I’m Douglas Schwan, member of the Juvenile Diabetes Foundation Board of Directors and a member of Insulin 4 All. I’m submitting written and oral testimony in support of S.B 1 & H.B. 5175. AN ACT CONCERNING DIABETES AND HIGH DEDUCTIBLE HEALTH PLANS. The bills are inadequate and lack mechanisms related to the publicly stated intentions of the bills. The bills are not strong enough and do not protect the very people the bills are intended to serve… the poor, working poor, and middle class. The current bills will only effect a small subset of the population they’re intended to serve. It’s estimated only 26% of Connecticut’s intended population, those that desperately need affordable insulin legislation, will actually get relief from the bills in their current, limited form. Why is the burden of lowering insulin costs for diabetics only being put onto insurance companies and distributors when the problem is with the manufacturers who set the original prices to begin with? This is completely backwards. I am tremendously grateful for insulin manufactures like Eli Lilly, Novo Nordisk and Sanofi. In short, we need them and can’t live without them. I truly appreciate you, and thank you, for all you have done to save the lives of so many of us in this room and across the globe. Yet I am profoundly uncomfortable, infuriated really, with the irony that we are here today, talking about saving diabetics’ lives because they can’t afford insulin. I’ve been there. If you really want to make insulin accessible and affordable you have to go to the source of the problem: • Pharmaceutical companies’ continuous evergreening of drug patents that guarantee a manipulated corporate welfare marketplace in favor of pharmaceutical companies on the backs of the Connecticut taxpayer. • The inelasticity of the supply & demand of the insulin market. • A return to a free market oriented pharmaceutical environment. • Insulin must be accessible as an over the counter pharmaceutical as it was years ago, to prevent more needless deaths. The only reason insulin now requires a prescription is so pharmaceutical companies get paid more when a prescription is required. • Any other diabetic or insulin related item also needs to be freely accessible and legal structures put in place guaranteeing affordability for these items also. The CT bills ONLY address out of pocket caps on yearly deductibles, per prescription and/or bottle of insulin monthly co-pays, etc. and are ONLY targeting insurance companies, and to a lesser degree, distributors. The root cause of rapid insulin price increases originates from insulin producers, NOT insurance and distributors. Insurance and distributors do play a role in this without a doubt. But, of course Lilly, Novo & Sanofi appear neutral at best with the current bills because they see all the emphasis for combating high insulin prices is being placed onto insurance companies, NOT pharmaceutical companies! Vaccines and modern drugs affect humanity like no other thing. Everyone in this room and across the world directly benefits from vaccines and drugs. It’s as simple as this: Any of us are only here today because we didn’t die from Measles, Polio, Small Pox as a child, didn’t die from infection due to an accidental cut because of antibiotics, or received lifesaving cancer treatment., etc. The creation of synthetic insulin in 1929 falls into this list of life saving the therapies. It appears Big Pharma is actually in support of what is in the current bills. I would expect this to be the case since none of the bills touch the pharmaceutical industry at all and shifts all the burden of pricing adjustments onto insurance companies and distributors. Big Pharma gets to continue business as usual. We all understand drug development is risky and most drugs don’t make it to market. But many pharmaceutical industry claims about research and development investments fail to acknowledge the reality that the pharmaceutical industry directly builds on the knowledge funded by the taxpayer. For example, National Institutes of Health-funded research was associated with every one of the 210 new drugs approved by the Food and Drug Administration (FDA) from 2010–2016. U.S. taxpayers are compensated for this investment by being charged the highest drug prices in the world. The pharmaceutical industry doesn’t even try to hide the fact anymore that they charge dramatically less for drugs, like insulin, everywhere else in the world, but not here in the USA. Why? Because the pharmaceutical lobby has a direct hand that created the laws that allow them to do so. It’s not their fault. Laws make it legal to profit on the backs of American taxpayers by scooping up NIH funded research for next to nothing, developing that research into a new drug, and then selling it for as much as they can get away with… only in the United States, however. But, just because you can do something doesn’t mean you should. We now live in an age where the standard has