Affording To Live…

GOP lawmakers–including, of course, Indiana’s two Senators–recently blocked a Biden Administration effort to cap the price of insulin for Americans with private health insurance. (Americans on Medicare will see their out-of-pocket costs decline, thanks to other provisions of the Inflation Reduction Act.)

GOP opposition to the measure, which I can’t help thinking of as a manifestation of the Republican “Let them eat cake” approach to policymaking, reminded me of a recent discussion with my sister. Her doctor had rordered some medical tests, and when she  was scheduling them, she was told that one of them–a test for cancer!–wasn’t covered either by Medicare or by her private insurance. The test was $300, and she told me that her first thought was “I can afford this, but what about all the people who can’t? What about  people who don’t have an extra $300 but do have cancer?”(Fortunately, she didn’t.)

This conversation, rather obviously, wouldn’t have occurred in most Western democracies, because in those countries, health care isn’t just for people who can afford it.

When it comes to capping the price of insulin, the influence of Big Pharma–particularly Indiana’s own Eli Lilly–was front and center with the GOP.

Lilly’s enormous profits owe a lot to the high price of insulin. That’s especially ironic, given the generosity of those who first held the patent.

Before the 1920’s, a diabetes diagnosis meant a death sentence for people all over the world. The main treatment was starvation diets to prolong the inevitable.

In 1920, a Canadian physician and scientist named Frederick Banting began working on an idea to isolate and extract insulin. He worked in the laboratories of J.R.R. McLeod, a professor of physiology at the University of Toronto. The medical student Charles Best aided him in his work to test out insulin on dogs. Chemist James Collip worked with Banting and Best to purify and refine insulin for clinical trials in humans.

On January 23rd, 1923 Banting, Best, and Collip were awarded the American patents for insulin. They sold the patent to the University of Toronto for $1 each. Banting notably said: “Insulin does not belong to me, it belongs to the world.” His desire was for everyone who needed access to it to have it.

In order to make insulin widely available, Eli Lilly, Sanofi and Novo Nordisk were given the right to produce it, and they’ve turned it into a massive profit generator. As the linked article reports, “by 1923, insulin was the highest-selling product in Eli Lilly’s history, and profits from it accounted for over half of the company’s revenue.”

And that brings us to the recent refusal of Indiana’s Senators and other GOP recipients of Lilly largesse to ensure insulin’s affordability.

As The Intercept reports, Lilly Endowment–ostensibly separate and independent from the company–is not neutral when it comes to funding entities opposed to controlling the price of medications. The Endowment,”led in part by former Eli Lilly executives and still financed by corporate stock options” funds think tanks that “work to shield corporations from taxation or government regulation,” and has given millions of dollars to libertarian groups that lobby against price controls on insulin, categorizing those recipients as “community development organizations.” (The Endowment is also the largest shareholder of Eli Lilly, Inc., holding 104,161,053 shares worth approximately $31 billion.)

The Federalist Society, for example, has received over $1.5 million from the charitable arm over the last decade and is listed under “community development” grantees of the Lilly Endowment. The Washington, D.C.-based group is a professional society for conservative attorneys, with an eye toward pro-business ideological positions.

The Federalist Society funds included a $150,000 grant last year, at the same time that the group was sharply criticizing a new Minnesota law that forces manufacturers to provide free or affordable insulin to low-income residents. The law “[inflicts] an injustice upon companies that are regularly demonized in the media,” an attorney for the Goldwater Institute writes on the Federalist Society’s website.

Last year, Eli Lilly collected over $2.4 billion in revenue from its insulin products, including the brand Humalog, with roughly $1.3 billion of that from U.S.-based sales.

“One vial of Humalog (insulin lispro), which used to cost $21 in 1999, cost $332 in 2019, reflecting a price increase of more than 1,000%. In contrast, insulin prices in other developed countries, including neighboring Canada, have stayed the same,” wrote S. Vincent Rajkumar in the journal of the Mayo Clinic in 2020.

There’s much more detail in the linked article, and I encourage you to click through and read it. That said, the real issue is the one my sister identified: if government is supposed to provide a physical and social infrastructure within which citizens can flourish, isn’t access to health care and lifesaving medication as essential a part of that infrastructure as police, firefighters, roads and bridges?


  1. Now they start the ads claiming that if the evil government regulates the price gouging, new medications will not be developed. The reality is that many new meds are developed by government funded university labs and not the pharma folks.

  2. Yes, Patmcc is correct. Lilly and the universities receive R&D funding from us taxpayers, but once patented, all profits go to Lilly. It’s socialism for the oligarchy – rugged capitalism for the people.

    And, as I said yesterday, try protesting by NOT paying your taxes and see what happens.

