Today is the 100th anniversary of the discovery of insulin. Diabetes affects about 367,000 adults in Connecticut and that number is rising. Before the 1920s, a diabetes diagnosis was a death sentence. The discovery of insulin allowed people with diabetes to live their lives. Until the 1970s, insulin was affordable, but it’s now so costly that one in four patients has to ration doses, endangering their lives. Diabetes was Connecticut’s seventh-leading cause of death in 2017.
On July 27, 1921, Fredrick Banting, with medical student Charles Best and chemist James Collip, successfully isolated insulin in borrowed lab space at the University of Toronto. Banting won a Nobel Prize and a knighthood for the discovery. A bottle of insulin is memorialized on the Canadian 100-dollar bill. Understanding the importance of what they’d just created, Banting and his colleagues sold the patent for a dollar. They wanted insulin to be affordable for everyone who needed it. Unfortunately, that’s no longer true.
Insulin prices now bear no relation to the costs to manufacture it. While newer insulin versions cost $3.69 to $6.16 per vial to manufacture, the companies have set their prices at $174 to $300 per vial. Some patients need six vials each month to manage the disease. Prices have risen over 15% annually since 2012.
Insulin is expensive because of a massive market failure. As it was developed 100 years ago, insulin’s price is not driven by recovering research and development costs. A large population of vulnerable people need it to survive, the market is controlled by three companies with monopolies, and there is little competition.
Insulin is one part of America’s larger problem of excessive drug prices. The most commonly used forms of insulin cost 10 times more for Americans than in other countries. Unlike the U.S., those countries have rational, evidence-based mechanisms to price drugs that allow for both innovation and affordability.
While Connecticut passed legislation last year limiting out-of-pocket insulin costs for insured patients with diabetes to $25 per month, the total price of the drug didn’t change. Those excessive prices are shifted onto everyone who pays premiums in our state.
The solutions are clear, but very hard to implement. Drug companies employ lots of lobbyists and patient groups to protect their profits. Every other developed country has rational policies governing pharmaceutical pricing, ensuring that consumers get what they pay for. The U.S. needs to do this.
Ellen Andrews, PhD, is the executive director of the CT Health Policy Project. Follow her on Twitter @CTHealthNotes.
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