Wednesday, October 20, 2010

The history of the market for injectable insulin

First came the great, long awaited discovery. The NY Times has a great account by Dr. Abigail Zuger: Rediscovering the First Miracle Drug.

It's well worth reading the whole thing, but here's one snippet that caught my eye:

"“In some sense, the breakthrough is the easy part,” he said. “Then the real work begins.”

"For both insulin and the AIDS drugs the big challenge was “getting it from here to there,” Dr. Sepkowitz said. The expense and logistics of large-scale insulin manufacture were initially daunting. But soon trainloads of frozen cattle and pig pancreas from the giant Chicago slaughterhouses began to arrive at Lilly’s plant. By 1932 the drug’s price had fallen by 90 percent. "

Diabetes remains a killer disease, but now it's a chronic disease that haunts adults, instead of quickly killing children. 

"But the miracle went only so far: insulin was not a cure. In 1921, New York City’s death rate from diabetes was estimated to be the highest in the country, and today the health department lists diabetes among the city’s top five killers. Now though, it is adults who die, not children. What insulin did was turn a brief, deadly illness into a long, chronic struggle, and both the exhibit and the book, “Breakthrough,” by Thea Cooper and Arthur Ainsberg, on which it is based highlight the complicated questions that inevitably follow medical miracles: Who will get the drug first? Who will pay for it? Who will make enough for everyone?"

Diabetes is of course one of the big causes of kidney failure, and a real cure would go a long way to easing the long lines of people waiting for kidney transplants while undergoing dialysis. (Here's a good recent article on the various dialysis options from the WSJ.)

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