Insulin, a miracle medicine of the 19th century that has skyrocketed in cost in the 21st century

March 6, 2019

 

I hope you're ready for some history, blurred lines of supply and demand, medical needs, and a fresh dose of reality. Let’s get started. 

 

First: the history of insulin. It is important to understand when insulin was founded, and how it came to be produced after it was founded. In 1922, 14 year-old, Leonard Thompson, was injected with insulin at Toronto General Hospital. An injection that saved his life and gave him several more years of living, in a time when type-one diabetes was a death sentence following the diagnosis. News traveled around the world highlighting this life changing medication that was made from extracting insulin from an animal’s pancreas, purified, and administered to humans. The discovery of insulin had been made and was tested on dogs between 1920 and 1921, by William Banting. Banting ended up being awarded a Nobel Prize in 1923 for his discovery. The next 60 years, type-one diabetic patients were treated with insulin coming primarily from pigs and cows. In 1963, insulin was the first protein to be chemically synthesized, thanks to the discovery of protein sequencing by biochemist, Fred Sanger, in 1955. In fact, because of Sanger's discovery, we have learned that human protein has unique sequencing of all of the 20 types of amino acids. Sanger was awarded a Nobel Prize in 1959. Unfortunately, researchers were unable to produce larger quantities needed to supply the potential demand, if synthetic insulin was going to be used to replace animal insulin to treat patients with type-one diabetes. Dorothy Hodgkin was able to decipher the molecular structure using an x-ray crystallography. This provided the needed understanding of how insulin was formed, which receptor it bonds to, how it was made, and how it is transported in the body. For her work, Dorothy Hodgkin was awarded a Nobel Prize in 1969. Her findings were the key to start producing synthetic insulin that would be effective, easily replicated, and up-scaled. In 1978, a synthetic form of insulin came to the market. In fact, this is the same type of insulin that is produced and supplying the medical market today. 

 

The cost of insulin in 1972 was $1.49/vial (this is comparable to $8.86 in current times). Now fast forward to 1996, a vial of the same insulin was $21/vial......in 2004, the same insulin was $60/vial.....in 2019, that very same insulin goes for, on average, $300/vial????????????????? That's a great market value for an insulin that was first made in the 1970's. But you know cost of living has to be accounted for, years of research, growth in the companies that produce insulin to meet the market demands. These companies can increase production, make more profit, and increase prices, when the medical field is glued to the insulin boob, like an infant to their mother.

 

And yet no change has been made?????

 

There was a great article published by CNN yesterday, 3/4/2019: https://www.cnn.com/2019/03/04/health/insulin-price-humalog-generic-eli-lilly-bn/index.html 

In the article, the CEO is eagerly describing his concerns for the public to have access to a lower cost insulin available in a generic form, that is, in fact, half the price of name brand insulin. What a great guy. He’s reducing the almost 20x mark up of insulin slide by at just 10x the mark up price to give those dependent on this insulin a break. Wow, he really cares. In fact, this comes only after publicized deaths of people trying to afford their medication, but were unable to make what they could afford stretch......I ask you, where does this money go? 

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