The world should hope we don’t fix it. Most of the R&D is done here because the market opportunity is huge. But if that dries up, then costs will go up for everyone else.
Modern insulin analogs were not invented 100 years ago.
Diabetes is a very old disease that ironically is pushing the limits of sensor fusion, but it is very poorly understood by people outside of the Type 1 community.
I personally wish these two diseases were completely renamed as it does a disservice to both Type 1 and 2 patients.
"Unlike many pharmaceutical markets, which see the entry of generic competitors, no generic or biosimilar insulins have been approved in the United States.68 This is not due to patent protection of the existing products.69 The patents for the majority of human and analog insulin products have expired or are about to expire.70 At the end of 2015, 11 insulin products had no associated patents or exclusivities.71 This number has since risen to approximately 17 by July 2019 (including those products where only the insulin pen device is protected), shown in Table 2."
Knox, Ryan. “Insulin Insulated: Barriers to Competition and Affordability in the United States Insulin Market.” Journal of Law and the Biosciences 7, no. 1 (July 25, 2020): lsaa061. https://doi.org/10.1093/jlb/lsaa061.
This is corroborated by Health Access International's deep dive from several years ago:
"There are no patents on any formulations of human insulins. Based on the filing date and a 20 year patent period, patents on analogue insulins already on the market in the US and Canada have expired or will soon expire in these countries and elsewhere (Figure 1)."
https://haiweb.org/wp-content/uploads/2015/05/HAI_ACCISS_fac...
https://haiweb.org/wp-content/uploads/2016/04/ACCISS-PatentR...
And yet, despite this, the US remains alone in having prices not only multiple times the cost of any other country, but increasing at an alarming rate (tripling over the past deacde) while prices stay the same or fall elsewhere. There's zero shortage of analysis and ink spilled in both the popular press or in academic analysis/ peer-reviewed press on why markets are so fucked in the US pharmaceuticals, so I just assume any talk about how R&D cost recovery happens to only be a thing in the US (and somehow accelerating despite new products not being released) to be either extreme low effort or just plain bad-faith (which are you anon?), but for those reading along that might be interested, a few places to start to do their own research if they really care about the topic:
Mulcahy, Andrew W., Daniel Schwam, and Nathaniel Edenfield. “Comparing Insulin Prices in the United States to Other Countries: Results from a Price Index Analysis.” RAND Corporation, October 6, 2020. https://www.rand.org/pubs/research_reports/RRA788-1.html.
Hirsch, Irl B. “Insulin in America: A Right or a Privilege?” Diabetes Spectrum : A Publication of the American Diabetes Association 29, no. 3 (August 2016): 130–32. https://doi.org/10.2337/diaspect.29.3.130.
Schneider, Tyler, Tara Gomes, Kaleen N. Hayes, Katie J. Suda, and Mina Tadrous. “Comparisons of Insulin Spending and Price Between Canada and the United States.” Mayo Clinic Proceedings 97, no. 3 (March 1, 2022): 573–78. https://doi.org/10.1016/j.mayocp.2021.11.028.
Herman, William H., and Shihchen Kuo. “100 Years of Insulin: Why Is Insulin So Expensive and What Can Be Done to Control Its Cost?” Endocrinology and Metabolism Clinics of North America 50, no. 3S (September 2021): e21–34. https://doi.org/10.1016/j.ecl.2021.09.001.
Luo, Jing, and Aaron S Kesselheim. “Evolution of Insulin Patents and Market Exclusivities in the USA.” The Lancet Diabetes & Endocrinology 3, no. 11 (November 2015): 835–37. https://doi.org/10.1016/S2213-8587(15)00364-2.
You can have the ‘old insulin’ for something like 25$ / 1k units. But it’s very hard to use relative to modern analogs, so people prefer modern analogs.
Edit: Minus points for facts that disrupt the narrative. I love it.
https://medcitynews.com/2019/03/lilly-to-introduce-lower-pri...
The problem is that there isn't competition on the market for this product. The Open Insulin people were trying to make it available to the public but they are stuck trying to get through the regulation.
It's entirely possible that if we got rid of the regulation then the whole problem takes care of itself and it becomes a non issue.
Humalog and other types of the same exact insulin are pennies on the dollar in other countries with very different healthcare compensation programs between the vendors and purchases. It's bizarre to say the least.
But basically you are correct that regulation is the largest barrier to price reductions. Patients pay the price of FDA regulation (for better or worse). That’s not really the drug companies fault.
Are you actually suggesting people are going into debt [1] and killing themselves[2] just because they prefer modern analogs?
[1] this post
[2] https://www.independent.co.uk/news/world/americas/us-politic...
The new stuff lets you eat a wider range of foods without having to time everything precisely or worry as much. about hypoglycemic events.
I don’t know if that’s a preference or if it reflects the way Drs treat T1 patients.
>I don’t know if that’s a preference
so which one is it?
In the long run, these drugs go off patent and become low cost and highly available.
Yes, people today will struggle, maybe even die today. But in a generation more people will thrive.
BioNTech SE
An der Goldgrube 12
55131 Mainz, Germany
Specifically with COVID-19, there was a lot of global collaboration.
But that said, the key point remains; the US is where the money is. The US underwrote the mRNA platforms with a guarantee of 10 billion in revenue while the EU haggled with AZ for like 1 billion.
In the process, the US developed an entire scalable delivery pipeline for mRNA that didn’t exist prior.
Cuba, of all places, have pretty great medical R&D?
Don’t think your statement means too much.