Post by ashliy on Feb 12, 2022 13:13:34 GMT
Politics of insulin reveals the sickness of US health system
Until January 1922 diabetes was a death sentence. A hundred years ago, on 11 January 1922, a 14-year-old Canadian boy became the first diabetic to escape that fate by receiving an injection of insulin. Before that, those with Type 1 diabetes usually lived no more than two years after diagnosis. In 1923 the team of researchers who discovered insulin sold the patent to the University of Toronto for $1 because they wanted to keep the medicine affordable for everyone.
Flash forward 100 years and the price of insulin is anything but. Prices have soared: some formulations cost 1,000% more than they did at the turn of the 21st century. The price of one vial of Humalog insulin stood at $21 in 1999; it cost $332 in 2019, and many diabetics require more than one vial a month.
The reasons for the price rises are complex but can be whittled down to a simple fact: without insulin, diabetics die. Pharmaceutical companies that manufacture insulin have enormous leverage to charge whatever they want. In most developed countries diabetics don’t pay hundreds and sometimes thousands of dollars a month for insulin because governments regulate the price. The US, of course, is the exception. But with 10.5% of the US population diagnosed with diabetes — a percentage which is sure to grow — the rising cost of insulin has become a political punching bag.
It seems strange that a medicine invented 100 years ago has ballooned in price to the point that one in four diabetics reports rationing insulin because of cost. Yet despite its age, insulin remains relatively difficult to make. Unlike drugs such as paracetamol that are chemically derived, insulin is a biologic drug extracted from living organisms. Only three pharmaceutical companies — Eli Lilly, Sanofi and Novo Nordisk — produce insulin and control 90 per cent of the market.
This control makes it difficult for a generic drugmaker to come up with its own version. By the time it could bring a generic to market, the big three insulin makers would have developed a newer version incrementally better than the older one. Because doctors naturally want to prescribe the best medicine for their patients, a company making a generic equivalent would find itself squeezed out of the market.
“Honestly, we sometimes call the big three insulin makers a cartel,” says Elizabeth Pfiester, founder and executive director of diabetes advocacy group T1 International. “They have demonstrated behaviour where they raise insulin prices in lockstep, and they have a near-complete dominance in the market. They also put large amounts of money into sponsorships and patient advocacy groups, so their influence is huge.”
www.newstatesman.com/world/americas/north-america/us/2022/02/politics-of-insulin-reveals-the-sickness-of-us-health-system
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This shouldn't be happening.
Until January 1922 diabetes was a death sentence. A hundred years ago, on 11 January 1922, a 14-year-old Canadian boy became the first diabetic to escape that fate by receiving an injection of insulin. Before that, those with Type 1 diabetes usually lived no more than two years after diagnosis. In 1923 the team of researchers who discovered insulin sold the patent to the University of Toronto for $1 because they wanted to keep the medicine affordable for everyone.
Flash forward 100 years and the price of insulin is anything but. Prices have soared: some formulations cost 1,000% more than they did at the turn of the 21st century. The price of one vial of Humalog insulin stood at $21 in 1999; it cost $332 in 2019, and many diabetics require more than one vial a month.
The reasons for the price rises are complex but can be whittled down to a simple fact: without insulin, diabetics die. Pharmaceutical companies that manufacture insulin have enormous leverage to charge whatever they want. In most developed countries diabetics don’t pay hundreds and sometimes thousands of dollars a month for insulin because governments regulate the price. The US, of course, is the exception. But with 10.5% of the US population diagnosed with diabetes — a percentage which is sure to grow — the rising cost of insulin has become a political punching bag.
It seems strange that a medicine invented 100 years ago has ballooned in price to the point that one in four diabetics reports rationing insulin because of cost. Yet despite its age, insulin remains relatively difficult to make. Unlike drugs such as paracetamol that are chemically derived, insulin is a biologic drug extracted from living organisms. Only three pharmaceutical companies — Eli Lilly, Sanofi and Novo Nordisk — produce insulin and control 90 per cent of the market.
This control makes it difficult for a generic drugmaker to come up with its own version. By the time it could bring a generic to market, the big three insulin makers would have developed a newer version incrementally better than the older one. Because doctors naturally want to prescribe the best medicine for their patients, a company making a generic equivalent would find itself squeezed out of the market.
“Honestly, we sometimes call the big three insulin makers a cartel,” says Elizabeth Pfiester, founder and executive director of diabetes advocacy group T1 International. “They have demonstrated behaviour where they raise insulin prices in lockstep, and they have a near-complete dominance in the market. They also put large amounts of money into sponsorships and patient advocacy groups, so their influence is huge.”
www.newstatesman.com/world/americas/north-america/us/2022/02/politics-of-insulin-reveals-the-sickness-of-us-health-system
-
This shouldn't be happening.