A curious case of Insulin.

I understand that insulin was patented in 1922, and that innovations about how to make insulin and how to administer the drug have each been patented and have each undergone regulatory review. This has increased the cost of manufacture, and manufacturers want to recover the fixed costs of innovation. So they raise the price, and there is limited competition because only the newest-bestest insulin and treatment techniques will be approved by doctors and paid for by insurance companies.

If doctors and insurance companies would approve some Honda-Civic quality insulin treatments instead of only Cadillacs, then maybe some people would be able to pay less for the treatment.

I don't always eat Honeycrisp apples. Sometimes I eat a Golden Delicious or a Gala. Not everyone has to have the best of everything all the time, but with health care we tend to insist that everyone have the Caddy.

We tend to think that there is something wrong with the wealthy having access to higher quality education and health care. If we lived in a completely static world I would be able to sympathise with that completely. But we live in a changing world, and if some people with more money can spend some of it to create an incentive for someone to develop a treatment for a rare disease, then I want to let them do that. Maybe someone I know today won't have access to that drug, but more people in the future will have access than if we don't allow the wealthy to buy it today.

CD players used to be luxury goods that only the wealthy owned. I remember my dad bought one for over $400 in the early 90's. I broke it and felt terrible. Until I realised I could buy a new one a year later for a fraction of the price. Early adopters make access to luxury goods by the masses possible. Now we throw CD players away.

Medicine might be analogous. But the insulin story seems odd, because it has been around for so long. So has music. But we were willing to pay a premium for CDs for a while.

I hear that some people are learning to home-brew insulin. Awesome. But I'd rather it were easier to access last-gen insulin quality and treatment at the current marginal cost of production.