Anyone paid $250 for half an ounce of water recently? Didn’t
think so. When Trump, between shouts and interruptions made the outrageous claim
that “He” had made insulin as “cheap as water”, insulin dependent persons who
had ever voted for him must have been at least a little surprised. With a coupon, Humalog insulin right now, as I
write, costs $230 for a box of five 3 milliliter shots. That’s about half an
ounce. “But”, you will say in his defense, “So he exaggerated a little.” No, Jethro, he lied his ass off!
Like Polio vaccine, insulin was seen by its discoverers as
so important a breakthrough that profiting from it would be immoral. Three researchers
discovered insulin back in 1921. Dr.
Frederick Banting and Charles Best were the main two, along with Dr. James
Collip — all three had their names attached to the patent awarded in January
1923 to their method of making insulin. Their original intellectual property
rights were sold for just $3 Canadian. When the researchers were ready to turn
over the patent of their discovery to the University of Toronto for production
purposes in 1923, they agreed to receive only $1 each (the equivalent of $14
today) in compensation.
Here’s a narrative of the early days from a 2002 article: “For
$1.00 to each, the three discoverers assigned their patent rights to the Board
of Governors of the University of Toronto. The application had stressed that
none of the other researchers in the past had been able to produce a nontoxic
anti-diabetic extract. A patent was necessary only to restrict
manufacture of insulin to reputable pharmaceutical houses who could guarantee
the purity and potency of their products. It would also prevent unscrupulous
drug manufacturers from making or patenting an impotent or weakened version of
this potentially dangerous drug and calling it insulin.”
The university granted Lilly several and other pharma
companies the right to make it, royalty-free, and also offered them the ability
to improve the original formulation and patent anything they created down the
road.
Looks like Insulin should be really inexpensive, right? That’s
before the “business” of diabetes was invented. Lilly who owns the patent in Humalog,
a synthetic insulin, admits to shareholders that their profits have recently been
driven by arbitrary price hikes to Insulin. Of course, there is little market pressure
on the drug, since neither Medicare nor Medicaid can, by law, bargain cheaper pricing.
The VA, as an example does negotiate drug prices, however; this results in a 30-day
supply of Humalog insulin for about $8.
Once upon a time, drug companies used to claim that R &
D costs were what made drugs costly. This simply isn’t true for any major drug company
at present. What’s today’s number one on the cost side of the balance sheet?
Advertising! Well, OK then, perhaps
insulin is just expensive to produce, right? Wrong again Rufus. A 2018 study
estimated that one vial of human insulin costs $2.28-$3.42 to produce, and one
vial of analog insulin costs $3.69-$6.16 to produce. Meanwhile a vial (the same
10 ml size) of the human insulin retails at $95 and the analog at $185. I did
the math, since it’s easy. That’s a 3000% profit per vial for analog insulin. The 2018 study concluded that a
year's supply of human insulin could cost $48-$71 per patient, and analog
insulin could cost $78-$133 per patient per year. The dismal reality is that for most patients
3 vials a month is typical, meaning the yearly retail cost of diabetes for an
analog insulin user could be $6,660 annually (might well be less to the patient
depending on insurance, but someone’s going to pay)! For the drug company that
equates to quite a handsome profit, as is, but wait…there’s more.
Considering the
success of the Epi-pen and the huge profit to be made for selling a simple plastic
auto injector at another huge profit, Lilly also sells the Kwik Pen. Does the same
thing a syringe does, hurts about the same as a plastic disposable syringe but
costs sooo much more. This is from Lilly’s own web site: “The list price1 of a
5-pack of 3 mL Humalog U-100 KwikPens (15 mL or 1,500 units) is $530.40.” Again, breaking it down, three of these packs
would be an average monthly dosage. Yes, that’s right, the annual cost of diabetes
if you pay retail and use Kwikpens is over $19,000! That’s a bit more than the cost
of water.
The coda to
this song of woe is that contrary to Trump’s blustering, he didn’t do jack to
lower drug costs. Some governors, Colorado’s as an example, have, however by
simply banning the sales of insulin at more than $100 monthly. And here’s the
odd part…they still sell insulin in Colorado.
In truth and in
direct contrast to Trump’s bloviation the latest attempt to enact meaningful
drug price control legislation was introduced as the Affordable Drug Act by Senator
Liz Warren, who, the reader is reminded is not of Trump’s party. As expected in
a McConnell controlled Senate, it died a slow death fueled by massive Pharma
lobbying efforts. Hopefully next January will see the dawn of a new day,
VOTE, Dammit!
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