Among them is Laura Marston, 34, of the District, who has been on insulin for more than half of her life. When she was diagnosed with Type 1 diabetes as a teenager, meaning her body can’t make insulin, she took Humulin, a drug invented the year she was born. With insurance, her insulin cost $10 for a month’s supply.
Shortly after, Marston’s doctor switched her to a brand-new insulin called Humalog, which took effect faster. The drug was just as affordable with insurance.
Then, in 2012, Marston abruptly lost her job and health insurance. She found herself suddenly on the hook for the full price of Humalog, which was listed at $140 a vial — and she needed three vials each month. She managed to obtain a very pricey insurance plan, but the insulin still cost her about $200 a month.
An older insulin could have been cheaper, but she didn’t know it was an option. She had years of experience and comfort managing her disease on her current regimen. But she’s been closely tracking the price of new and old insulins ever since.
“Nor will I, ever again, go on a new insulin. I’ve learned my lesson,” Marston said.
Drug companies commonly say that their rising prices reflect, in part, the costs of future innovation — the research and development to create new and better drugs. That makes Marston feel trapped: Companies say they charge high prices for old drugs so they can launch newer and better ones — and charge more for them, too.
“If the justifications pharma is giving are true, then it never ends for us,” Marston said.
Laura Marston holds up a vial of Humalog, the insulin she takes for Type 1 diabetes. When she was diagnosed at age 14, the list price for the drug was $21 per vial. Now it's more than $250 a vial.
(Jorge Ribas, The Washington Post)
Evolution of insulin
Irl Hirsch remembers when insulin cost 75 cents a vial. The 58-year-old doctor has used insulin for more than half a century and knows firsthand that pricing and access weren’t an issue for much of that time.
Drugstore ads from the 1960s published in The Washington Post advertised insulin for as little as 84 cents a vial — less than a bottle of Breck shampoo, three bags of Halloween candy bars or a can of Suave hair spray. The most expensive version listed in the ad was less than $2 a vial.
For years, the price was affordable as far as he knows, Hirsch says — as it should be.
“This is not a concierge medication,” he said.
As a diabetes specialist at the University of Washington School of Medicine in Seattle and as a patient, Hirsch has witnessed insulin’s evolution: a scientific quest driven by an effort to make insulin molecules that more closely mimic the way the hormone works in the body. The first insulin he took was crude by today’s standards, extracted from the macerated pancreas of farm animals. Some patients had allergic reactions, such as skin rashes.
The modern age of insulin innovation kicked off with Eli Lilly’s introduction of Humulin, in 1982. Using genetic engineering, biologists figured out a way to modify bacteria into tiny, specialized factories that could create insulin that matches the kind the human body produces. Allergic reactions became rare as more people used the newer version.
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