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Expensive Insulin—The Epicenter of a Large, Life-Threatening Problem

JAMA Intern Med.Published online June 1, 2020. doi:10.1001/jamainternmed.2020.1299

For millions of people with diabetes, including those with type 1 diabetes, access to insulin can be a matter of life and death. Shortly after discovering insulin in 1921, Banting, Best, and Collip sold the original patent to the University of Toronto (in Canada) for just $1, with the intention of giving affordable access to this life-saving drug to all individuals who needed it.1In the 1980s, the development of recombinant DNA technology allowed drug manufacturers to inexpensively produce a seemingly unlimited supply of biosynthetic insulin using the cellular machinery of bacteria and yeast.2Today, although a vial of insulin is estimated to cost no more than US $3 to $6 to produce,3its skyrocketing price has threatened access to the drug. A vial of Humalog (insulin lispro), which cost $21 in 1996, now costs $250 to $400.4Insulin pricing exemplifies the problem with a health care system that allows charging an exorbitant amount of money for life-saving medications.

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