Insulin was godsend, and developers knew it ‘belongs to the world.’ It must be affordable

On Wednesday, April 18, 1906, my wife’s maternal grandfather was in San Francisco when an extreme earthquake with a magnitude of 7.9 struck the coast of Northern California. He was there with others to take his board exam to become a certified medical doctor.

The disaster took a huge toll on the city’s medical facilities, as many of the hospitals were damaged or destroyed. Within a week, over 100 refugee camps were set up throughout the city, while outdoor kitchens were set up to feed the public. The future doctors were enlisted to help treat and care for the sick and wounded in improvised outdoor hospitals.

The Board of Health of San Francisco eventually waived the board exams for the medical residents for services rendered in the aftermath of the earthquake and subsequent fire. My wife’s grandfather then returned to Springfield, Illinois, to open up a medical practice.

An important piece of information about my wife’s grandfather is that he was a Type 1 diabetic.

Before the 1920s, a Type 1 diabetes diagnosis usually meant a death sentence for people all over the world. The only treatment available was a starvation diet that would prolong the inevitable. Unfortunately, my wife’s grandfather developed an infection and died in early 1922, just as the newly discovered insulin was successfully used to treat the first human being with dangerously high blood sugar levels.

This year marks the 100-year anniversary of the application of this miraculous drug in a human being. In 1920, a Canadian physician and scientist named Frederick Banting began isolating and extracting insulin in the laboratories of J.R.R. Macleod, a professor of physiology at the University of Toronto. He was aided in his work by medical student Charles Best, who tested insulin on dogs, and a chemist named James Collip, who helped Banting and Best to purify and refine insulin for clinical trials in humans.

On Jan. 23, 1923, Banting, Best and Collip were awarded the American patent for insulin, which they sold to the University of Toronto for $1 each. Banting famously said: “Insulin does not belong to me; it belongs to the world.” It was his desire for anyone with diabetes to have access to this life-saving drug.

The pharmaceutical company Eli Lilly and Co. was given the rights to mass produce insulin and make it widely available. By 1923, insulin was the highest-selling product in Eli Lilly’s history, and insulin profits accounted for over half of the company’s revenues.

Prices have continued to skyrocket ever since. Eli Lilly and two other major insulin producers, Sanofi and Novo Nordisk, have raked in billions of dollars every year by turning insulin into profit machines.

Big pharmaceutical companies are charging Americans three, four or even 10 times more than what they charge for the same drugs in other countries — even though they admit they still make a profit overseas. The soaring cost of insulin provides a clear example of broken drug pricing. Even though insulin was commercialized in 1922, its inflation-adjusted per-unit price has more than tripled between the 1990s and 2014. In the United States, insulin costs per patient nearly doubled from 2012 to 2016 ($2,864 versus $5,075).

The main argument advanced by pharmaceutical companies is that they need to raise drug prices to increase funding for the research and development of new drugs. However, a recent analysis by The Washington Post revealed that nine out of 10 big pharmaceutical companies spend more on marketing, sales and overhead than on research. In 2018, pharmaceutical companies spent a whopping $6.5 billion in advertising, a 100 percent increase since 2012.

The soaring price of prescription drugs is driving up health insurance premiums and increasing the taxpayer burden of financing Medicare and Medicaid. Until recently, the law forbade Medicare from negotiating lower drug costs. The Inflation Reduction Act, a new law passed along party lines in August (our four Republican congressmen voted against this law in the House and Senate), now requires Medicare to use its enormous buying power to negotiate lower prices for up to 20 of the most expensive drugs.

Starting next year, people on Medicare will enjoy no-cost vaccines and a $35 monthly cap on insulin. In 2025, a $2,000 ceiling on out-of-pocket drug costs will limit people’s exposure to outrageous bills.

While we should all celebrate this historic victory that brings us closer to Banting’s dream of making insulin and other life-saving medications affordable, we should not let our guard down. Big drug companies are already trying to overturn the new law so that they can keep charging the 100 million Americans who are diabetic or pre-diabetic the highest prices in the world.

This story was originally published September 18, 2022 at 4:00 AM.