The Bastards That Kill Diabetics for a Profit - podcast episode cover

The Bastards That Kill Diabetics for a Profit

Dec 20, 201839 minEp. 39
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Episode description

In Episode 39, Robert is joined by Katie Goldin (Creature Feature) to discuss the bastardful tale of Insulin.

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Transcript

Speaker 1

M everybody. I'm Robert Evans, and this is Behind the Bastards, the show where we tell you everything you don't know about the very worst people in all of history. And this was the highest energy introduction I've ever done. Sophie is laughing at me over in the corner. I don't understand why I thought it sounded pretty cool, fonds esque.

This is a show where I read a terrible story about history, about someone bad, or someone's bad, or usually a bunch of bad people doing bad things to a guest who is coming in cold and today that very cold guest is Katie Golden. Might be Katie coming in Colden anyway. She's birds rights activists on Twitter, where she advocates for birds even though as I understand that millennials are saying birds aren't real, those are lies, Those are

communist lives, communists lies. She's also the host of another podcast on This Stuff Network, Creature feature great podcast about animals doing weird ass shit science and stuffy science. Step. Yeah, we talked about animals and drugs. It's great to do drugs. It is great to do drugs. Uh. Speaking of drugs that are great to do today we're talking about insulin, which is not a well, I mean, it's fun and that if you need to take it, you die not taking it, right, I think it's fun not to die.

It is fun not to die, relatively fun not to die. Yet it was fun not to die of insulin shock or diabetic comas and stuff. Not fun. So I'm just going to get into it. On November seventeen, several parents brought the ashes of their dead children to the doorstep of the offices of Santa Fee, a pharmaceutical company that produces insulin. Sanofie and other insulin producers like Eli Lily have been steadily raising the prices of their insulin for years. Because of this, insulin can cost as much as a

thousand dollars a month for people without decent insurance. Oh my god, that's I I can't imagine spending a thousand dollars a month on anything of there than like rent, I guess, but even even a pretty expensive town. So you're essentially renting your own body, like you want to keep living in your body. A thousand bucks rent, yeah, get you a decent place like in Culver City. I feel like when I lived in Culver my rent was

about thousand months. Yeah, so it's it's frustrating, right, it's a little frist It's a little frustrating because clearly, I mean, no country on Earth can afford something like single pair of healthcare anywhere. It never be done. Um, and our government needs its money for stuff like I did you hear about when that hurricane hit the East coast the military forgot to remove like eleven two and they all got destroyed. That was one point four billion dollars. Well,

they gotta could have bought a lot. They gotta put another billion dollar coin in the f twenty seven vending machines. The funniest thing is there's no vending machine. We can't make the parts for them anymore, stop manufacturing any of the things that they are placeable. So, oh good, but we can't afford to help people with here. I'm sure we'll find a way to dig deep into the earth and find things that will destroy our planet that can

make new airplanes. Yeah, I'm sure we will. Now, people with type one diabetes do not naturally produce insulin, which is a magical substance that lets sugar not kill us instead of be delicious. I'm a fan of insulin yeah, I'm a big fan. Now, when insulin costs as much, if not more than rent, many people stopped taking it as often as they should and ration their precious supply so that they can afford to do things like exist in a capitalist society and pay the aforementioned rent that

we've been talking right. Also, um food, because here's the thing. Here's the thing is like insulin is basically useless if you don't eat, if right, because then you don't get any sugar, which without insulin. You know, it's like, well, I mean, Katie, I was really sympathetic with these people, but I think you've identified a way that they could not need insulin, which is the no eat diet. And you won't of insulent shock. You'll just die of starvation.

I do think they'll die. Oh yeah, you're right, probably medically speaking. Yesterday, Well, neither of us are doctors. No, you're not a doctor. No, I'm not a doctor. Fantastic, but I do read web and b like a lot. Well, then you're basically a doctor, fantastic now. Alec Rashawn Smith was one of the young people who got caught in this deadly dance with a necessary drug. When he was twenty six, he aged out of his mother's health insurance. One month after his birthday, he died of diabetic shock.

