Speaker 1: M everybody. I'm Robert Evans, and this is Behind the Bastards,
Speaker 1: the show where we tell you everything you don't know
Speaker 1: about the very worst people in all of history. And
Speaker 1: this was the highest energy introduction I've ever done. Sophie
Speaker 1: is laughing at me over in the corner. I don't
Speaker 1: understand why I thought it sounded pretty cool, fonds esque.
Speaker 1: This is a show where I read a terrible story
Speaker 1: about history, about someone bad, or someone's bad, or usually
Speaker 1: a bunch of bad people doing bad things to a
Speaker 1: guest who is coming in cold and today that very
Speaker 1: cold guest is Katie Golden. Might be Katie coming in
Speaker 1: Colden anyway. She's birds rights activists on Twitter, where she
Speaker 1: advocates for birds even though as I understand that millennials
Speaker 1: are saying birds aren't real, those are lies, Those are
Speaker 1: communist lives, communists lies. She's also the host of another
Speaker 1: podcast on This Stuff Network, Creature feature great podcast about
Speaker 1: animals doing weird ass shit science and stuffy science. Step. Yeah,
Speaker 1: we talked about animals and drugs. It's great to do drugs.
Speaker 1: It is great to do drugs. Uh. Speaking of drugs
Speaker 1: that are great to do today we're talking about insulin,
Speaker 1: which is not a well, I mean, it's fun and
Speaker 1: that if you need to take it, you die not
Speaker 1: taking it, right, I think it's fun not to die.
Speaker 1: It is fun not to die, relatively fun not to die.
Speaker 1: Yet it was fun not to die of insulin shock
Speaker 1: or diabetic comas and stuff. Not fun. So I'm just
Speaker 1: going to get into it. On November seventeen, several parents
Speaker 1: brought the ashes of their dead children to the doorstep
Speaker 1: of the offices of Santa Fee, a pharmaceutical company that
Speaker 1: produces insulin. Sanofie and other insulin producers like Eli Lily
Speaker 1: have been steadily raising the prices of their insulin for years.
Speaker 1: Because of this, insulin can cost as much as a
Speaker 1: thousand dollars a month for people without decent insurance. Oh
Speaker 1: my god, that's I I can't imagine spending a thousand
Speaker 1: dollars a month on anything of there than like rent,
Speaker 1: I guess, but even even a pretty expensive town. So
Speaker 1: you're essentially renting your own body, like you want to
Speaker 1: keep living in your body. A thousand bucks rent, yeah,
Speaker 1: get you a decent place like in Culver City. I
Speaker 1: feel like when I lived in Culver my rent was
Speaker 1: about thousand months. Yeah, so it's it's frustrating, right, it's
Speaker 1: a little frist It's a little frustrating because clearly, I mean,
Speaker 1: no country on Earth can afford something like single pair
Speaker 1: of healthcare anywhere. It never be done. Um, and our
Speaker 1: government needs its money for stuff like I did you
Speaker 1: hear about when that hurricane hit the East coast the
Speaker 1: military forgot to remove like eleven two and they all
Speaker 1: got destroyed. That was one point four billion dollars. Well,
Speaker 1: they gotta could have bought a lot. They gotta put
Speaker 1: another billion dollar coin in the f twenty seven vending machines.
Speaker 1: The funniest thing is there's no vending machine. We can't
Speaker 1: make the parts for them anymore, stop manufacturing any of
Speaker 1: the things that they are placeable. So, oh good, but
Speaker 1: we can't afford to help people with here. I'm sure
Speaker 1: we'll find a way to dig deep into the earth
Speaker 1: and find things that will destroy our planet that can
Speaker 1: make new airplanes. Yeah, I'm sure we will. Now, people
Speaker 1: with type one diabetes do not naturally produce insulin, which
Speaker 1: is a magical substance that lets sugar not kill us
Speaker 1: instead of be delicious. I'm a fan of insulin yeah,
Speaker 1: I'm a big fan. Now, when insulin costs as much,
Speaker 1: if not more than rent, many people stopped taking it
Speaker 1: as often as they should and ration their precious supply
Speaker 1: so that they can afford to do things like exist
Speaker 1: in a capitalist society and pay the aforementioned rent that
Speaker 1: we've been talking right. Also, um food, because here's the thing.
