How Banting’s hopes of insulin for all became a dark nightmare

Banting dreamed of a world where insulin would be available for all, but pharmaceutical companies have turned that dream into a dark nightmare.

Originally published by The Toronto Star, October 25, 2023.
By Rebecca Redmond and Nikolas Barry Shaw

Canadians celebrate Dr. Frederick Banting as a pioneering scientist who discovered insulin. I (Rebecca) know him as the relative who saved my life. As a distant cousin, I share our national pride in Banting. And as a person living with Type 1 Diabetes for nearly 25 years, I wouldn’t be alive without his groundbreaking discovery.

But on Wednesday, on the 100th anniversary of his Nobel Prize for co-discovering insulin, we long for the bygone era that he belonged to — an era before the rise of Big Pharma, before the triumph of patent rights over patients’ needs and before the crass commercialization of life-saving medicines like insulin became the norm.

The reality of a patient struggling to keep up with crushing health care bills — a struggle that many Canadians share — is a stark contrast to the principles that Banting, stood for a century ago. As a physician bound by the Hippocratic oath, he felt it was wrong to profit from life-saving medication that others needed just to survive, famously declaring, “Insulin does not belong to me, it belongs to the world.”

Instead of putting his name on a patent, Banting had insulin patented under the names of his co-inventors, who subsequently sold the rights to the University of Toronto for a symbolic sum of $1. They dreamed of a world where insulin would be available for all.

But pharmaceutical companies, who soon after got the commercial rights to mass produce and distribute the drug, have turned that dream into a dark nightmare.

Today, insulin has never been cheaper or easier to produce and yet Banting’s gift to the world remains out of reach for many — including in Canada.

Just three manufacturers — Eli Lilly, Novo Nordisk, and Sanofi — control close to 90 per cent of the global insulin market, charging excessive prices that force people in many countries around the world to skip doses of the life-saving medication.

In the United States, where Big Pharma’s profiteering is left unchecked by a for-profit health care system, uninsured diabetics can pay as much as $300 for just one vial of insulin.

Even here in Canada, the costs of living with diabetes can be astronomical. In the absence of a national and publicly administered pharmacare program, it’s our credit cards — not our health cards — that ultimately decide our fate.

For people who live with Type 1 diabetes and don’t have workplace drug coverage, out-of-pocket costs can be as high as $18,306 a year. And the eligibility criteria for getting expenses reimbursed through public plans vary widely between different provinces and territories.

Even those lucky enough to have workplace insurance run up thousands of dollars in bills each year for life-saving drugs, supplies and devices.

Every year, there are hundreds of premature deaths among Canadians living with diabetes who skip or stretch their doses because of the cost. Others experience complications like amputation, heart disease, stroke and kidney failure.

If Banting was alive today, we have no doubt he would be devastated by this reality.

A national, single-payer public pharmacare program in Canada would finally complete the unfinished business of medicare and give us access to medication based on our need, not our ability to pay.

For years, the federal Liberals have raised hope and expectation among desperate patients with talk of a national pharmacare program. But that promise has long been delayed, even after numerous commissions, studies, and expert reports have almost unanimously supported the implementation of a public, universal, comprehensive pharmacare program.

Predictably, the pharmaceutical and insurance industries have opposed such a plan. They’d rather we just add a few more insufficient Band-Aids to our current patchwork system, so that drug prices can remain high.

Banting and his colleagues didn’t discover insulin to create obscene wealth for the heads of a few pharmaceutical giants. They did it as a gift to the world.

We have a once-in-a-generation opportunity to create a national public drug plan that would dramatically expand access to medications for all. As we mark the 100th anniversary of Banting’s Nobel Prize, let’s do everything we can to give Canadians the gift of public pharmacare.

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