Smith's mom, Nicole, was one of the grieving parents who brought her son's ashes to Santa Fee that November day. She told the Boston Globe she wanted the company to quote, no, the price of their product is killing people when it's intended to save lives. Antoinette Worsham, whose twenty two year old daughter Antavia died last year while rationing insulin, told another interviewer that for people like her daughter, it's either pay your rent, pay your car payment, or get your medication.

Diabetes is currently the seventh leading cause of death in the United States. I heard this story of this guy who because like I've heard this thing where people say, well, just go fund me if you can't afford your medication instead of healthcare. Yeah, there was a guy who did that very thing and he short, yeah, fifty dollars short

of reaching his goal in the way. It was his monthly calls, right, and he needed insulin to survive, and he didn't have the money to pay for it, and he was like taking care of his ailing mom too. So that's part of the reason. He didn't have that high of an income, so like he tried to get it. He was fifty dollar short of reaching his goal. So you know how go fund me works. Then you get none of that money and he died. Yeah he should. We will be talking about him a little bit later.

Oh good. So clearly this situation is fucked right that it seems fun. Seems like we can all get on the same page. There, it's like a little like just maybe a smidge fun the old F bomb. Yeah, so what is fun? Why is this so messed up? People are dying? Well, I'm saying that that's why it's messed up,

Like why why would because insulin is not a new drug. Usually, when you've got like a case of this where something is incredibly expensive, it's number one, a drug that very few people need, and number two a drug that's really new. Because then you know, that's the way that these patents work.

For most medicines, After about twenty years after their invention, a generic patent comes out that's fairly affordable, right, right, That's one of the ways our system is supposed to work, so that that keeps drugs affordable for normal people, but also gives an incentive for companies to invest in research

and whatnot. Right, that is the promise in our capitalist system is that you will get better medicine under this system, because companies will find new medicines, you know, essentially due to the profit motive, but because of the way that this generic drug like that. That's the idea, Right, that's the promise that we've all bought in this system. Otherwise poor people are middle class people would never be able

to afford medicine exactly. Insulin has existed for nearly a century, but there is no cheap generic insulin available in the United States today. We're going to talk talk about why. But first we are going to talk about the invention of insulin as a medicine. Most cursory coverage of this will give credit to Dr Frederick Banting, some mention a small team of scientists who work with him. When I decided to look into it this story, it's because I

ran across a tweet about Banting. It stated that he had given the invention of medical insulin to the world, put it in the public domain, essentially as a gift to humanity, because he didn't want to profit off and he wanted people to be able to get medicine, and so the tweet was basically like this wonderful founder gave insulin to the world and wanted people to have it for free, and then the evil pharmaceutical companies fucked it up, which is true, but not detailed enough. So I wanted

to know what that story was. Let's get the details. So let's get the diets. That's what we are going to be talking about today. Now, like most things you find on social media, that version of events is not quite accurate. Insulin did not have a single inventor, and while pharmaceutical companies are the ultimate bastards here, the full story is weirder, sadder, and more infuriating than that. In Dr Frederick Banting was the first person to isolate secretions

from isolate cells, the cells that make insulin. He suggested these might hold a treat for diabetes, and he was basically right. He came up with a plan to tie up the pancreatic ducts of laboratory dogs and make their pancreases overproduce the cells that contain insulin until everything else in the pancreas dies. That was the idea, right, we did dogs die. The hope was they wouldn't. This is actually initially envision is like its beautiful one to punch

because we make these dogs pancreases overproduced the cells. They didn't really know. Insulin was like insulin was a theoretical substance they called, I think insuline. There was an e. I don't know how they pronounced it, but it was

spelled insuline. And the theory was like, if we make these dogs pancreases produce a bunch of these cells, we can take the pancreases out and they will contain concentrated versions that then we can extract whatever in the pancreas shoot it into a diabetic It will make them better. So the idea was, we gotta take these dogs pancreases out in order to do this thing, but then we can just give them what we make from it, and

if it works, it's a beautiful one too. Thing we don't have to kill the dogs will know that we've got a treatment for diabetes because these dogs won't be able to pre sinsulin. After we stuck up their pancreases.

