Friday, May 24, 2019

"Just take over insulin from the drug companies. Nationalize it."

Strib, LEE SCHAFER writing, yesterday:

Minnesota venture capitalist Andy Slavitt often goes to Washington, D.C., to talk health care policy, informed by his experience as a senior health policy official in the Obama administration.

[...] “Yes, I went full socialist,” he wrote on Twitter after appearing on a panel in April at the National Academies of Sciences, Engineering and Medicine. “I feel the same way about clean air, by the way.”

From what I’ve read, Slavitt is far from a proper socialist. His point may simply be that insulin is too important to too many Americans to be controlled by private companies that are interested in making as much money as they can.

The odds of Slavitt quickly winning this argument seem long, but players in health care may still want to pay attention to this kind of story. Given the structure of the insulin market and the incentives, what has happened seems inevitable. But at some point people won’t put up with any more price increases.

Pharmaceutical pricing has been making headlines for years, but part of what makes insulin so interesting is its origin story in Toronto nearly 100 years ago. The inventors essentially gave away their patent rights for nothing, thinking nobody should profit from a lifesaving invention like this.

Insulin in some ways maybe can’t even be considered a medicine. It’s a hormone our bodies create, although some people’s bodies don’t make enough or their bodies start resisting the insulin they produce, resulting in diabetes.

Scientists have found ways to produce better commercial insulin over the years, improving the lives of people with a chronic condition. That has led to the introduction more recently of products like Eli Lilly and Co.’s Humalog, which seems to often pop up in stories about out-of-control insulin prices.

Lilly launched Humalog in 1996, and between 2009 and 2017 the wholesale price of a single vial went from $92.70 to about $275, according to a story this year by Kaiser Health News. That’s a rate of increase about 13 times the consumer price inflation rate.

As Slavitt pointed out in a Twitter post last week, an annual cost of insulin now might be $4,000 to $6,000. While health insurance certainly helps cover the bills, many insulin users have high-deductible plans.

That leads to another interesting aspect of the story: maybe one in four people, as reported earlier this year in a relatively small study at Yale University, admitted to trying to stretch their insulin, delay filling a prescription or otherwise using less than prescribed, all because of insulin’s cost.

Going one step further, the unconscionable bastards should be put in jail and made to forfeit their ill gotten gains. In jail means the individuals running the rapacious firms, because you cannot put a corporation in the slammer. The bosses, yes, those can be jailed, so do it. If getting to that goal means having to get Trump and cronies out of office and cleaning up both houses of Congress, it's worth the effort and there would be other clear benefits arising.

Shame them for shameful conduct. Using people's life needs, threatening death for profit is awful, so fixing what's wrong with the weapons industry would be a next step after fixing pharmaceutical abuses. That one would require a worldwide fix, but any "culture" that permits and in some sectors even exults death-dealing for profit is sick.