On Tuesday afternoon, the Yale Law School Solomon Center for Health Law and Policy held a virtual panel marking 100 years since insulin was first discovered.
The panel, which featured experts in law, medicine and history, drew an attendance of around 40 people. The experts recounted the history of insulin since it was first discovered in 1921 and discussed different ways of making it more accessible to those who need it.
“100 years ago, a lifesaving medicine was discovered, yet people in the richest country in the world are still dying because they can’t afford that,” said David Beran, a researcher and lecturer at Geneva University Hospitals and the University of Geneva in Switzerland.
In addition to Beran, the panel featured multiple Yale professors and other academics from Harvard Medical School and Vanderbilt University.
The panel was moderated by Ryan Knox, senior research fellow at the Solomon Center who first became interested in insulin in 2014 as an undergraduate at Boston University. He said he hoped the panel would “add to the ongoing discussion and raise the issues that are more unique and more specific to insulin as we are trying to address drug pricing overall.”
The insulin market, both in the United States and around the world, is controlled mostly by three major companies: Novo Nordisk, Sanofi and Eli Lilly, sometimes called “the big three,” according to Beran. The panel discussed the many factors that led to this lack of competition in the market by making it difficult for new companies to break in. Panelists mentioned factors including regulatory elements related to the complexity of the insulin molecule, patented devices used to administer insulin, patients who may be reluctant to change from one insulin product to another and difficulty in getting new companies offering slightly different versions of insulin to be accepted by insurance companies.
Insulin prices have risen and are now prohibitively high, according to associate professor of medicine Kasia Lipska ’97, who said that of those in her diabetes clinic, costs have forced 25 percent of those who were prescribed insulin to ration it.
The panel also discussed several possible solutions to prices in the United States, including having the government regulate prices directly or manufacture insulin itself, or setting maximums for how much individuals can be charged out of pocket.
Lipska expressed concern with the last possibility, pointing out that it only benefits a limited number of insulin users — for example, the plan will not help those without insurance. “In clinical practice, these types of solutions never seem to work for the patient in front of me,” she said.
Daniel Kevles, professor emeritus of history and adjunct professor at the Law School, noted that when insulin was first patented in 1923, the original researchers did so specifically to ensure that they controlled the patent and could guarantee that insulin would continue to be readily available.
Beran also pointed out the differences in prices between countries like Switzerland and the United States, where prices can be several times higher.
“[Price regulation] sets the rules of the game,” he said. “I think that’s what’s missing now in the U.S.”
The next Solomon Center event will be a roundtable discussion this Thursday about long-term care in the wake of the COVID-19 pandemic.
Bradley Nowacek | email@example.com