Seemed like it was like a nice circle that they had that they had developed um Now, the problem with Banting's plan is that he was not up to date on the work other scientists were doing testing blood sugar to find diabetes and patients Banting did urine testing to find out blood sugar levels, which is not just did you just like taste it, because I know I just tasting their well, one of the one of the things is like, um, if you taste your urine or smell

your urine, it tastes sweet. It's a sign of diabetes because it's like I think it's called hyperkalemia, and it's because you're finding more sugars in your urine. You know, I've only drank my pea once. Uh for my book A Brief History advice, because I was I was trying an ancient Meso American treatment where you mix tobacco, garlic and urine as a treatment for constipation. It works, it makes you very ill, but functions and its intended purpose. I was not paying attention to how sweet it was.

There was a lot of garlic in there too, right, The garlic is well, the garlic is going to cut the sweetness as it's cooking. You know it's gonna But it sounds like what you're saying is that we should all be drinking r P every morning to learn if we are just a little bit a little bit. Just don't drink a lot of don't drink a lot of your taste a sample. That's the new behind the bastard's motto. Sample your own, sample your P, sample your P. Right,

this will be marketable. Let's get a T shirt going, sample pie. Start that process. Okay, So if he's shaking her head, she's not happy with that. All right, let's move on to talking about diabetes some more. So. Banny was the first guy to start isolating the slate cells that contain the hormone insulin, but the amounts he was able to get were too small to really be useful in his His work had a bunch of holes in it.

You know, he was good at a couple of things, but he was almost taking a lot of other areas. So we had to partner with other scientists. Professor John James Rickard McLeod was the head of physiology at the University of Toronto. McLeod agreed to give him laboratory space for his experiments, and he also served as sort of the manager in over. So you're for the whole project because Banting was an unstable personality of an asshole. So McLeod,

you means some scientists are assholes. Yes, really, the kind of guy who would who would poison the dog's pancreas in order to try to solve it as ease isn't great at working with other people. Interesting, I mean er intuitive, but you know you need to do the research. This horrible thing has to happen. But the kind of guy who's like, oh, yeah, what if we just toward your dogs to figure this out, it's probably not fun to work with. And he wasn't maybe just a little too.

He's got tunnel vision there. He's just so focused on that insulin. Everyone else is like, but dogs, there's just dead dogs everywhere. I know. I'm almost corpses, just crumpled up dog. We get it right, the dogs won't die. He's just at his desk and he's like, damn it, and he crinkles up another dog and tossed it. Just the trash can full of dead dogs. Sophie is really

not loving this conversation. There is a dog in the room, but because Anderson is a dog, does not understand what we're talking about which is the mercy of being a dog. Now back to the story. Banting came to hate McLeod because McLeod was good at talking and explaining their work to other people at conventions. Uh well, Banting was an

introvert and a big old nerd. So Banting started to worry that like McLeod was going to outshine him and get credit, even though remything I've been able to read, McLeod was just about, oh, yeah, this is a really important cause. I want to do everything I can do to make sure that this research gets completely He goes like on Reddit to complain about him, like what a stupid science child, Banting? Would a thousand percent be a

Reddit dude? Although we'll get to yeah a second. So Banting had an assistant, a guy named Charles Herbert Best, who did Charles Charles though I thought this is a fancy form of you know, Charles Charlie char No, No, not at all, plain old Charles like an American reading podcast for three hours. So Charles Herbert Best was his assistant, and Best did a lot of crucial work in the process. And it seems fair to say in general that all three men were critical parts of the development of insulin

as an effective medication. When they started their work, the existence of insulin was still not a confirmed fact. We knew that the islets of linger Hends, which is the name of those little cells, produced something that helped regulate sugar. Insulin was at this point still just the name of a hypothetical substance scientist thought existed. So just as a quick side note, the islets of Lingerham, imagine them as like these little islands, that little British islands microbial size.

