A couple of weeks ago, we talked about how many patients with Type 2 diabetes who are not on insulin don't really need to check their blood sugar so much. I nodded at the end of that episode as to how it's ironic that it's so easy to overspend on stuff we don't need and so hard to get the stuff many do need, like insulin. Why is that? This is Healthcare Triage News.

[Intro]

It's a well-known story, I think we've even hit on it in a podcast, that after Frederick Banting discovered insulin in 1921, he wouldn't put his name on the patent. Thought it was unethical to profit from saving lives. The other two inventors sold the patent to the University of Toronto for one dollar. They all wanted this literal life-saving drug to be available to anyone who needed it.

2016, the price of insulin was about 450 dollars a month in the United States. That's almost double what it had been in 2012, and it's gone up since 2016. How?

The United States has about 15% of the insulin purchasing market worldwide. It generates about 50% of the revenue for insulin, though. In other words, Americans are paying a lot more than other countries' citizens for the drug. 

Given that the original formulation of insulin was suppose to be cheap, what happened? Well, companies started to improve it. Some of the first improvements were huge. They started to make both long- and short-acting insulin. In the late 1970s, they figured out how to use recombinant technology to get E. coli to produce it better, and it was much safer. Then, they discovered insulins that could be absorbed better.

These weren't "me too" improvements. The insulin of today is much better and safer than the insulin of almost a century ago. That matters, because Americans want the newest and most expensive insulins that exist.

Are these newer formulations that much better than some of the other recent (and cheaper) drugs? There's not a lot of evidence for that. But, a larger reason that companies charge so much for insulin in the United States is because they can. The United States gets its drugs differently, and doesn't control prices. That matters.

What also matters is that there are currently no true generic options of insulin available in the United States. Granted, some of this is because of the incremental innovations I described before; others are because, even if the insulin is off patent, the fancy ways of delivering the insulin (think those nice pens) are not.

Regardless, it's clear that insulin is an area where the system is still somewhat broken down. People are getting upset, and congress is threatening action. There were some hearings on Wednesday, which hopefully you watched. We're going to check them out, and we'll bring them to you later.

[Outro]

Hey, did you like this video? It always helps if you like or subscribe to the show in general. You might also enjoy this video on Type 2 diabetes and blood sugar testing which I mentioned at the beginning. 

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