Insulin Was Meant To Be A Gift To Humanity

June 25, 2024. By Anuj Jailwala.

2023-24 Schweitzer Fellow Anuj Jailwala

Insulin wasn’t meant to be a gift to the pharmaceutical industry, but it seems to have become one. As a medical student, I help patients most by spending time on the phone. When a new medication is prescribed, I call the pharmacy to see if the patient can afford the out-of-pocket costs or the monthly co-pays, especially for our patients with diabetes. I often find myself down a hole with a patient figuring out what they might have to give up to afford their Insulin. Unfortunately, some patients make it seem like everything’s okay even though they are rationing their Insulin to make ends meet.

According to the CDC, the most recent studies show that approximately 11.6% of the US population has diabetes, with total estimated costs on the US healthcare system of $413 billion. In medical school, it seems like diabetes is a risk factor for every other illness we are learning. It’s a tough cycle. The American Diabetes Association found that diabetes disproportionally affects adults from racial and ethnic minorities and lower income backgrounds. It’s these same patients that have a hard time securing treatment. As a future physician, I may be biased towards believing that healthcare is a basic human right. I think a decent amount of people would agree with me. I’m not sure how many people would agree with extending such a right to specific medications, such as Insulin. Maybe we can debate the idea in the future. A good first step would be making the costs associated with diabetes medications fair.

I was surprised to learn that Frederick Banting originally sold the Insulin patent to the University of Toronto for $1 under the premise that “Insulin does not belong to me, it belongs to the world.” If he was still alive, I wonder how Dr. Banting would feel about the Washington Post’s report that a version of Insulin costing $17 in 1997 now costing $138 today, an increase far above the rate of inflation and with similar costs to production. Manufacturers, middlemen, pharmacies, and insurance companies make it difficult to determine why the price is increasing. This seems to be a particularly American issue. The American Diabetes Association reports that while North America accounts for approximately 7% of the world’s diabetes, it accounts for 52% of global Insulin sales. In Canada, the same vial of Insulin costs much less because the government caps the price.

As a society, we’ve long recognized the importance of balancing morality against ambition and wealth. With regard to Insulin, it seems like we haven’t been able to help ourselves. Thankfully, according to the U.S. Department of Health and Human Services, the U.S.’s new Inflation Reduction Act goes into effect in 2024. The act will cap the out-of-pocket costs for Medicare patients to $35 a month. Although it’s not changing the actual cost of the drug and not helping those not covered by Medicare, it’s an important win for diabetes advocacy groups and their years of work. I applaud Dr. Banting for his gift to our world. I hope we can find a way to respect its origins and the people meant to receive it. It’s crucial for us to continue advocating for our patients that need Insulin through social media and communication with our local and national leaders.

Anuj Jailwala

2023-24 NC Schweitzer Fellow

Wake Forest University School of Medicine, Class of 2025