Speaker 1: Here's the thing is like insulin is basically useless if
Speaker 1: you don't eat, if right, because then you don't get
Speaker 1: any sugar, which without insulin. You know, it's like, well,
Speaker 1: I mean, Katie, I was really sympathetic with these people,
Speaker 1: but I think you've identified a way that they could
Speaker 1: not need insulin, which is the no eat diet. And
Speaker 1: you won't of insulent shock. You'll just die of starvation.
Speaker 1: I do think they'll die. Oh yeah, you're right, probably
Speaker 1: medically speaking. Yesterday, Well, neither of us are doctors. No,
Speaker 1: you're not a doctor. No, I'm not a doctor. Fantastic,
Speaker 1: but I do read web and b like a lot. Well,
Speaker 1: then you're basically a doctor, fantastic now. Alec Rashawn Smith
Speaker 1: was one of the young people who got caught in
Speaker 1: this deadly dance with a necessary drug. When he was
Speaker 1: twenty six, he aged out of his mother's health insurance.
Speaker 1: One month after his birthday, he died of diabetic shock.
Speaker 1: Smith's mom, Nicole, was one of the grieving parents who
Speaker 1: brought her son's ashes to Santa Fee that November day.
Speaker 1: She told the Boston Globe she wanted the company to quote, no,
Speaker 1: the price of their product is killing people when it's
Speaker 1: intended to save lives. Antoinette Worsham, whose twenty two year
Speaker 1: old daughter Antavia died last year while rationing insulin, told
Speaker 1: another interviewer that for people like her daughter, it's either
Speaker 1: pay your rent, pay your car payment, or get your medication.
Speaker 1: Diabetes is currently the seventh leading cause of death in
Speaker 1: the United States. I heard this story of this guy
Speaker 1: who because like I've heard this thing where people say, well,
Speaker 1: just go fund me if you can't afford your medication
Speaker 1: instead of healthcare. Yeah, there was a guy who did
Speaker 1: that very thing and he short, yeah, fifty dollars short
Speaker 1: of reaching his goal in the way. It was his
Speaker 1: monthly calls, right, and he needed insulin to survive, and
Speaker 1: he didn't have the money to pay for it, and
Speaker 1: he was like taking care of his ailing mom too.
Speaker 1: So that's part of the reason. He didn't have that
Speaker 1: high of an income, so like he tried to get it.
Speaker 1: He was fifty dollar short of reaching his goal. So
Speaker 1: you know how go fund me works. Then you get
Speaker 1: none of that money and he died. Yeah he should.
Speaker 1: We will be talking about him a little bit later.
Speaker 1: Oh good. So clearly this situation is fucked right that
Speaker 1: it seems fun. Seems like we can all get on
Speaker 1: the same page. There, it's like a little like just
Speaker 1: maybe a smidge fun the old F bomb. Yeah, so
Speaker 1: what is fun? Why is this so messed up? People
Speaker 1: are dying? Well, I'm saying that that's why it's messed up,
Speaker 1: Like why why would because insulin is not a new drug. Usually,
Speaker 1: when you've got like a case of this where something
Speaker 1: is incredibly expensive, it's number one, a drug that very
Speaker 1: few people need, and number two a drug that's really new.
Speaker 1: Because then you know, that's the way that these patents work.