Langerham expedition goes out and discovers like little white blood cells and naval hats. Sorry that I just had to get that image, Duke. Yeah, you're right, that's yeah, that's how it was discovered. Tiny tiny explorers, tiny explorers. Banting, McLeod and Best started work in May nine. It did not go well at first. I found an article in the Journal of Clinical Chemistry that went into the discovery of insulin in exhausting detail. Here's how they described the

few months of work. After legation of the ducts, the dogs were expected to recover from the surgery and live more or less normally. After several weeks, the pancreas and able to secrete fluid into the duadendum would gradually atrophy and would be removed in process to extract the internal secretion. The extract would then be administered to other dogs made

diabetic by removal of the pancreas. It was a laborious task for someone with no experience and animal work, and it did not go well at first his Banting struggle to improve his surgical technique. By the end of the second week, seven of their tin dogs had died. To resupply the animal cages, they resorted to buying dogs in the streets of Toronto. The three dollars with no questions asked, we need dogs, We need a lot of dogs. It's just some guy with an overcoat, Like, hey, I heard

you was looking for dogs. This doctors never worked on dogs. He's killing the left and right. It's just like opening up the trench coat and I'll give you nine dollars. Is that enough for three dogs? They're like off brand dogs, Like no, no, these are dogs. Three of these are cats. Sophie really not happy with me right now. We should be good. We should be good. Sorry, we had to

deal with some noise. We also learned something that I'm just coming into which is that the guy have been calling McLeod is is McLeod So everybody have a good real mcclaude, aren't you. Everybody have a good laugh, good old laugh at old old Robert Evans's expense not knowing enough about scotsman. Uh so, Um, you may have already noticed that this is horrible because dogs are good, and

medically torturing them to death is bad. But the world is a gigantic wheel of pain and brutal crush and cruelty, and sometimes is sometimes necessary in order to save the lives of billions of diabetics. Uh so, yeah, that's just the way the world works. Sometimes dogs continue to diet rapid rates throughout the research, but Banting and Best were eventually successful in creating an extract that seemed to work at regulating the blood sugar of dogs who'd had their

appendix is removed. They debuted their work to an audience. It was one of those things you've seen on TV where the doctors do their work in like a big pit surrounded by an auditorium full of other doctors and pharmaceutical industry people. Old timey thanks they had like they had instead of bags of popcorn was like bags dead dogs, bags of dead dogs, and those little circle things on their heads that old timey doctors wore. One man present at this early insulin demo was George H. A. Cloud's,

a research director for Eli Lily, the pharmaceutical company. After the presentation, he sidled up to McLoud and asked if his company could work with the scientists in order to get a product on the market sooner. McLeod turned him down, claiming that the work was not far enough along yet. This seems to have pissed Banting off, largely because McLoud

had spoken for the group. Banting was also frustrated by the fact that McLoud was a much better presenter than he was, which made Banting worry that other scientists would get the credit and popular acclaim Banting felt he deserved. So like Banting is like watching as McLeod is like riding in on a skateboard and like hey dudes, and like like he's just like curing and he's too nervous to talk to anyone, so we can't answer the questions which McLeod can. But then he's like he's taking credit

for me. He's getting shoved in science lockers. He totally would be an in cell. I'm calling it now. The inventor of insulin is an in cell. Yeah, yeah, perfect involuntary cellular biologist. Nice, nice, nice, really good. Uh So it took a lot more work and a lot more dead dogs before Banting and his team made more progress

on insulin. By nine two, they were close to a breakthrough, and Banting decided that McLeod was the center of a gigantic conspiracy to steal the credit for their immediate breakthrough. Banting and his team started to work with another scientist named colep Colip had figured out how to actually purify the pancreatic extracts that they were making and create usable insulin. In January of n the group carried out a clinical

test of their new extract that failed disastrously. The bad results sparked a fight, and during a heated exchange, Colip threatened to leave the band and take his purification method with him. He threatened to patent it's that they'd have to pay him to use it. So was Eli only the yoko oh no of the situation or they were just sparking a fight, Yes, but they didn't They hadn't done anything yet. Calyp was kind of the well, no Banting was, the Banting was the Yoko was both Yoko

and Lennon Ouch. That's a that's a harsh personality to have. He seems like a rough guy to work with. So uh yeah. Here's a quote from that journal article about the invention of insulin. This was a breach of the agreement between Calyp, Banting, and Best to exchange all results. Banting never showed a righteous anger or noted for meekness or restraint. When he felt wronged, exploded with clinched fists, and in a moment Calyp was laying dazed on the

floor of the laboratory. Fortunately he was not seriously hurt. There are no contemporary records of this encounter, no reference by Colip, and only two accounts, neither of which, according to Bliss, should be considered entirely reliable. One was by Banting and his unpublished nineteen forty memoir, the other by Best in a letter to Sir Henry Dale dated February twenty nine. So he like beat him with his fists,