become, “I did nothing illegal, or they couldn’t prove I did anything illegal therefore, I did nothing wrong.” It’s not just wrong to price insulin out of the reach of Connecticut’s middle class, it’s unethical, unjust and immoral…. All of which are unAmercian. The fundamental problem with healthcare in America, and insulin prices in particular, are U.S. patent laws and marketplace inelasticity. There is no mechanism of supply & demand when you’re diabetic. We are relying on 3 pharmaceutical companies that create oligopoly market conditions to do the right thing within the disguise of a free market driven system. For markets to work, you must have price elasticity. Price goes up; you consume less. Price goes down; you consume more. Diabetics consume what they have to, no more no less, that is if they want to be healthy or alive. Diabetics need what they need! Diabetics can’t respond to market prices by altering their demand unless they want, at a minimum, life threatening complications. Insulin pricing is a microcosm of a sick free market place and sick healthcare system. I mean that figuratively and literally. Not only are diabetics unable to participate in a free market system because it would kill them to do so, there is no such thing as a free market when 3 pharmaceutical companies are allowed to craft the marketplace however they want. Where is the Capitalism? That’s what we want! All I see is corporate communism. Developing pharmaceuticals transformed the daily existence of humanity as much as Gutenberg’s invention of the movable typeset printing press. Mass production printing created the ability to educate to the world. Dissemination of information could now bypass the bias that comes with spoken word alteration. The printing press gave mankind the ability to think objectively for themselves on a mass scale. We have been down the insulin price fixing road before. See April 1, 1941 Chicago Tribune & Indianapolis Star stories about indictments for violation of the Sherman Antitrust Act by Eli Lilly and 2 other drug companies. See healthline.com link on following page. Insulin dependent diabetics only have days to live without insulin… and within a very short amount of time you’ll wish you were dead as your body turns into a toxic acid bath that forces organ failure that is hellishly painful. Please keep this in mind when crafting improvements to the current bills so all the players involved in creating artificiality high insulin prices and dealt with equally. Thank you, Douglas Schwan https://www.healthline.com/diabetesmine/history-of-insulin-costs#5 Way Back When... Insulin Was Cheap (And Then It Wasn't) Written by Mike Hoskins on September 28, 2016 In light of all the outrage over high insulin costs these days, we thought it would be interesting (to say the least!) to take a "Wayback Wednesday" walk through the history of this topic in the U.S... This Chicago Daily Tribune story from April 1, 1941 , reports that a federal grand jury indicted a corporate trio -- insulin manufacturer Eli Lilly in Indianapolis, distributor Sharp & Dohme in Philadelphia, and drug maker and distributor E.R. Squibb & Sons in New York -- for conspiring to unlawfully "bring about arbitrary, uniform, and non-competitive prices for insulin and to prevent normal competition in the sale of the drug." That was a federal charge of violating the Sherman Antitrust Act, the landmark legislation preventing anti-competitive business practices. In the Beginning Remember those guys who actually discovered insulin back in 1921? Dr. Frederick Banting and Charles Best were the main two, along with Dr. James Collip -- all three had their names attached to the patent awarded in January 1923 to their method of making insulin. Well, did you know that their original intellectual property rights were sold for just $3 in Canadian money? That's right. When the researchers were ready to turn over the patent of their discovery to the University of Toronto for production purposes in 1923, they agreed to receive only $1 each (the equivalent of $14 today) in compensation. Here's an excerpt from a 2002 article chronicling this: "For $1.00 to each, the three discoverers assigned their patent rights to the Board of Governors of the University of Toronto. The application had stressed that none of the other researchers in the past had been able to produce a nontoxic anti-diabetic extract. A patent was necessary to restrict manufacture of insulin to reputable pharmaceutical houses who could guarantee the purity and potency of their products. It would also prevent unscrupulous drug manufacturers from making or patenting an impotent or weakened version of this potentially dangerous drug and calling it insulin." Since insulin was in such high demand, the university granted Lilly (and other pharma companies) the right to make it, royalty-free, and also offered them the ability to improve the original formulation and patent anything they created down the road.