Speaker 1: For most medicines, After about twenty years after their invention,
Speaker 1: a generic patent comes out that's fairly affordable, right, right,
Speaker 1: That's one of the ways our system is supposed to work,
Speaker 1: so that that keeps drugs affordable for normal people, but
Speaker 1: also gives an incentive for companies to invest in research
Speaker 1: and whatnot. Right, that is the promise in our capitalist
Speaker 1: system is that you will get better medicine under this system,
Speaker 1: because companies will find new medicines, you know, essentially due
Speaker 1: to the profit motive, but because of the way that
Speaker 1: this generic drug like that. That's the idea, Right, that's
Speaker 1: the promise that we've all bought in this system. Otherwise
Speaker 1: poor people are middle class people would never be able
Speaker 1: to afford medicine exactly. Insulin has existed for nearly a century,
Speaker 1: but there is no cheap generic insulin available in the
Speaker 1: United States today. We're going to talk talk about why.
Speaker 1: But first we are going to talk about the invention
Speaker 1: of insulin as a medicine. Most cursory coverage of this
Speaker 1: will give credit to Dr Frederick Banting, some mention a
Speaker 1: small team of scientists who work with him. When I
Speaker 1: decided to look into it this story, it's because I
Speaker 1: ran across a tweet about Banting. It stated that he
Speaker 1: had given the invention of medical insulin to the world,
Speaker 1: put it in the public domain, essentially as a gift
Speaker 1: to humanity, because he didn't want to profit off and
Speaker 1: he wanted people to be able to get medicine, and
Speaker 1: so the tweet was basically like this wonderful founder gave
Speaker 1: insulin to the world and wanted people to have it
Speaker 1: for free, and then the evil pharmaceutical companies fucked it up,
Speaker 1: which is true, but not detailed enough. So I wanted
Speaker 1: to know what that story was. Let's get the details.
Speaker 1: So let's get the diets. That's what we are going
Speaker 1: to be talking about today. Now, like most things you
Speaker 1: find on social media, that version of events is not
Speaker 1: quite accurate. Insulin did not have a single inventor, and
Speaker 1: while pharmaceutical companies are the ultimate bastards here, the full
Speaker 1: story is weirder, sadder, and more infuriating than that. In
Speaker 1: Dr Frederick Banting was the first person to isolate secretions
Speaker 1: from isolate cells, the cells that make insulin. He suggested
Speaker 1: these might hold a treat for diabetes, and he was
Speaker 1: basically right. He came up with a plan to tie
Speaker 1: up the pancreatic ducts of laboratory dogs and make their
Speaker 1: pancreases overproduce the cells that contain insulin until everything else
Speaker 1: in the pancreas dies. That was the idea, right, we
Speaker 1: did dogs die. The hope was they wouldn't. This is
Speaker 1: actually initially envision is like its beautiful one to punch
Speaker 1: because we make these dogs pancreases overproduced the cells. They
Speaker 1: didn't really know. Insulin was like insulin was a theoretical
Speaker 1: substance they called, I think insuline. There was an e.
Speaker 1: I don't know how they pronounced it, but it was
Speaker 1: spelled insuline. And the theory was like, if we make
Speaker 1: these dogs pancreases produce a bunch of these cells, we
Speaker 1: can take the pancreases out and they will contain concentrated
Speaker 1: versions that then we can extract whatever in the pancreas
Speaker 1: shoot it into a diabetic It will make them better.
Speaker 1: So the idea was, we gotta take these dogs pancreases
Speaker 1: out in order to do this thing, but then we
Speaker 1: can just give them what we make from it, and
Speaker 1: if it works, it's a beautiful one too. Thing we
Speaker 1: don't have to kill the dogs will know that we've
Speaker 1: got a treatment for diabetes because these dogs won't be
Speaker 1: able to pre sinsulin. After we stuck up their pancreases.