but he didn't hurt him at all. He beat him with his fist and I think it probably hurt pretty bad, but calyp was too felt bashful about it and didn't write about it. Banting is the only one who wrote about it, because I'm thinking maybe his fists were like soft and small as apricots, and it's just like that, like I solved as small as acot oh apricot apricot

handed Banting. That's it's possible too. It's possibly just sucked it punching right, But either way, I just liked this story of like these genius scientists creating one of the most valuable medicines in history, fist fighting each other over the credit at one point. It's beautiful. Now, the four scientists did eventually work out their disagreements enough to allow

them to get back to work. Banting and Best would de pancreatized dogs, Colip wouldn't extract insulin, and McCloud would coordinate everyone's research, everybody doing playing to their strengths, play into their strength, like you're great at deep pancretize deep pancretizing. Is that he was the best to pancretizer. Nobody's questioning Banting's ability to take out dogs. You can PANCRETI tin pancreas as a per minute. If you're if you've had a dog with too many pancreai, this is your man.

He's got ten ppm. So um. Banting developed a hatred for the professor that made his life unbearable. Banting became an alcoholic, regularly drinking himself to sleep. Since it was prohibition, he had to steal liquor hundred and ninety proof alcohol from the laboratory. He later said, I do not think there was one night during the month of March nineteen two when I went to bed sober. Well, that seems like a not great practice. It just seems like March.

I mean, March is my birthday months, so I rarely go to bed sober on March. And he says he was making life like unbearable for the other scientists. Was he like playing drunken pranks on them? Like, no, he's just being a really angry as I throwing dogs at the crossing dog corpses left and right. You sons of bitches. Yeah,

but their work bore fruit. On May third, Cloud presented a paper to the Association of American Physicians The Effect produced on diabetes by extracts of pancreas the paper described their discovery of insulin and it's by now clear therapeutic success on treating diabetes. The Cloud received a standing ovation, the first one given in the entire history of the society's existence. Banting and Best weren't there to see it.

Banting had refused to go because he's a caddy bitch and badgered his colleague and not going as well as a protest against McCleod. Yeah, it's it's pretty missed. That rare scientist standing ovation, which are radical because they're just like air horns. Belas so uh. At this point, via the team reached out to Elit Lily for help figuring

out how to produce insulin in large quantities. So they figured out how to extract insulin, they could prove that it was a thing that had a therapeutic effect, but they were like, we don't actually know how to like produce a medicine for a shipload of people were just torturing dogs over here. Although at some point there's a

horrible note in the story. I was reading it like they were using cows at one point and they needed like the fetuses of young cows to get the pancreases out, and they were like, thankfully, lots of slaughterhouses get the cows pregnant before they kill them to make them fatter. So there's tons of cow fetuses. Well, isn't that nice worked out? We're swimming in cow fetuses who are eyeballs

and cow fetuses. Three dollar dogs. They just have cow fetuses in the bullet like the front desk of these farms, like take a cow, cow fetus, too many cow fetus. Fetus just going to be going into sausage. It is sausages. It's just cow fetuses and pig assholes. That does seem like a like turn of the century movie like Too Many Cow Too Many cow fetuses, starring Jamis and Jimson speaking of cow fetuses. Uh, wonderful products that help people. It's ADS time. We're back. We're back. ADS are done.

As has happened? ADS has happened back to insulin banting. Call Up and Best were awarded a patent on January three. They did not give their patent to the public domain as a gift demand kind, but they did sell it for a dollar each to the Board of Governors of the University of Toronto. Their goal bargain. That's bargain, great price for all of insulin solid. Their goal was for the medicine itself to be used for the benefit of

mankind and not pure profit. They deserve credit for getting all all getting on the same page about one thing, which is that insulin is too vital to be something that's purely a profit thing right now. They basically gave the patent to the university so they could restrict the production of insulin to reputable pharmaceutical companies. They wanted to stop quacks from trying to make their own products and then selling people poison Brandon as right, just like liquefied dog. Yeah,

we're just killing out. The pan also made it impossible for drug companies to produce a weaker version of the drug and still use the name insulin, So that's good. As messy as they were, it does seem like these guys Hearts were in the right place. Eli Lily got a non exclusive licensing contract and for a while insulin was a reasonably affordable medicine. After a couple of decades, the University Toronto's patent expired and any pharmaceutical company was

