Diabetics are in the news as insulin prices soar to levels that many cannot afford. Patients are rationing themselves to the point of death. Still many in Congress have been brainwashed to believe that not only do we have the best healthcare system in the world, drugs companies are doing everything they can to lower prices on critical drugs like insulin.

Many of my pharmacy colleagues may not remember the names Banting and Best from the University of Toronto who had worked with dogs (under the forbearance of Professor John Macleod) to demonstrate that a pancreatic extract could alleviate morbidity and mortality in dogs without a pancreas. By 1922 they tried a purified version on a 14-year-old boy with a degree of success (the first injection resulted in minimal effect and a sterile abscess at the injection site). Further purification by a University of Toronto biochemist named Collip yielded a better product. Once word spread through the scientific community the improvements came fast and furious. Soon commercial products from beef and pork took over the market.

You can Google the details of further development as well as I so I’ll simply say that from that first bold trial until 1978 when the first recombinant DNA human insulin was produced by Genentech. Genentech signed an agreement with the Eli Lilly company to commercialize the product and in 1982 Humulin N and Humulin R hit the US market. These products and subsequent new types of rDNA insulins were paralleled with products from a Danish company Novo Nordisk. Normally this would be undiluted great news for diabetics, who suffered from a variety of side effects from the beef and pork products. But…

In 1923, Macleod and Banting won and shared the Nobel Prize with Best and Collip. They also obtained the patent for insulin which they sold for $1 each to the University of Toronto, saying that such a life-saving drug should be as widely available as possible, perhaps fearing what commercialization would do to the availability of their discovery. The University grant right to Lilly and other companies to produce insulin royalty free and to obtain new patents on any improvements they might develop. Insulin had left the realms of science, academia, and altruism and been naively cast into capitalism. And now, for the scientists, their worst nightmares have come true and are beyond anything they could have imagined.

BY 1941, Lilly, and 2 other insulin distributors were found in violation of the Sherman Antitrust Act for conspiring to arbitrarily fix insulin prices. They all took a plea of “no contest” and each company was fined $5,000 and each corporate officer $1,500. Today those old animal derived products are gone from the market (beef in 1998, pork in 2006). That sort of thing has gone dead silent as today’s insulin all seem to sport exorbitantly high prices within a few dollars of each other. Quite a coincidence!

I find it amazing that from the launch of rDNA insulin in 1982 to today that all we have managed to do is create more expensive insulin!

There are only three companies in the U.S. insulin market: Eli Lilly and Co., Novo Nordisk, and Sanofi (HQ in Paris).

For fiscal year 2018, the CEO of Lilly was compensated well over $15 million dollars. All told the CEO and leadership took home over $41 million. That’s for 6 individuals.

Things are different in Denmark: At Novo Nordisk, the most compensated executive makes $700,000, annually, and the lowest compensated makes $50,000.

Meanwhile , Sanofi sales took a hit and it’s CEO took a hit: The CEO’s pay package was slashed by 25% in 2018 to €7.28 million ($8.2 million).

To me, $700k seems a healthy income for anybody and keeps company income disparity at a more reasonable level of 14:1 versus Lilly’s 314:1.

This has been a long-winded way to get to my points.

  • Insulin must be affordable. If it takes Medicare for all or a reasonable national health plan, then I’m for it.
  • I feel that income disparity is as big a problem as inequitable taxation.
  • Healthcare should not be a commodity provided at exorbitant profit.
  • I realize that statesmanship is virtually dead. We must return civility and rationality to the national psyche and integrity to our government.
  • Learn. Speak. Vote.