Speaker 1: Seemed like it was like a nice circle that they
Speaker 1: had that they had developed um Now, the problem with
Speaker 1: Banting's plan is that he was not up to date
Speaker 1: on the work other scientists were doing testing blood sugar
Speaker 1: to find diabetes and patients Banting did urine testing to
Speaker 1: find out blood sugar levels, which is not just did
Speaker 1: you just like taste it, because I know I just
Speaker 1: tasting their well, one of the one of the things
Speaker 1: is like, um, if you taste your urine or smell
Speaker 1: your urine, it tastes sweet. It's a sign of diabetes
Speaker 1: because it's like I think it's called hyperkalemia, and it's
Speaker 1: because you're finding more sugars in your urine. You know,
Speaker 1: I've only drank my pea once. Uh for my book
Speaker 1: A Brief History advice, because I was I was trying
Speaker 1: an ancient Meso American treatment where you mix tobacco, garlic
Speaker 1: and urine as a treatment for constipation. It works, it
Speaker 1: makes you very ill, but functions and its intended purpose.
Speaker 1: I was not paying attention to how sweet it was.
Speaker 1: There was a lot of garlic in there too, right,
Speaker 1: The garlic is well, the garlic is going to cut
Speaker 1: the sweetness as it's cooking. You know it's gonna But
Speaker 1: it sounds like what you're saying is that we should
Speaker 1: all be drinking r P every morning to learn if
Speaker 1: we are just a little bit a little bit. Just
Speaker 1: don't drink a lot of don't drink a lot of
Speaker 1: your taste a sample. That's the new behind the bastard's motto.
Speaker 1: Sample your own, sample your P, sample your P. Right,
Speaker 1: this will be marketable. Let's get a T shirt going,
Speaker 1: sample pie. Start that process. Okay, So if he's shaking
Speaker 1: her head, she's not happy with that. All right, let's
Speaker 1: move on to talking about diabetes some more. So. Banny
Speaker 1: was the first guy to start isolating the slate cells
Speaker 1: that contain the hormone insulin, but the amounts he was
Speaker 1: able to get were too small to really be useful
Speaker 1: in his His work had a bunch of holes in it.
Speaker 1: You know, he was good at a couple of things,
Speaker 1: but he was almost taking a lot of other areas.
Speaker 1: So we had to partner with other scientists. Professor John
Speaker 1: James Rickard McLeod was the head of physiology at the
Speaker 1: University of Toronto. McLeod agreed to give him laboratory space
Speaker 1: for his experiments, and he also served as sort of
Speaker 1: the manager in over. So you're for the whole project
Speaker 1: because Banting was an unstable personality of an asshole. So McLeod,
Speaker 1: you means some scientists are assholes. Yes, really, the kind
Speaker 1: of guy who would who would poison the dog's pancreas
Speaker 1: in order to try to solve it as ease isn't
Speaker 1: great at working with other people. Interesting, I mean er intuitive,
Speaker 1: but you know you need to do the research. This
Speaker 1: horrible thing has to happen. But the kind of guy
Speaker 1: who's like, oh, yeah, what if we just toward your
Speaker 1: dogs to figure this out, it's probably not fun to
Speaker 1: work with. And he wasn't maybe just a little too.
Speaker 1: He's got tunnel vision there. He's just so focused on
Speaker 1: that insulin. Everyone else is like, but dogs, there's just
Speaker 1: dead dogs everywhere. I know. I'm almost corpses, just crumpled
Speaker 1: up dog. We get it right, the dogs won't die.
Speaker 1: He's just at his desk and he's like, damn it,
Speaker 1: and he crinkles up another dog and tossed it. Just
Speaker 1: the trash can full of dead dogs. Sophie is really
Speaker 1: not loving this conversation. There is a dog in the room,
Speaker 1: but because Anderson is a dog, does not understand what
Speaker 1: we're talking about which is the mercy of being a dog.