allowed to produce it. This is the point at which the market should have been flooded with cheap generic versions of insulin, but something else happened instead, Eli, Lily and other pharmaceutical companies started tweaking insulin, making minor improvements or alteration through the delivery system, tiny changes that maybe maybe

it work slightly better here and there. Uh the time, these updates strategically so that insulin has remained for all these different companies a patented medication from right today right Because so I used to do medical learning materials for pharmaceutical companies, and one of the things I learned is

about the process of doing generic medications. So, if you have a patent and you want to extend it beyond what the law intake, right, what you do is you can tweak it very slightly, make like you said, minor improvements, or you can even not tweak it, but say it's useful for something else like um like antidepressant medication and

being used for postpartum depression or PMS. Well that's clearly different, right, And then then you can cling on to that patent long for a much longer than what is the spirit of the law, which is right right, which is a long time too. So it's and that prevents other companies from creating biosimilars which are like, not the exact same formulation, but kind of a similar one. And it's really terrible because it can well, let's continue with your horrible story. Now,

it's not impossible. It's some point to say. One of the differences with the case of insulin is that it's not impossible for a company to go back to the original recipe and make a generic version of insulin. That is something that's totally possible. To what these companies are doing is that they're just never releasing a generic. They just keep tweaking their insulin. Every time it comes up.

It gets old enough. So basically, any pharmaceutical company could try to make their own insulin, but any organization that could afford to do so would be a pharmaceutical money And in that case, why not just whip up their own kind of insulin? Twigg a little bit, the charge a lot of money. Why make a generic? Why help people?

Why help people? As a pharmaceutical Now, this is the conclusion reached by doctors Jeremy Green and Kevin Riggs, who published a study in the New England Journal of Medicine accusing the pharmaceutical industry of using a process called evergreening to extend their patents, particularly the patents. For instance, this is the name of what you were just explaining. I'd like to quote from a summary of their article in

Medicine Express. This keeps older versions off the generic market, the authors say, because generic manufacturers have less incentive to make a version of insulin that doctors perceived as obsolete. Newer versions are somewhat better for patients who can afford them, say the authors, but those who can't suffer painful, costly complications.

We see generic drugs as a rare success story, providing better quality at a cheaper price, says Green, an associate professor of the history of medicine at Johns Hopkins University School of Medicine and a practicing internist. And we see the progression from patent to drug to generic drug is almost automatic. But the history of insulin highlights limits of generic competition. Is a framework for protecting the public health now.

Riggs and Green were both inspired to study this problem because so many patients were coming into their Baltimore area clinics with blurred vision, weight loss, thirst, and other symptoms of unmedicated diabetes. They realized that a ton of people who should have been on insulin were opting to suffer instead of go broke. Green and Riggs set out to learn why generic insulin wasn't a thing, and they traced

out a legacy of evergreening. In the nineteen thirties and forties, pharmaceutical companies developed long acting forms that allowed most patients to take a single daily injection. In the nineteen seventies and eighties, manufacturers improved the purity of cow and pig extracted insulin. Since then, several companies who developed synthetic analogs

biotech insulin is now the standard in the US. The authors say patents on the first synthetic insulin expired in two thousand and fourteen, but these newer forms are harder to copy, so the unpatented versions will go through a lengthy Food and Drug Administration approval process and cost more to make. When these insulins come off the market, they

may cost just less than the patented versions. Riggs and Green right now, generic versions of medication often bring the price down to something like cheaper, so when cheaper insulin comes in, it's going to be this kind of biotech insulin that's just cheaper as opposed to so essentially still twice as much as at least so like, so companies could be making these generics, but there's just no monetary incentive for them, so it's not profitable, right right, I

mean you might get a profit, is not as profit right because if you're a small enough company that you would want to maybe do it, like, then you couldn't. You don't have the resources. You don't have the resources. So if you're a bigger company, you're like, well, there's more demand than would mean, like people wouldn't be voting

