Insulin is not a single drug. Discounters such as Walmart already offer low prices for generic insulin. The expensive branded forms have different release profiles which are more effective at controlling blood sugar in some patients.

https://www.cnbc.com/2021/06/29/walmart-unveils-low-price-an...

While we should do more to improve insulin affordability, the pricing is a bit of a distraction from the core issue. While type-1 diabetics will always need some exogenous insulin, the majority of diabetics are type-2. And research has shown that the majority of those patients can put the disease into remission with lifestyle changes. That is where governments should be focusing.

https://www.virtahealth.com/research

Many companies manufacture insulin. There's also not just one kind. Two pervasive types are fast acting and slow acting, the latter typically used to provide a low level continuous boost throughout a day. Manufacturing high quality product in volume isn't particularly easy because it's a biologic drug requiring genetically modified organisms to create the protein, typically E Coli, and purification to human injectable standard is costly, requiring removal of the pieces of cells that were used to make it, including endotoxins in the case of E Coli.

Beyond that, there's an easy way to guide analysis of what appear to be excessive costs in any market: find out where government force has screwed it up. It will always be the cause.

I’m seeing the price per vial of generic insulin lispro (Humalog) for roughly $20 a vial. I’m not sure how many vials a person needs but that’s not completely nuts.

Yeah they’ve invented newer more expensive types of insulin that better control blood sugar, and they are continuing to invent newer types that are even better. Which I think is great and allowing there to be a financial incentive to create new and better insulins.

Welcome to crony capitalism. It's America's specialty.