Speaker 1: Now back to the story. Banting came to hate McLeod
Speaker 1: because McLeod was good at talking and explaining their work
Speaker 1: to other people at conventions. Uh well, Banting was an
Speaker 1: introvert and a big old nerd. So Banting started to
Speaker 1: worry that like McLeod was going to outshine him and
Speaker 1: get credit, even though remything I've been able to read,
Speaker 1: McLeod was just about, oh, yeah, this is a really
Speaker 1: important cause. I want to do everything I can do
Speaker 1: to make sure that this research gets completely He goes
Speaker 1: like on Reddit to complain about him, like what a
Speaker 1: stupid science child, Banting? Would a thousand percent be a
Speaker 1: Reddit dude? Although we'll get to yeah a second. So
Speaker 1: Banting had an assistant, a guy named Charles Herbert Best,
Speaker 1: who did Charles Charles though I thought this is a
Speaker 1: fancy form of you know, Charles Charlie char No, No,
Speaker 1: not at all, plain old Charles like an American reading
Speaker 1: podcast for three hours. So Charles Herbert Best was his assistant,
Speaker 1: and Best did a lot of crucial work in the process.
Speaker 1: And it seems fair to say in general that all
Speaker 1: three men were critical parts of the development of insulin
Speaker 1: as an effective medication. When they started their work, the
Speaker 1: existence of insulin was still not a confirmed fact. We
Speaker 1: knew that the islets of linger Hends, which is the
Speaker 1: name of those little cells, produced something that helped regulate sugar.
Speaker 1: Insulin was at this point still just the name of
Speaker 1: a hypothetical substance scientist thought existed. So just as a
Speaker 1: quick side note, the islets of Lingerham, imagine them as
Speaker 1: like these little islands, that little British islands microbial size.
Speaker 1: Langerham expedition goes out and discovers like little white blood
Speaker 1: cells and naval hats. Sorry that I just had to
Speaker 1: get that image, Duke. Yeah, you're right, that's yeah, that's
Speaker 1: how it was discovered. Tiny tiny explorers, tiny explorers. Banting,
Speaker 1: McLeod and Best started work in May nine. It did
Speaker 1: not go well at first. I found an article in
Speaker 1: the Journal of Clinical Chemistry that went into the discovery
Speaker 1: of insulin in exhausting detail. Here's how they described the
Speaker 1: few months of work. After legation of the ducts, the
Speaker 1: dogs were expected to recover from the surgery and live
Speaker 1: more or less normally. After several weeks, the pancreas and
Speaker 1: able to secrete fluid into the duadendum would gradually atrophy
Speaker 1: and would be removed in process to extract the internal secretion.
Speaker 1: The extract would then be administered to other dogs made
Speaker 1: diabetic by removal of the pancreas. It was a laborious
Speaker 1: task for someone with no experience and animal work, and
Speaker 1: it did not go well at first his Banting struggle
Speaker 1: to improve his surgical technique. By the end of the
Speaker 1: second week, seven of their tin dogs had died. To
Speaker 1: resupply the animal cages, they resorted to buying dogs in
Speaker 1: the streets of Toronto. The three dollars with no questions asked,
Speaker 1: we need dogs, We need a lot of dogs. It's
Speaker 1: just some guy with an overcoat, Like, hey, I heard
Speaker 1: you was looking for dogs. This doctors never worked on dogs.
Speaker 1: He's killing the left and right. It's just like opening
Speaker 1: up the trench coat and I'll give you nine dollars.
Speaker 1: Is that enough for three dogs? They're like off brand dogs,
Speaker 1: Like no, no, these are dogs. Three of these are cats.
Speaker 1: Sophie really not happy with me right now. We should
Speaker 1: be good. We should be good. Sorry, we had to
Speaker 1: deal with some noise. We also learned something that I'm
Speaker 1: just coming into which is that the guy have been
Speaker 1: calling McLeod is is McLeod So everybody have a good
Speaker 1: real mcclaude, aren't you. Everybody have a good laugh, good
Speaker 1: old laugh at old old Robert Evans's expense not knowing
Speaker 1: enough about scotsman. Uh so, Um, you may have already
Speaker 1: noticed that this is horrible because dogs are good, and
Speaker 1: medically torturing them to death is bad. But the world
Speaker 1: is a gigantic wheel of pain and brutal crush and cruelty,
Speaker 1: and sometimes is sometimes necessary in order to save the
Speaker 1: lives of billions of diabetics. Uh so, yeah, that's just
Speaker 1: the way the world works. Sometimes dogs continue to diet
Speaker 1: rapid rates throughout the research, but Banting and Best were
Speaker 1: eventually successful in creating an extract that seemed to work
Speaker 1: at regulating the blood sugar of dogs who'd had their
Speaker 1: appendix is removed. They debuted their work to an audience.
