In a Perfect World, Ancient Drugs Would Not Cost More and More Over Time

Insulin was discovered in 1921 and first given to a patient in 1922. It used to be cheap. Now, a month’s supply of basal (24-hour) insulin at 50 units per day costs $400 for pens (needles are extra) and $450 for vials (but then you need to also buy syringes with needles). In a perfect world, insulin would not cost as much as the USDA “Liberal” monthly grocery bill for one (the “Thrifty” amount is $200).

Albuterol inhalers, introduced in 1956, were around $10 in the early years of my practice. They are now around $75. Because of environmental concerns, the CFC propellant of older inhalers had to be changed, and that opened the door for new patents that kept prices high for many years. Even though those patents are expiring, the cost of this basic medication is prohibitive for many people.

Epinephrine, first synthesized in 1904, lifesaving for anaphylaxis, is famously priced from $350 upward of $650 for two auto-injectors. Generic vials that require having syringes and knowing how to use them (and nerves and time enough to do it) are around $20, except at Walgreens, where they cost $70.

I once had an elderly patient who scorned inhalers for his asthma and carried a vial of epinephrine and a syringe in a metal box. Is that a practice asthmatics and allergy sufferers will soon have to resort to?

Return Visit: A Shot in the Arm

3 Responses to “In a Perfect World, Ancient Drugs Would Not Cost More and More Over Time”


  1. 1 DrJKH August 17, 2021 at 9:23 am

    IF you want designer insulin, then yes it’s expensive. It’s not exactly ancient, nor are any of the things you mentioned. Non designer insulin is fairly inexpensive.

    Albuterol inhalers are cheap. That were expensive for a while, thanks to Bill Clinton and the Democrat Party forcing them to reformulate the propellant for no scientifically proven reason, then allowing them to patent it.

    There are also bizarre government interferences for epinephrine, which has given the manufacturer of Epi Pen a virtual monopoly, which then drives up the price of the competitors.

    Everything you don’t like about healthcare can be traced back to a Big Government solution in search of a problem.

  2. 2 Mamadoc August 19, 2021 at 9:22 am

    One more. It was always a mystery to me how colchicine, which has been used for gout since Biblical times suddenly became branded and very expensive.


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