    Here’s the other issue for diabetics, it’s an endocrinology problem. The food we eat makes it worse, but so does the pollution in our air, water, and soil. Especially our water supply.

    My endocrinologist told me over 30% of males with diabetes suffer from depression due to depleted testosterone. All the ED pills out there correct this problem, but it’s just a symptom of too much estrogen in the water due to plastics and fertilizers in the water supply.

    Yes, the oligarchy is creating patients for other oligarchists. It’s insidious.

    The whole system is corrupt and feeds off each other. This is why oligarchs like Lilly and Koch energy spends billions fighting any progressive legislation that addresses the corrupt system.

    Guess who else profits from all the corruption – the media industry.

    Once you see how it is all interconnected and owns both political parties, unions, media, etc., you’ll see the difficulty in changing it.

    You might want to fire up the Matrix trilogy. 😉

  3. Great, informative contribution today, Todd…except for your usual rant about the media.

    I used to work for a subsidiary of Eli Lily in San Diego. IVAC invented and built the first electronic IV controllers and thermometers. They were the pioneers in the biomedical industry. I met some of the senior executives of that time – circa 1980 – 1984, and even pitched a million dollar manufacturing project. They approved before I finished my presentation. Sadly, the local management wasn’t on board and the project languished for a year. Typical middle management.

    But the more important point today is the confirmation of the theme of PROFITS BEFORE PEOPLE. Those doctors who sold their insulin patents for a dollar are from a dying breed of real professionals dedicated to doing good. As Rebecca Costa states in her book, “The Watchman’s Rattle”, if there’s no immediate money in something that does good, it doesn’t get done. That’s what capitalism has become. I’ve excoriated that subject in my book, “Racing to the Brink: The End Game for Race and Capitalism”.

    What a sad state of affairs we’ve become. How pathetically craven our biomed industry is. And, as Todd often says, the media is in it for the money too. The truth doesn’t sell. It’s hard to be positive in such a cynical world.

  4. Marketing committees and VPs will come up with “good reasons”, but it is really just selfish, protective greed.

  5. I recall a horrible incident two decades ago involving a young woman who could afford only limited amounts of insulin. So she rationed it. She died from diabetes later that year. The story was on PBS. Last week I was charged an extra 150 for my insulin due to some formula by big pharma. I could pay. Not everyone can!

  6. And just this morning I saw, but did not read, an AOL news item regarding seniors can buy Viagra for $0.87; strange the item was no longer available when I tried to return to learn more after see the issue on the blog this morning. Or; maybe not so strange. The priorities of Republicans and Big Pharma have been providing easier access to all forms of Erectile Dysfunction while cutting birth control for women. Those old white men again!

    Sex and money vs. life-and-death prescriptions priced beyond the ability to afford has been a priority for Republicans who consider that as health care. All part of corporate business of health care in this country. I remember when Indianapolis was proud to be the home of Eli Lilly, maybe they deserved it or maybe we didn’t know the truth.

  7. While Lilly Endowment has done great things for the city and the state, in the recent decade they have dived deep into extremist conservative issues, helping to fund climate change denials for one thing. It would be interesting to know how such a shift took place and who all was behind it.

  8. As my late lab chief at the NIMH used to tell us, our job was to do the risky experiments. Once we found something that promised to work, it was the drug company’s turn to finish development and testing — and make the profit.

    That ethos hasn’t changed at NIH or NIMH, but at the universities, the paradigm has. Now it is discover something and create a start up. The days of selling patents for $1 or not taking out a patent are gone. The last patent-free breakthrough was monoclonal antibodies, but it was a screw up by the would be patent owners and not altruism. Any drug with ‘mab’ at the end of its name is thanks to that scientific breakthrough.

    But patents are only part of the problem. I use a generic drug that only costs a few pennies less than the name brand did — and it is a grandfathered drug (used for many decades before it was turned into a pill and patented). Another drug, high dose Niacin, used to treat high triglycerides, is another drug that is so expensive, it is much cheaper to just buy the vitamin tablets (not covered by insurance).

    Insulin, including Humalog, is off patent. There is simply no excuse for the price gouging.

    BTW – JoAnn – if someone is buying generic Viagra for $.87, they are buying it from a shady off-shore site. The price is about $2 per pill. The number 87 is stamped on the 50 mg generic Viagra pill as an identifier (color, shape, and imprint identify pills in pharmacies).
    Also – Viagra and it’s cousin Cialis are not covered by medicare or private insurance. Cialis is also used to treat the condition BPH, without the undesirable side effects of other medications for that condition, but it is a “sex” pill so it will never be covered by insurance. Just FYI.

  9. Change the formula or add a benefit to the lists of treatable diseases and get a new patent. That’s what pharma is doing with drugs that should be generic. Patent law is one area that truly needs an overhaul. Senator Warren, what are you waiting for?

