Insulin’s deadly spike
Insulin’s deadly spike
Rising prices have forced many patients to question whether pharmaceutical companies have too much control.
He’s dizzy, tired and sick to his stomach.
It’s only been a few hours since his last dose, but junior Brett Marsh is feeling the effects already.
Living with type one diabetes is an obstacle Marsh has to overcome every day, and the daily doses of insulin are a big aspect of Marsh’s routine.
Recently, the cost of insulin has increased exponentially. According to CBS News, the price of insulin has doubled in the past five years. The drug is a necessity for people with diabetes, but it is becoming difficult to obtain. From rationing, to abandoning insulin altogether, people like Marsh are putting their health at risk because the financial burden is just far too high.
There are two types of diabetes: type one and type two. Type one is insulin-dependent while type two is not. The body produces insulin in order to keep blood sugar levels in a normal range. An inability to produce adequate amounts of insulin can result in serious consequences, according to School Nurse Julie Doerge.
“When you get high blood sugar over an extended period of time [due to a lack of insulin], you end up with the bad parts of diabetes, which is losing your vision, losing a limb or going into kidney failure,” Doerge said. “There’s all kinds of terrible things that can happen.”
Diabetes is a multisystem disease that affects your entire body, according to Dr. Prabha Mohan, sophomore Rishi Mohan’s mother.
“It affects your heart,” Mohan said. “It affects your blood vessels, and blood vessels are everywhere. So, [diabetes] has just made it very difficult for people to survive. Even keeping diabetes under control is a challenge.”
Diabetes is a hardship that millions of Americans have to face and control on a daily basis. Marsh became one of those millions when he learned that he had type one diabetes in second grade.
“I was drinking water and asking to go to the bathroom all the time during class,” junior Brett Marsh said. “Eventually, my teacher got really mad about it, so she told my parents that I was going to the bathroom all the time. They took me to the doctor, and they told me, ‘You have diabetes.’”
From then on, his life was changed forever. Marsh would have to monitor his insulin levels every day and rely on an insulin pump. If Marsh goes without insulin for a few hours, the impact is almost immediate.
“I was sleeping over at a friend’s house for four hours, barely anything,” Marsh said. “My insulin pump failed at five a.m., and I left at nine a.m. When I got home, I felt awful, and I just started vomiting for five hours straight.”
From sleepovers, to daily activities, Marsh’s insulin levels are a central focus of his life because of the impact it has on his body. This harsh reality gets in the way of the simplest of tasks.
“Anytime I try to leave to go anywhere, if my blood sugar is low, I can't drive,” Marsh said. “Because if you start driving [with] low [blood sugar] and the cops think you’re driving wacky, that's a DUI. I think I've been late to every single yearbook workday, and I'm always late to ACT tutoring.”
People with diabetes have to receive multiple doses of insulin each day, but the exact amount varies from person to person. This daily care is extremely expensive and the bills can quickly add up.
“There's the pharmacy cost, and then there's your insurance cost,” Doerge said, “and a lot of people have had to go to these high deductibles — five or ten thousand dollar deductibles. So, you're out of pocket a lot. If you think about a student at St. Mark’s, he has a whole lifetime ahead of him to pay, and I don't think it's sustainable.”
Multiple doses day in and day out over the many years of one’s life costs an enormous amount. That cost has skyrocketed in recent years. Fifteen years ago, a patient with diabetes could pay less than $200 for a 20-milliliter vial of Humulin R U-500, a type of long-acting insulin. Today, that same vial costs almost $1,500, according to Elsevier’s Gold Standard Drug Database.
“A lot of my patients who can’t afford it go across the border to get insulin,” Mohan said. “They get it from Canada. They get it from Mexico. They get it from India. The same companies are doing it over there. How come they can provide it so much cheaper a few miles above the border in Canada but not here in the U.S.?”
The Three major insulin providers, Eli Lilly, Sanofi and Novo Nordisk, hold the vast majority of the $27 billion global insulin market. The large corporations are able to maintain this monopoly by tweaking their insulin and filing for new patents.
“I would say at least in the last ten years the big pharmaceutical companies have not made any major changes in the insulin world,” Mohan said.
Many factors affect the price increase besides the companies wanting to make a profit. Insulin, like many other medications, is not direct-to-consumer, so the price set by the companies making insulin is not the price people pay.
“I think you have to keep in mind that it's not as simple as the drug companies wanting to make more money,” Doerge said. “There are a lot of people involved in it.”
Insulin was never supposed to cost so much. Frederick Banting and his team of researchers invented insulin in 1921, and they sold their patents for the medicine to the University of Colorado for $1 each. They hoped that by selling their patents for next to nothing insulin would be available to everyone, regardless of financial security.
But now, things are different. Insulin is so expensive that people are forced to buy it from foreign countries where it is cheaper.
“Even in Britain right now with Brexit, there are people stockpiling insulin because they get their insulin from Ireland and the border is about to be closed,” Doerge said. “You can't really stockpile insulin because it doesn't last forever, but they're just trying to think, ‘How are we going to live? Where are we going to get our medicine from?’”
So what’s the solution? Will the major insulin producers lower their prices? Marsh believes laws need to be put in place to make a change.
“Until there's something, legislation-wise that changes, nothing is really going to happen,” Marsh said, “because there's nothing that the big companies, technically, are doing wrong. It is wrong, but there's nothing legally wrong with what they're doing.”
At least for now, insulin is extremely expensive, and it will stay that way for the foreseeable future until a major change is made.
“It's really tough,” Marsh said. “It's really just unfair because people can't help needing it. You can be in complete control and still have horrible days and have to use more insulin, so it's just really not fair.”