the Annamese Cordillera (Chane Annamitique), but secondary ranges abound. On the Xiangkhoang Plateau in north-central Laos, the Plain of Jars (Thng Haihin; the name derived from large prehistoric stone jars discovered there) consists of extensive rolling grasslands rather than a true plain and provides a hub of communications. The karst landscapes of the central provinces of Bolikhamxay and Khammouan contain caverns and severely eroded limestone pinnacles. In the south the Bolovens Plateau, at an elevation of about 3,600 feet (1,100 metres), is covered by open woodland and has generally fertile soil. The only extensive lowlands lie along the eastern bank of the Mekong River.

The general slope of the land in Laos is downhill from east to west, and all the major riversthe Tha, Beng, Ou, Ngum, Kading, Bangfai, Banghiang, and Kongare tributaries of the Mekong (Mnam Khong). The Mekong flows generally southeast and south along and through western Laos and forms its boundary with Myanmar and most of the border with Thailand. The course of the river itself is severely constricted by gorges in northern Laos, but, by the time it reaches Vientiane, its valley broadens and exposes wide areas to flooding when the river breaches its banks, as it did most notably in August 1966. A few rivers in eastern Laos flow eastward through gaps in the Annamese Cordillera to reach the Gulf of Tonkin; the most important of these is the Ma River, which rises in the northeast, just inside the Vietnam border.

Soils in the floodplains are formed from alluvium deposited by rivers and are either sandy or sandy clay with light colours or sandy with gray or yellow colours; chemically, these are neutral to slightly acidic. Upland soils derived from crystalline, granitic, schistose, or sandstone parent rocks generally are more acidic and much less fertile. Southern Laos contains areas of laterite (leached and iron-bearing) soils, as well as basaltic soils on the Bolovens Plateau.

Laos has the typical tropical monsoon (wet-dry) climate of the region, though the mountains provide some variations in temperature. During the rainy season (May to October), the winds of the southwest monsoon deposit an average rainfall of 50 to 90 inches (1,300 to 2,300 mm), with totals reaching some 160 inches (4,100 mm) on the Bolovens Plateau. The dry season (November to April) is dominated by the northeast monsoon. Minimum temperatures average between 60 and 70 F (16 and 21 C) in the cool months of December through February, increasing to highs of more than 90 F (32 C) in March and April, just before the start of the rains. In the wet season the average temperature is 80 F (27 C).

Laos has tropical rainforests of broad-leaved evergreens in the north and monsoon forests of mixed evergreens and deciduous trees in the south. In the monsoon forest areas the ground is covered with tall, coarse grass called tranh; the trees are mostly secondary growth, with an abundance of bamboo, scrub, and wild banana. Laos is also home to hundreds of species of orchids and palms.

The forests and fields support a wealth of wildlife, including nearly 200 species of mammals, about the same number of reptiles and amphibians, and some 700 varieties of birds. Common mammals include gaurs (wild oxen), deer, bears, and monkeys. Elephants, rhinoceroses, and tigers, as well as several types of wild oxen, monkeys, and gibbons, are among the countrys endangered mammals. Geckoes, snakes, skinks, and frogs are abundant; several types of turtles are threatened. The canopy and floor of the forest are inhabited by countless warblers, babblers, woodpeckers, and thrushes, as well as an array of larger raptors. Numerous water birds live in the lowlands. Several dozen species of Laoss birds are threatened, including most hornbills, ibises, and storks.

Related Equipments