  10. I wouldn’t read too much into selling their patent for $1. It’s the token amount for employees assigning their rights to their employer. Something to do with basic contract premises, where both sides have to contribute something of value. What UoToronto, in turn, sold it to the pharmaceuticals for is more relevant.

  11. Autoimmune diseases run in my family’s DNA so being female, I got the thyroid disease gene mutation. Every single female on my mother’s side gets some form of thyroid disease either Hyperthyroidism (Graves) or Hypothyroidism (Hashimoto’s). My niece had Graves and when she had her thyroid removed 20 years ago, she turned Hypo. So we’re both on medication for life.

    My sister’s granddaughter turned 7 recently and during the first lockdown in 2020, my niece took her to the ER because her daughter was very ill. It was Juvenile Diabetes. She’s got one of those pumps and is stable now but this child did nothing to “get” diabetes, she inherited the gene mutation.

    If the family lived in the UK, their insulin would be life sustaining so free to the patient. My medication for thyroid disease is 30 (dollars) for 100 pills in this country. In the US, those same exact pills cost 200 dollars for 28 pills! Not even a month’s worth!

    The US needs to get this life sustaining medication to patients for free especially when Pharma companies like Lilly are making a killing on them. Enough! Greed and profit has destroyed so many lives and patients have enough stress managing their life changing diseases without the choosing between food and medicine.

  12. Oh, the conservatives are just trying to protect people from sugar addiction. All insulin does is stuff sugar into fat cells. It makes you fatter. The real cure is to stop sugar addiction, and the best way is cold turkey. It takes dedication and persistence because it takes 3 weeks to 3 years to kick the habit. Try to find foods that don’t have a little extra added sugar … a great marketing scheme to feed the addiction.

    Insulin is a bad treatment for an addiction. But Lilly and pharma makes a fortune off it, so you don’t see anybody actually talking about it. Remember the television cereal commercials? “Sweeet!”

  13. I was in a discussion the other day and it got around to the tax base in Indianapolis’ Center township. A lot of the real estate is occupied by state and federal government buildings. But a lot of real estate is occupied by “Not-for-Profits”. The obvious are charitable organizations and churches. Not so obvious are hospitals with billions of dollars of revenue. One of the people in the group is a Russian immigrant and she asked why to not-for-profit organizations get such favorable treatment, especially like hospitals that make billions in revenue.

    I used the example of the “The sisters of Mercy” that, a hundred years ago, ran an infirmary at the convent. That charity organization morphed into the billion dollar hospitals we see today. I went on to explain that the idea is, that because people believe the government can’t do it all, these organizations get special treatment under the tax code to provide charity care. Well, in 2022, I suspect the charity care provided by IU Health amounts to a fraction of a percentage of their bottom line, and I suspect part of that is just uncollected debt that they knew was not worth selling to a collection agency.

    It is expected in the American system that the private sector will form that social safety net and that activity is encouraged by special tax treatment. This makes wealthy people feel good when they can give to a “charity”. It make politicians feel good when they say that people have “options”. Guess what? In most western governments they have realized this is an unrealistic expectation with out some government intervention. Shelia’s blog is a perfect example of the failed American social safety net.

  14. Eli Lilly’s presentation to Indiana and the country as the great benefactor is real. However, Lilly giveth with one hand and taketh away much more with the other. As a Member of ALEC (American Legislative Exchange Council) they financial support the organization and once sponsored a national meeting here. ALEC writes a great deal of the boilerplate legislation for state legislatures that is destroying education and much, much more for those with the least money and power.

  15. I didn’t know that the Lilly Endowment had donated money to the Federalist Society. So now the fruits of their donations have resulted in the overturn of Roe, and Lilly is “punishing” the state of Indiana by declaring that any expansions of the business will not be happening in the state. Interesting. I realize that they are separate organizations, but you’d think that with all those PhDs over there that they would have thought through the potential unintended consequences. But it is all about money, isn’t it.

  16. Dan, I totally agree with you. For years I have advocated to have EVERY owner of EVERY piece of property pay property tax. All should pay their fair share for police and fire protection, local government, street and roads maintenance, and the PUBLIC schools.

  17. It has been thus for virtual aeons: Insurance companies used to “own” the old GOP, back in the day,
    and Big Pharma, as well as fossil fuel companies get huge largesse from the gov’t, as they then happily
    screw the folks who pay their fair share of taxes to the gov’t.
    Nixon did not help the situation, when he signed the legisalation creating HMO’s, stating that he was doing it
    as a favor for his “friend” Joe Kaiser.

  18. The business mantra, make more money now no matter the impact on anyone else, ever, is part of the American lexicon now, arguably the global lexicon. Of course, it’s code for redistributing wealth up and away from workers, to those more entitled to the bulk of it. The fact that the same redistribution is from darker to lighter skin shade, is just an “unintended” consequence.

