In 1921, the course of diabetes treatment had changed. It was the discovery of insulin, which promised a whole new way of treating diabetes. However, the scientists who discovered insulin were troubled by the idea whether they should patent the drug.
This discovery altered the outlook of diabetes and the researchers agonized whether they should profit from such a medicine which can transform diabetes from a deadly to a manageable disease.
Finally, the scientists decided to sell the patent to the University of Toronto for $3 or $1 for each person. They believed that in that way no company would have a monopoly and the patients will be able to use a safe and effective medicine.
Michael Bliss, a historian, stated that these researchers had the motivation to do a great humanitarian thing rather than a commercial profit.
Unfortunately, this discovery became a gift for the pharmaceutical companies. The University of Toronto has given licenses to many pharmaceutical companies which produced insulin in large quantities in order to keep up with the high demand.
Even nowadays, one thing remains vague. How such drugs have become more and more expensive, and the competition does not try to reduce the prices. The companies claim that they invest in improvements, but the experts point out that this is only a strategy to keep the prices high.
Some of the improvements are of highest importance since they replaced the insulin derived from animals with a human version which provided fewer side effects.
One important question arises.
Unfortunately, nearly 6 million Americans depend on insulin. The rising cost of this medicine is often masked with health insurance since most of the patients do not pay the full price.
But, some people have limited health coverage and gaps in their insurance. These people have experienced how much the price has increased.
One such example is Laura Marston, 34, who has been using insulin for more than 17 years. She was diagnosed with type 1 diabetes since she was a teenager. At that period, she used Humulin which with insurance cost her $10 for a month’s supply.
Then she started using an entirely new insulin drug Humalog, which was affordable with insurance and provided faster effects.
In 2012, she lost her job and her health insurance. Now, she had to pay the full price of Humalog or $140 and she needed 3 vials each month. Luckily, she obtained a very low insurance plan and had to pay $200 a month.
She could have used the older insulin since it was cheaper, but she was not informed of that option. With years, she treated her disease with the current regimen. However, she has no intention to go on a new insulin again since she learned her lesson.
Irl Hirsch, the 58-year-old doctor, remembered when insulin cost 75 cents a vial. He has used it for more than 50 years, and he is well aware that pricing and access were an issue for most of the time.
According to the drugstore ads published in the 1960s in the Washington Post, insulin cost less than 84 cents a vial. This is less than 3 bags of Halloween candy bars, a bottle of Breck shampoo or a Suave hair spray. The highest price was $2 for a vial.
Hirsch, first as a patient and then as a diabetes specialist, was a witness of the insulin evolution. It was a scientific quest whose main motive was to make the insulin molecules mimic the way the hormone works in the body.
However, with genetic engineering, the researchers found a way how to create insulin which works in the same way as the one the body produces. This newer version has brought about less allergic reactions.
According to Nathan, this is a highly efficient way of insulin production. In this way, the quantity would never run out, and the prices would be kept under control.
In 1991, Novo Nordisk, a Danish company has started producing its bioengineered human insulin. It was expected that this would lower the price, but the prices began to rise.
The Washington Post has conducted an analysis of Truven Health Analytics data which shows that the competition has raised the insulin prices 450% over inflation.
There have come more and more insulins on the market, and the researchers wondered whether they are really beneficial and necessary for the patients. Unfortunately, their prices have rapidly increased. For example, Humalog cost $21 for a vial and has reached $250 in the last 20 years.
Nevertheless, it must be pointed out that there was a considerable improvement in the insulins in the last 25 years.
It is not their effectiveness in relation to newer drugs that comes into question but if their benefit is worth the increased cost.
According to the senior vice president at Express Scripts Holding, Glen Stettin, for some people, the way insulin works may be different. For other people, the insulin improvements may not be the improvements at all.
The government wants to provide the lowest price for prescribed medications, but the drug companies argue that the list prices are fiction. These pharmaceutical companies claim that the list price inflation is entirely deceiving.
According to Enrique Conterno, the senior vice president of Eli Lilly, a drug company, the pharmaceutical companies do not always realize the profit from the increased price of insulin. As the prices rise, they invest more in deeper researches.
However, this does not mean that the pharmaceutical companies do not benefit from such increases. For example, last year Lilly’s income from Humalog increased 9% due to these increase in prices.
Last week, Lilly stated that the Humalog’s income was significantly reduced in comparison to the previous year.
Also, Sanofi reported that the net price of Lantus, the best-selling insulin drug has reduced over the past five years. The net price reduced for 14% in 2015.
There are still efforts to create cheaper insulin. For example, Walmart sells ReliOn, the human insulin to Novo Nordisk for $25 for a vial. Eli Lilly is about to release the first copycat insulin analog at the end of this year.
Insulin can’t be easily made into a pill due to its complexity as a molecule. It is created with living cells and bioreactor in a highly expensive process.
The physician and historian of medicine at Johns Hopkins University School of Medicine, Jeremy Greene reported that while practicing medicine in Baltimore, he found patients with poorly controlled blood sugar. In fact, they were not taking insulin due to its high price.
Patricia Bailey, a 66-years-old from Springville stated that her insurer gave her another insulin with neither explanation nor warning. The other drug works the same, but her costs have increased. Now, she pays nearly $400 for 3 month’s supply.
She is economical with her insulin. She leaves the tubing until empty. In case she runs out of insulin at night, she waits for a couple of hours until she gets insulin.
In this way, she stretches her insulin supply as much as she can, without informing her doctor.
This is one of the most important “benefits” of the modern medicine. People can live normal life thanks to the drugs which constantly appear. But, this makes them captives to these medications with rising price tag.