Speaker 1: It was one of those things you've seen on TV
Speaker 1: where the doctors do their work in like a big
Speaker 1: pit surrounded by an auditorium full of other doctors and
Speaker 1: pharmaceutical industry people. Old timey thanks they had like they
Speaker 1: had instead of bags of popcorn was like bags dead dogs,
Speaker 1: bags of dead dogs, and those little circle things on
Speaker 1: their heads that old timey doctors wore. One man present
Speaker 1: at this early insulin demo was George H. A. Cloud's,
Speaker 1: a research director for Eli Lily, the pharmaceutical company. After
Speaker 1: the presentation, he sidled up to McLoud and asked if
Speaker 1: his company could work with the scientists in order to
Speaker 1: get a product on the market sooner. McLeod turned him down,
Speaker 1: claiming that the work was not far enough along yet.
Speaker 1: This seems to have pissed Banting off, largely because McLoud
Speaker 1: had spoken for the group. Banting was also frustrated by
Speaker 1: the fact that McLoud was a much better presenter than
Speaker 1: he was, which made Banting worry that other scientists would
Speaker 1: get the credit and popular acclaim Banting felt he deserved.
Speaker 1: So like Banting is like watching as McLeod is like
Speaker 1: riding in on a skateboard and like hey dudes, and
Speaker 1: like like he's just like curing and he's too nervous
Speaker 1: to talk to anyone, so we can't answer the questions
Speaker 1: which McLeod can. But then he's like he's taking credit
Speaker 1: for me. He's getting shoved in science lockers. He totally
Speaker 1: would be an in cell. I'm calling it now. The
Speaker 1: inventor of insulin is an in cell. Yeah, yeah, perfect
Speaker 1: involuntary cellular biologist. Nice, nice, nice, really good. Uh So
Speaker 1: it took a lot more work and a lot more
Speaker 1: dead dogs before Banting and his team made more progress
Speaker 1: on insulin. By nine two, they were close to a breakthrough,
Speaker 1: and Banting decided that McLeod was the center of a
Speaker 1: gigantic conspiracy to steal the credit for their immediate breakthrough.
Speaker 1: Banting and his team started to work with another scientist
Speaker 1: named colep Colip had figured out how to actually purify
Speaker 1: the pancreatic extracts that they were making and create usable insulin.
Speaker 1: In January of n the group carried out a clinical
Speaker 1: test of their new extract that failed disastrously. The bad
Speaker 1: results sparked a fight, and during a heated exchange, Colip
Speaker 1: threatened to leave the band and take his purification method
Speaker 1: with him. He threatened to patent it's that they'd have
Speaker 1: to pay him to use it. So was Eli only
Speaker 1: the yoko oh no of the situation or they were
Speaker 1: just sparking a fight, Yes, but they didn't They hadn't
Speaker 1: done anything yet. Calyp was kind of the well, no
Speaker 1: Banting was, the Banting was the Yoko was both Yoko
Speaker 1: and Lennon Ouch. That's a that's a harsh personality to have.
Speaker 1: He seems like a rough guy to work with. So
Speaker 1: uh yeah. Here's a quote from that journal article about
Speaker 1: the invention of insulin. This was a breach of the
Speaker 1: agreement between Calyp, Banting, and Best to exchange all results.
Speaker 1: Banting never showed a righteous anger or noted for meekness
Speaker 1: or restraint. When he felt wronged, exploded with clinched fists,
Speaker 1: and in a moment Calyp was laying dazed on the
Speaker 1: floor of the laboratory. Fortunately he was not seriously hurt.