    Cultural beliefs rarely get seriously questioned as to if there are any possible other ways to live. They are our, that’s just the way things are done around here.

    I suppose it’s possible that every other way does have a downside, maybe even more serious than the consequences of this way. I can’t say that I know for sure.

    But also, maybe not. Someday we’ll know more.

  19. Sometimes I can only cry.

    And, by the way, I am a Vietnam vet who has long received excellent health care from the VA.

    One reason some people bash the VA is that it proves, “socialized medicine” works.

    As the VA’s own site says:
    “The Veterans Health Administration (VHA) is the largest integrated health care system in the United States, providing care at 1,298 health care facilities, including 171 VA Medical Centers and 1,113 outpatient sites of care of varying complexity (VHA outpatient clinics) to over 9 million Veterans enrolled in the VA health care program.”

    Just last week I got new trifocal eyeglasses at virtually no cost, and this afternoon I will get a 6-month dermatology cancer scan for a $15 co-pay.

  20. @Vernon Turner …… Media gets $5 billion a year for TV drug advertising. I suspect that dampens any negative reporting by the major networks regarding big pharma. It’s hard to imagine that $5 billion doesn’t buy some influence.

  21. Len; my daughter suffers from congenital heart failure, Lupus, Diabetes, cirrhosis of the liver, emphysema, asthma, white lung disease, has several serious spinal problems and recently diagnosed with stomach cancer. All but the stomach cancer diagnosed and treated at Community East Hospital; about 8 years ago they informed her she had Hepatitis C and looking at past blood tests found that they had missed the Hep C 2 years earlier. The Hep C was the source of many of her diagnosed illnesses. She transferred to Eskenazi Hospital who provided much better treatment for all of her many health problems which continued to worsen due to Hep C. Then Harvoni appeared on the market; a miracle drug which actually does CURE Hepatitis C, the cost was $1,152.00 PER PILL. The 4th or 5th time she was taken to the hospital near death Eskenazi doctors found someone to cover her co-pay of $700.00 PER PILL; her Hep C was cured but the missed diagnosis and delay to cover her treatment caused all other health problems to worsen. She has only a matter of time and spends much of her income on medications. Further research about Harvoni showed that it costs $17.00 per pill to manufacture. The obvious goal was PROFIT, not saving lives. So if people buy Viagra or any other drug from “off shore sites”, that may be the only way they can afford medication so good for them.

  22. The comedian Lewis Black said it best, “…we have decided to make a gold mine out of illness.” It’s good for profits if you’re sick, but if you’re too sick you are uninsurable. Remember the golden rule is really, “He who has the gold, rules.” No surprise it was a republican who taught me that phrase.

  23. Numerous benevolent nonprofit organizations exist to help low income citizens obtain bare minimum basic necessities to sustain life. I believe there would not be a need for many of those organizations if people in our country were paid at least a living wage and our government didn’t allow corps to get away with not paying their fair share of taxes. Whatever help people receive in the form of food stamps and rental assistance still doesn’t enab!e them to cover basic expenses or have a chance to get ahead. Instead we taxpayers are forced to subsidize huge corporate profits while those corporations also price gouge us. Then they create their feel good/ look good nonprofit foundations that make truly benevolent orgs beg for money to help the less fortunate. Then they must publicly thank those ‘generous’ corporations for donating to help the people they robbed.

    It is all such a bogus cycle of making the rich richer and stealing from the less fortunate that don’t have the power/money to fight for change.

  24. Medical patents assure a means of circumventing some of the strictures of Sherman, and Lilly has plenty of company in overcharging those who are frequently the least able to pay. Government intervention in pricing is called for whatever the aegis or ism under which such intervention is undertaken. On the other side of this socioeconomic equation and in these inflationary times, perhaps a new minimum wage of $25 an hour would both alleviate poverty and allow the sick to pay for their medication.

  25. Those who jump on the anti-GOP bandwagon regarding Big Pharma need to do their research. Big Pharma owns ALL the politicians, even the Congressional Black Caucus gets their pockets lined by Pharma.

    The oligarchs cannot afford only to finance one side of the political aisle. The Democratic Party is just as guilty.

    @Vernon – the media loves pharma ads! Don’t fool yourself.

  26. The cost to the consumer that derives from patent-protected monopoly pricing might be ameliorated. Each patent application should be audited to learn the value of the public’s investment in the science that led to the patent. That value could be reimbursed to the public treasury in one or a combination of many different ways. Fair is fair. If the public pays for research, it should benefit financially from that investment, if there is profit involved.

  27. I’ve said it before and I’m sure I’ll say it again. A health CARE system is necessary. A health INSURANCE system is simply obscene.

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