A recent commentary (M Fralick, AS Kesselheim. NEJM 2019; 381: 1793-5) describes the U.S. Insulin Crisis.

Background: 

• 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.

Current Situation:

• 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.

Related blog posts:

• Another Shady Pharmaceutical Practice: Citizen’s Pathway to Delay Competition
• 5000% Increase for Well-Established Drug
• Drug Waste Costing Billions. Who benefits? Pharmaceutical Companies
• How to Undermine Value Care: Lessons from Pharmaceuticals
• The Solution to Drug Prices” | gutsandgrowth
• Cornering the Generic Markup | gutsandgrowth
• Upside Down Incentives in Pharmaceutical Development -Profit …

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