A 14-year-old boy in Toronto with type 1 diabetes became the first person to be treated with insulin in January 1922.
Diabetes has been with us for millennia, having been identified in Egyptian papyri as well as in ancient Arab, Chinese, Greek and Indian medical works.
Yet globally, the premature mortality rate due to diabetes is increasing while the probability of dying from cardiovascular diseases, chronic respiratory diseases or cancer is declining.
Practitioners of Ayurvedic medicine in India discovered that urine containing excessive sugar levels proved attractive to ants. They named the resulting disease Madhumeha (Sanskrit; madhu or honey).
In the 3rd century BCE, the Greek physician Apollonius of Memphis named the condition diabetes (Greek: to pass through) because the condition is associated with excessive urination. Although originally associated with the kidneys, diabetes occurs when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin that it does produce.
In 1921, a team of four scientists in the Department of Physiology at the University of Toronto discovered how to extract and purify insulin, first from dogs and then from cattle: Sir Frederick G. Banting, Charles H. Best, James B. Collip and J.J.R. Macleod.
In 1923, Banting and Macleod jointly received the Nobel Prize in Physiology or Medicine. They shared the prize money with their collaborators.
Banting, Best, and Collip sold their American patents for insulin to the University of Toronto for $1.00 (Canadian) each on 23 January 1923.
Sir Frederick G. Banting reportedly said, “Insulin belongs to the world, not to me.”
Jump forward to 1941, when a grand jury indicted insulin manufacturer Eli Lilly; distributor Sharp & Dohme; and drug maker and distributor E.R. Squibb & Sons for violating the Sherman Antitrust Act.
All three companies eventually pleaded “no contest,” but never admitted any wrongdoing. In July 1941, newspapers reported that the accused companies were fined $5,000 each [$100,000 in 2022 dollars] and their corporate officers each faced $1,500 in individual fines [$30,000 in 2022 dollars] for the price-fixing charges.
This wasn’t the first time Lilly had attempted to milk excess profits from insulin production. That started in 1923 with its initial experimental license from Toronto.
According to the American Diabetes Association, the price of insulin tripled between 2003 and 2012. A vial that cost $100 in 2009 had almost tripled to $300 in 2021. That’s not insignificant:
Patients with Type 1 diabetes typically require two to three vials of insulin per month, whereas patients who are more resistant to insulin (such as those with Type 2 diabetes) may require six or more.
The issue of excessive drug prices and excess profits is real.
STAT News “examined the provenance of the highest-selling prescription medicines of Pfizer and Johnson & Johnson, the two largest pharmaceutical and biotechnology companies in 2018.”
That research revealed “that these large pharmaceutical companies did not actually invent most of the drugs they sell.”
For the 44 Pfizer products listed in their 2017 annual report, “discovery and early development work were conducted in house” only 10 (23%).
For Johnson & Johnson, only two of 18 (11%) were “discovered in house.”
Note that the BioNTech-Pfizer COVID-19 vaccine was developed by the German pharmaceutical company.
In the United States, 1-in-5 adults 65 and older were diagnosed with diabetes in 2018, an increase from about 1-in-7 in 2000.
The states with the largest percentage (age-adjusted) of adults diagnosed with diabetes are West Virginia, Louisiana, Mississippi, Alabama and Arkansas.
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