Diabetes

 As you know, there are two types of diabetes: Type 1, in which the immune cells destroy the pancreatic cells that synthesize and secrete insulin; and Type 2, in which pancreatic cells still produce insulin, but its effectiveness is compromised. Type 1 used to be called “juvenile” diabetes, and Type 2 was called “adult-onset” diabetes. Here’s something I didn’t know: adults can get Type 1 diabetes and children can get Type 2 diabetes.

 Anyhow, in the past, people used to be treated with cow insulin because there was no source of human insulin. But a lot of people were allergic to cow insulin. A scientist by the name of Arthur D. Riggs figured out how to use recombinant DNA technology to convert bacteria into factories that produce human insulin. He made his discovery while working at the City of Hope National Medical Center in Duarte, California. In order to produce the human insulin, Riggs partnered with scientists at the biotech company Genentech. In 1982, the FDA approved a human insulin product called Humulin.  

 The partnership made Genentech and Dr. Riggs rich. But Dr. Riggs declined the opportunity to make even more money working in the for-profit sector. After his contract with Genentech ended, he returned to City of Hope full time, living in the same modest house for fifty years. He died this year at the age of 82. He donated $310 million to City of Hope, most of it anonymously.

 The price of insulin has nearly tripled over the last fifteen years. A single vial of Humalog (a fast-acting insulin) cost $21 in 1999. In 2019, it cost $332—an increase of more than 1,500 percent. In Canada, the price didn’t budge. The difference is that in the U.S., there’s neither a real free market nor government price controls for insulin. Instead, there’s an oligopoly of three drug companies—Eli Lilly, Novo Nordisk, and Sanofi—that appear to set prices in sync. In other words, price fixing. I’m sure this is not what Dr. Riggs had envisioned.

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