Democratizing Insulin

Imagine if you knew a drug could save your child’s life but it was too expensive to afford. That’s the reality for many people in America today. That drug is called insulin, which is used to manage blood sugar in people with diabetes. For millions of people with Type 1 diabetes and an increasing number with more advanced forms of Type 2 diabetes, insulin can be the difference between losing your eyesight, losing a limb, or even losing your life.

What’s particularly sad about this situation . . . some would say shameful . . . is that insulin is not very expensive to manufacture, and the research costs associated with bringing it to market have long ago been recovered. There is no reason that can justify the prices we pay today.

Insulin was discovered by Frederick Banting and Charles Best in 1921 at the University of Toronto. Once Banting and Best realized that insulin could save the lives of so many people who were dying from diabetes, they gave all the rights from their amazing discovery to the University for $1 to ensure that this new miracle drug would be available to everyone at the lowest possible prices.

If Banting and Best were alive today, they would be sorely disappointed and angry at what became of their discovery. Today, insulin is so expensive that many people, especially those without insurance or who lack financial resources, have to go without or ration it. Over the last 20 years, the average list price of insulin has increased by 11% each year and the average cost per year exceeds $6,000, putting it out of reach for many Americans. And when people who need to take insulin have to go without taking it for periods of time, longer term health and care costs are dramatically higher, and their quality of life drops from the resulting complications.

Who’s responsible for this? There are many places to point fingers – manufacturers, distributors, pharmacy benefit managers, and health plans. In combination, they have not only pushed prices up but have little interest in lowering them.

Many people and organizations have tried to solve this challenge over the years and have been unsuccessful. Why? Many years ago, Upton Sinclair wrote, “It is difficult to get a person to understand something when their salary depends on them not understanding it.” Because so many of these organizations profit handsomely from not doing the right thing . . . they seem to have lost the ability to understand what the right thing is.

As recently as two days ago, during his State of the Union address, President Biden addressed insulin pricing and proposed a solution (which remains to be passed into law) that would limit the maximum amount paid by an individual to $35 a month or $420 a year versus $6,000. We applaud the President’s focus on solutions for people with diabetes. However, the challenge is that his solution doesn’t address the root cause, rather it would have taxpayers footing the bill . . . which would be billions of our dollars. Similarly, Walmart introduced dramatically lower priced insulin recently showing how retailers and corporations can put health consumers first. But we’re ready for the next step and we believe that innovation should start with the private sector.

Enter Civica. Some years ago, having had enough of overpriced drugs that were out of reach of many people who needed them, a group of like-minded individuals and organizations truly focused on improving health and care created Civica to manufacture biosimilar drugs. Civica is a non-profit, non-publicly traded company with a mission to “ensure that essential quality medicines are available and affordable to everyone.” Their success in driving down the cost of highly priced drugs has been amazing. The result . . . millions of people are getting access to affordable medication therapy. And now, working with a consortium including some of the country’s largest health systems, innovative health plans, charitable foundations, and JDRF, we’re going after insulin pricing.

Civica will develop and commercialize three biosimilar versions of insulin --- aspart, lispro, and glargine --- which represent approximately 80% of insulin prescriptions in the U.S. and bring them to market as early as 2024. Civica will charge the lowest sustainable price --- $30 or less --- which is what most people today pay for their insurance co-pays. Civica will, as my friend and the individual who spent years leading this effort, Dan Liljenquist, Chief Strategy Officer at Intermountain Healthcare, likes to say, “democratize insulin,” making it available to everyone at the same affordable price.

Today is a good day and will lead to great days ahead for people with diabetes. In addition to our initial launch support of this program, my Foundation is adding a $5 million grant to accelerate the deployment of the first insulin doses from Civica for 250,000 people in underserved inner city and rural areas across the United States. I’m hoping we will be joined by others who understand that we can, today, take on big and important health problems and make a difference. So, until there is a cure, let’s give people living with diabetes the insulin they need to stay healthy, happy, and productive.

Thank you, Dan. Thank you Civica. Thank you to all those who made today possible.

Glen Tullman
Chief Executive Officer
Transcarent