There is no way to overstate the importance of the discovery of insulin and the impact it has had on the world. Insulin has either extended or saved the lives of countless diabetics in the nearly 100 years since the discovery occurred. While the event and the attention it would bring would lead to significant strains on the interpersonal relationships of those involved, the researchers nonetheless pressed forward and continued on with work that would eventually lead to a Nobel Prize; the awarding of which would strain those relationships even further.
The patent rights for insulin were sold off by each researcher for the sum of $1.00. This is not a typo – each researcher sold their patent rights to the Board of Governors of the University of Toronto for one dollar in an effort to keep the manufacturing processes pure and to the proper specifications, while also making the continued manufacturing of the drug affordable and virtually guaranteed.
One has to wonder, then, what these pioneers would think if they saw the mess that had been made of their discovery. Insulin, by its very nature, is difficult to produce. However, the sheer volumes involved, combined with its critical role in the fight to control diabetes, had kept it relatively affordable over the decades. That would all change, however, in 2002. From 2002 to 2013, the price of some brands of insulin would triple. And now, with some vials costing upward of $300, many diabetics find themselves having to decide between eating and other living expenses and an expense that literally keeps them living.
The medical community is speaking out in increasing numbers about the rate of insulin price inflation, and a fantastic analysis that is both well-cited and easy to read can be found in Dr. Danielle Ofri’s January opinion piece in The New York Times. In it, she breaks down the walls between doctor and patient and gives a no-nonsense telling of why patients have to hold their breath every time they have an insulin prescription refilled. And, unsurprisingly, much of the blame lies with the insurance industry. More specifically, it lies with entities that have lurked in the shadows until now but are gradually coming under harsher and harsher light. They are called P.B.M.s, or pharmacy benefit managers.
The interactions between drug companies and these P.B.M.s is the crux of a lawsuit that accuses the world’s three primary insulin manufacturers of being deceptive in their pricing methodologies. According to Reuters, Levemir, a Novo Nordisk insulin product, was priced at $120.64 per vial in 2012. In 2018, the price of the same vial was $293.75. Such a price hike over the course of six years would be newsworthy on its own. However, the fact that HumaLog (an insulin product produced by pharmaceutical manufacturer Lilly) and Lantus (made by pharmaceutical manufacturer Sanofi) both had similar price hikes over the exact same period suggests at least some degree of coordination. And, while Minnesota was the first state to file a lawsuit seeking to investigate these occurrences, Washington and New Mexico now appear to be asking their own questions as well.
Diabetes and the costs of treating and controlling it is a subject that reaches across virtually every age group and demographic. With stories featured on longtime stalwarts like CBS News to hip and agile new media sources like Netflix’s Patriot Act with Hasan Minhaj (Volume 2, Episode 2: Drug Pricing, time marker 5:24), these predatory practices are being exposed for all to see, no matter how each generation chooses to consume content and information.
The question, as always, remains whether those with the power to do something will look past the hundreds of millions of dollars the insurance and pharmaceutical lobbies spend every year and actually be moved to action.