Insulin: why the price of a 100-year-old drug has tripled in a decade

Insulin prices have skyrocketed to the point where many people with diabetes live in insulin poverty, with one in four rationing their insulin and an even larger proportion trading off other life necessities (food, rent, clothing) to afford their insulin supply.

The rise in insulin prices has nothing to do with recouping R&D costs (the majority of which are funded by government agencies, in any event): the cost of Humalog has risen 1000% in a decade, without any reformulations or refinements.

Why are the prices so high? Because there's no competition to speak of. Re-patenting and legal saber-rattling have kept most new entrants out of the market, while lax antitrust enforcement has allowed existing companies to merge, eliminating potential competitors.

Elizabeth Warren has made federal manufacture of generic drugs a campaign plank, with an emphasis on producing generic insulin.

Insulin prices have been rising for years, with lethal consequences. The effects of being unable to afford lifesaving medicine are weird, too: from forming insulin caravans to Canada to making DIY small-batch insulin of your own. Trump's insulin czar, meanwhile, is the Eli Lily president who oversaw a tripling in the price of insulin.

For Alec, that price was already steep: Even with his promotion, he was making $35,000 a year with no benefits. He and Smith-Holt had combed through Minnesota's Obamacare marketplace for months in search of a decent plan, but the affordable ones all had sky-high deductibles. That meant that he'd be paying full price for his insulin for months before his junk insurance kicked in, on top of hundreds of dollars in monthly premiums—sucking up some 80 percent of his take-home pay once he paid the rent. So he made a rational decision: He'd go uninsured, save the cost of the premium, and just pay for his meds out of pocket, while racking up work experience that could serve as a springboard to a better position with health insurance.

As it turned out, it wouldn't have made a difference if Alec had been insured or not: The price of his insulin had apparently gone up again to $1300, which was more than he had in his bank account. Perhaps he felt embarrassed, too proud to borrow money so soon after finally moving out of his parents' place. Perhaps he didn't want anyone to worry about him, and figured he could keep his blood sugar down until payday.

So he left. He never told his mother and he never told his girlfriend. Five days later, he was dead.

The Insulin Racket [Natalie Shure/American Prospect]

(via Kottke)