A recent commentary (M Fralick, AS Kesselheim. NEJM 2019; 381: 1793-5) describes the U.S. Insulin Crisis.
- In 1922, insulin was first injected into a 14-year-old boy with severe type 1 diabetes mellitus (T1DM). Prior to this, T1DM had been considered a universally fatal disease
- Frederick Banting, John Macleod, and members or their team that discovered insulin sold their patent for $1 to assure it could be widely affordable
- “U.S. law allows pharmaceutical manufacturers to price their products at whatever level they believe the market will bear and to raise prices over time without limit”
- “Direct competition in the insulin market is lacking”
- Since insulin is a biologic drug, this necessitates “additional testing beyond what is usually required for generic drugs before approval by the” FDA.
- A carton of insulin that sells for $300 in the U.S. could be purchased in Canada for $20 (in U.S. dollars)
- Nearly 100 years after the development of insulin, “insulin is inaccessible to thousands of Americans because of its high cost.”
My take: Why does insulin cost 15 times more in the U.S. than Canada? These excess costs with insulin are occurring despite a great deal scrutiny; unfortunately, U.S. consumers are paying extra for a wide range of pharmaceuticals. Going from the Nobel discovery of insulin to our current state is a clear indication of the need to reform of our healthcare system.
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