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Continued medical improvements deny patients generic insulin
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Many patients who need insulin to control their diabetes cannot afford it, and some are hospitalized with life-threatening illness as a result, according to a recently published editorial.
Generic insulin has been under patent since 1923 in the United States due to incremental improvements made by drug companies, according to the researchers.
In the editorial, Jeremy Greene, MD, PhD, and Kevin Riggs, MD, MPH, both of Johns Hopkins University School of Medicine, wrote that the history of insulin is an example of “evergreening,” in which pharmaceutical companies continue to make improvements to existing medications to keep the drugs under patents for many decades. This keeps older versions off the market because there is less of an incentive to make a generic version that prescribers will consider obsolete.
Jeremy Greene
“We see generic drugs as a rare success story, providing better quality at a cheaper price,” Greene said in a press release. “And we see the progression from patented drug to generic drug as almost automatic. But the history of insulin highlights the limits of generic competition as a framework for protecting the public health.”
Diabetes can often be controlled without drugs or oral medications, but some patients need daily insulin injections. Currently, insulin can costs $120 to $400 per month for patients who have no prescription drug coverage.
“Insulin is an inconvenient medicine even for people who can afford it,” Riggs said in the release. “When people can’t afford it, they often stop taking it altogether.”
In 1921, a University of Toronto medical team discovered insulin and gave drug companies the right to manufacture insulin and patent any improvements in 1923. During the 1930s and 1940s, long-acting forms were developed that allowed most patients to take a single daily injection, and in the 1970s and 1980s the purity of insulin extracted from cattle and pigs was improved. Several pharmaceutical companies have since developed synthetic analogues of insulin.
Kevin Riggs
“As the increasing waves of generic-drug shortages in the past decade also remind us, the drugs that ultimately see extensive generic competition differ from those that attract few, if any, manufacturers,” the researchers wrote. “The history of insulin highlights the limits of generic competition as a public health framework. Nearly a century after its discovery, there is still no inexpensive supply of insulin for people living with diabetes in North America, and Americans are paying a steep price for the continued rejuvenation of this oldest of modern medicines.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
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