with their wallets, so they'll still sell it. Yeah, and uh, you know, insulin has improved a lot over the years, you know, to give some credit to the pharmaceutical companies. We no longer have to torture dogs to make it. It's not all derived from animals anymore. Human insulin can be produced using recompetent DNA technology that basically turns bacteria and insulin factories. It's pretty cool. The they deserve to be rewarded for the innovations, or at least the scientists

do for the innovations that have been made to insulin. UM. But with each innovation, essentially older but still working forms of insulin UH stop being used as opposed to just being sold as generics because it's not profitable to run them. I read a Business Insider article on exactly this problem. It notes that the number of Americans with diabetes has tripled since nineteen eighty. You might expect that to make insulin cheaper, since it's now easier to make and being

produced on an economy of scale. Instead, the prices sword astronomically. Some insulin products have seen their price triple since two thousand two. Yeah. Levi Mere, one popular medication made by Novo Nordisk, cost a hundred and twenty dollars for a hundred units two twelve. Today, the same amount costs three hundred dollars. Now, as we know, a generic versions of medication often helpfully, you could buy so many dogs with that.

You could you could buy three dollar dogs even, yeah, even a three dollar dog, which is an expensive dog. In the insulin, you could buy a hundred your own yeah yeah. Now, as we noted earlier, generic versions of medication can lower the price by as much as eight percent. This would be life changing for someone with diabetes. Struggling to deal with an extra five hundred and seventy dollars a month insulin bills. That's what the average diabetic American

past Jesus Christ. So you're talking four hundred bucks that could be back on the can be spent on dogs, could be spent on dogs, or maybe food and your or maybe food and rent. But yeah, there is no generic insulin, and Riggs and Green suspect that this is because no pharmaceutical company considers making such a product to be a worthwhile investment. On February two thousand seventeen, Shane Patrick Boyle posted a go fund Me to raise enough money from one month of Inceland. For him. This meant

seven hundred and fifty dollars. As we already discussed, he came up fifty dollars short, and he died a couple of weeks later of diabetic keto acidosis. The current Secretary of Health and Human Services, appointed by Donald Trump and confirmed by Congress is Alex Azar. Before he got into politics, Mr Azar had a different job. He worked for Eli Lily from two thousand seven to two thousand seventeen. Starting in two twelve, he was the president of Lily USA.

The company's largest division. I'd like to quote from an article in the Nation. During Azar's tenure, Eli Lily raised the prices on its insulence in the United States by twenty point eight percent in two thousand fourteen, sixteen point nine percent in two thousand fifteen, and seven point five percent in two thousand and sixteen. Eli Lily's biggest seller, humal log insulin, is now off patent, but rather than becoming cheaper, Human Logue costs more now than when it

first came to market in nineteen ninety six. When Azar started working at Eli Lily in June two thousand seven, the list price for a vile of human Logue was seventy four dollars. When he quit in January two thousand seventeen, it was two hundred and sixty mine. So have they made changes to human Logue. It's just they're just jacking the price. Oh my god, It's like that's shouldn't that be sort of like I'm murder I mean, the Health and Human Service as secretary did it, So how could

it be that? Well, you know how people get so worked up when they see stores jack up the prices of water before disaster. This is like that every day, every single year for twenty years, and then you become a secretary at about Oh that is really depressing. It's horrible. Yeah, oh that was That was a very sudden right into the wall in there. No, I mean, there's not much to say. I read the story about those parents bringing their dead kids ashes to a pharmaceutical company and read

about it, and it's fucked up. That is so terrible heavy I mean alex asar and everyone else involved in these companies and changing the prices of them as a piece of ship. Because I mean, so one thing is to be clear about diabetes. There are two types. So there's childhood diabetes where there's no lifestyle. Yeah, Type one, they're born with it. You just random chance. Should he spend that big roulette wheel mother nature just dick and around.

But I mean that's not to say people type two deserve it or anything like that, because like I mean, it's such an irony where we have such little restrictions on all these foods that are high in sugar and killing us with you know, just creating these high incidents of diabetes, and then the medicine that can save your life is also just the price is jacked of Jesus Christ. That is, if that isn't an indictment of our society. I don't know. Yeah, it's pretty pretty horrible and gross. Yeah.

