Insulin is free now?

The plummeting stock value and ever increasing price of insulin

It’s World Diabetes Day today and it’s not often that anything to do with diabetes fills me with glee, but here’s a thing that happened recently. 

You have probably heard about the palaver going on at Twitter since Elon Musk bought it last week. If you haven’t, the short of it is that he introduced a thing where you could buy a blue check mark, previously an official verification of identity for famous people and companies, for US$8/month. Someone bought a verified blue tick for a fake account impersonating pharmaceutical giant Eli Lilly and tweeted that insulin would now be free. 

For context, insulin is very very not free in the United States. It costs so much that some diabetics are forced to ration out doses, which means they become sick in the short term and risk serious long term complications. Some die.

Eli Lilly & Co was forced to tweet a retraction, but the damage was done. Its share price plummeted to the tune of billions of dollars, and that’s what the glee is about. Because Eli Lilly is doing America dirty. The exorbitant price of insulin doesn’t reflect the actual cost of insulin, nor is it even a small profit margin commensurate with running a business. It is blatant price gouging. 

I often think about healthcare in the US, because I have multiple chronic conditions, one in particular which would kill me quickly if untreated. I was diagnosed with Type 1 Diabetes at the age of eight. 27 years ago. I have had times when I’ve been at death’s door, in the emergency department, in a diabetic coma. I’ve had times when I’ve been unemployed or under-employed and wouldn’t have had or been able to afford health insurance, such as when I was a single mother to a young toddler, or when I was studying. I see my GP regularly, not to mention the hospital appointments that I have with the endocrinologist, or having preventative laser eye surgery, or the podiatrist, or the dietitian. I’ve been hospitalised several times with Diabetes Ketoacidosis, spending up to a week in hospital receiving lifesaving care.

Almost all of it is free. The most I have to spend to stay alive is ~$20 for the GP appointments and repeat prescriptions a few times a year. Even the prescription fees at the pharmacy are non-existent when I get my scripts at the Countdown pharmacy. (Otherwise it’s $5 per item on the script for 3 months worth - still far more affordable than paying the non-subsidised cost.)

I don’t know how I could afford to live if I was in America. 

A display of diabetes technology over the years at the Wellington hospital endocrinology clinic. I remember having to squeeze blood onto a plastic strip, time it, wipe it off, and then compare the colour of the strip to the chart on the side of the box to see roughly what my blood sugar was. Now machines can test blood sugar levels within seconds. I used to have to measure insulin out with syringes, flicking them to get rid of potentially deadly air bubbles. Now I just dial up a number on an insulin pen.

It’s hard for me to fully comprehend what it’s like for people who live in a country without public healthcare, which I’ve relied on for 27 years. I didn’t see the film Purple Hearts, because so many people said it was thinly veiled military propaganda, but it features a ‘marriage of convenience’ where a diabetic is struggling to afford her insulin and marries a Marine for his military health insurance. I can imagine a world in which I wouldn’t have been able to leave my husband if I had relied on his employment and insurance when I was a stay at home parent to our baby.

The corporate greed of Eli Lilly (as well as Novo Nordisk and Sanofi, which manufacture the two types of insulin I use) has horrific effects on American diabetics, and the fact that one little tweet had such a significant impact on the company’s value, and has news outlets and others talking about the cost of insulin is important. 

Me the first time I wore a Freestyle Libre continuous glucose monitor, October 2020.

It’s not all roses in New Zealand. There are incredible technologies out there for diabetes management that we don’t have public funding for (which are funded in Britain and Australia, and no doubt other countries too). For example, I pay $105 a fortnight for a continuous blood glucose monitor that has vastly improved my diabetes control. It’s worth it for me, but I wouldn’t have been able to afford it a few years ago. I would love to have an insulin pump but they cost thousands of dollars. Nonetheless, blood glucose meters are funded, and manual insulin pens are also funded, so diabetics in NZ can keep themselves alive and aren’t forced to skimp on insulin or stay in marriages for insurance purposes. I hope that CGMs and pumps get fully funded here, but I don’t see it happening for a long time. It is a hard and constant battle, living with diabetes, and adding prohibitive cost to the already overwhelming list of things to worry about and balance out is supremely unfair.

The Nobel prize-winning doctors and scientists who formulated injectable insulin in the 1920s refused to profit from their invention; selling the patent for $1 to the University of Toronto. They weren’t saints, as the first linked article explores, but their work has saved millions of lives, including mine. If I’d been born 70 years earlier I wouldn’t have made it to the age of nine.

So this World Diabetes Day I’d like to wish pharmaceutical corporations a giant ‘fuck you’ and doctors, scientists, and nurses a heartfelt ‘thank you’ for saving my life and helping me live it.