liquid gold has become more literal than figurative
NPR has a very interesting interview with Dr. Jeremy Greene who has just
published a paper about the history of insulin in America. The reason Dr. Greene decided to research and write up such a
paper was simple.
Greene, a professor of medicine and history of medicine at Johns Hopkins University, started asking patients at his clinic in Baltimore why they had so much trouble keeping their blood sugar stable. He was shocked by their answer: the high cost of insulin.
Greene decided to call some local pharmacies, to ask about low-cost options. He was told no such options existed.
The history of insulin in America is an interesting read. The short version is that early production of insulin for diabetes was developed by extracting insulin from cows and other animals' pancreases. The drawbacks had to do with the purity of the insulin—leading to the need for multiple daily injections for some and cases of minor allergic reactions in others. Over time scientists developed purer insulin drugs, leading to fewer bad reactions.
"All of these innovations helped to make insulin a little bit safer, a little bit more effective," Greene says.
Then, in the 1970s, scientists developed a new technique they could use for insulin production, called recombinant DNA technology. It involves putting the human gene for insulin into bacteria, which then produce large quantities of the hormone.
Then, a funny thing happened, Greene says: "The older [animal] insulin, rather than remaining around on the market as a cheaper, older alternative, disappeared from the market."
While Greene doesn't offer specifics, clearly companies didn't think the older and cheaper versions would be profitable. But this isn't simply a case of people being denied cheaper medicine because companies just want to upset a drug. The public has been under the false assumption that newer drugs are better drugs.
But newer drugs aren't always better, says Dr. Adriane Fugh-Berman, a professor of medicine and pharmacology at Georgetown University. That's partly because drug companies don't have to prove that a new drug is better than what is already on the market — they just have to prove that it's not worse.
"In government-funded studies that have compared older drugs to newer drugs, often older drugs come out looking better or equal to newer drugs," Fugh-Berman says
Interestingly enough, animal derived insulin has its benefits. For some people it can help cause fewer cases of hypoglycemia.
As the older versions have vanished in the U.S., newer versions have stayed expensive. The drug can cost up to $400 a month. Because of that high cost, many of the estimated 29 million people living with diabetes in the U.S. can't afford it.
With the rates of people being diagnosed with diabetes
rising sharply since the Affordable Care Act, it means very little if they cannot afford their meds.