So if you're diabetic, so are you're dealing with this? If you happen to know where alex Asar's car is. I'm not going to say, commit a crime on alex Asar's car, but maybe do crimes? Do crimes? Not? Maybe I'm just do crist generally, do cry generally do crimes? I mean my goal is to train a flock of birds to follow them around and give those birds a really healthy but very high in fiber diet and just have them follow car a lot of a lot of

like wheat husks, yeah, chia seeds. If you train birds and live in the d C area, we have a gig for you. We got a job. Listen, well, crowd fund this like we would crowd fund someone's insulin payment. Yeah. And if we fall fifty short, though, we won't die. We won't die. His car will just not be filthy. Shirt will not be shipped on if you train birds in d C. Right, if you drop a line, if you practice falconry in the DC area, the greater metropolitan

DC area. You know D M. Robert or if you're Oswald, Tomilkins, the greatest car here in the East Coast. Everybody knows Oswald. Yeah, absolutely, he's fantastic. Maybe key this guy's car, you know, to do it the I don't know, maybe key. In an image of an urn with a dead twenty seven year old diabetic dashes in it. It's so heavy because it's one of these things where we freaking found the cure to this. We found shouldn't be a problem. It shouldn't

be a problem. You know. We talk about things like how terrible cancer is and how we crave a cure so much, and of course we do, because cancer is awful. But then we have a freaking cure for diabetes that will keep people from dying, from imminently dying, and just to dangle it above them like, oh, oh you want this cure, Oh, try and get it. Oh, and the people dangling and are only using one hand because they're getting paid tens of millions of dollars and bonuses for

doing the dangling. What a great system, I know, super gonna last forever and not collapse in fire and death. Yet, like, you know, does it feel good when you get your like second luxury. Yah, like you might as well just why not skip all of the middleman stuff and just make it out of dead diabet Just make a giant bone yacht made out of the bones of dead diabetic people. If Alex Asar was sailing up to Kinnebunkport, Maine in a bone yacht, well, okay, he's terrible, but like, this

guy at least has some pane, at least he's forth right. Yeah, he's honestly a bone merchant. Cut the metaphor. Hubbard would have built a boat out of bones. Yeah, absolutely, Yeah, either build a bone boat or I'm gonna keep telling people to key your car, Alex has aer. That's my threat to the Secretary of Human Services. We will train a flock of birds. Train a flock of birds to ship on your car. Constant flow stream of ship flowing

as much as insulin should be flowing patients. The bird ship will flow like insulin until the insulin gets cheaper. That is the terroristic threat we are making on this episode. Behind the Bastards. Great cool. I'm glad you put a label to it so it'll really make dhs. Uh. You's gonna make it easy for those yes for their search engine to go like, oh, there we go. I'm gonna get an interview like like how many birds are in your birds? You have? What kind? Let me see your

keys because there was their paint on them. Katie, you got any plug plug? Well, of course, my show Creature feature where we talk about creatures who are more human like than you expect in humans who act in animal ways, like the freaking barbaric animals who deny people insulin. Well, actually, animals would never do anything that sucked up. No, they wouldn't.

I mean, animals do some fucked up things, like they'll mind control of spiders into weaving them a little nest and then killing them and get behind right right, there's something like metal about that. There's there's nothing cool about just depriving people of insulin. Uh And So you can follow me at Katie Golden on Twitter. You can follow my bird twitter at pro Burg writes uh and, Yeah, please do check out my show. There's a great episode with Robert Innett called uh Re for Madness for Madness.

There we go from the name of that movie, Yeah for madness, madness All rightert Evans. This has been behind the Bastards. You can find me on Twitter at I right, okay. You can find us on Instagram and uh twitter at at bastards pod. You can find us online with all the sources for this article at behind the Bastards dot com. We have a t shirt shop. You can buy cups there, mugs, phone raps, and stuff with cool logos made up and

catch phrases and stuff from the show neat images. So like taste your PA, sample your p that'll be coming out soon, So go to t public, look up behind the Bastards public. Hello, maybe this week instead of buying a shirt, donate some money to somebody's go fund me if they're trying to buy Incelin or something they clearly need the help. Vote or vote. Hopefully you just voted. There's no voting to do immediately. Well soon, keep voting, yeah,

I keep voting constantly. Look out for your your diabetic friends because it's rough. Yeah, all right, I love about three percent of you. H

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