Speaker 1: There are no contemporary records of this encounter, no reference
Speaker 1: by Colip, and only two accounts, neither of which, according
Speaker 1: to Bliss, should be considered entirely reliable. One was by
Speaker 1: Banting and his unpublished nineteen forty memoir, the other by
Speaker 1: Best in a letter to Sir Henry Dale dated February
Speaker 1: twenty nine. So he like beat him with his fists,
Speaker 1: but he didn't hurt him at all. He beat him
Speaker 1: with his fist and I think it probably hurt pretty bad,
Speaker 1: but calyp was too felt bashful about it and didn't
Speaker 1: write about it. Banting is the only one who wrote
Speaker 1: about it, because I'm thinking maybe his fists were like
Speaker 1: soft and small as apricots, and it's just like that,
Speaker 1: like I solved as small as acot oh apricot apricot
Speaker 1: handed Banting. That's it's possible too. It's possibly just sucked
Speaker 1: it punching right, But either way, I just liked this
Speaker 1: story of like these genius scientists creating one of the
Speaker 1: most valuable medicines in history, fist fighting each other over
Speaker 1: the credit at one point. It's beautiful. Now, the four
Speaker 1: scientists did eventually work out their disagreements enough to allow
Speaker 1: them to get back to work. Banting and Best would
Speaker 1: de pancreatized dogs, Colip wouldn't extract insulin, and McCloud would
Speaker 1: coordinate everyone's research, everybody doing playing to their strengths, play
Speaker 1: into their strength, like you're great at deep pancretize deep pancretizing.
Speaker 1: Is that he was the best to pancretizer. Nobody's questioning
Speaker 1: Banting's ability to take out dogs. You can PANCRETI tin
Speaker 1: pancreas as a per minute. If you're if you've had
Speaker 1: a dog with too many pancreai, this is your man.
Speaker 1: He's got ten ppm. So um. Banting developed a hatred
Speaker 1: for the professor that made his life unbearable. Banting became
Speaker 1: an alcoholic, regularly drinking himself to sleep. Since it was prohibition,
Speaker 1: he had to steal liquor hundred and ninety proof alcohol
Speaker 1: from the laboratory. He later said, I do not think
Speaker 1: there was one night during the month of March nineteen
Speaker 1: two when I went to bed sober. Well, that seems
Speaker 1: like a not great practice. It just seems like March.
Speaker 1: I mean, March is my birthday months, so I rarely
Speaker 1: go to bed sober on March. And he says he
Speaker 1: was making life like unbearable for the other scientists. Was
Speaker 1: he like playing drunken pranks on them? Like, no, he's
Speaker 1: just being a really angry as I throwing dogs at
Speaker 1: the crossing dog corpses left and right. You sons of bitches. Yeah,
Speaker 1: but their work bore fruit. On May third, Cloud presented
Speaker 1: a paper to the Association of American Physicians The Effect
Speaker 1: produced on diabetes by extracts of pancreas the paper described
Speaker 1: their discovery of insulin and it's by now clear therapeutic
Speaker 1: success on treating diabetes. The Cloud received a standing ovation,
Speaker 1: the first one given in the entire history of the
Speaker 1: society's existence. Banting and Best weren't there to see it.
Speaker 1: Banting had refused to go because he's a caddy bitch
Speaker 1: and badgered his colleague and not going as well as
Speaker 1: a protest against McCleod. Yeah, it's it's pretty missed. That
Speaker 1: rare scientist standing ovation, which are radical because they're just
Speaker 1: like air horns. Belas so uh. At this point, via
Speaker 1: the team reached out to Elit Lily for help figuring
Speaker 1: out how to produce insulin in large quantities. So they
Speaker 1: figured out how to extract insulin, they could prove that
Speaker 1: it was a thing that had a therapeutic effect, but
Speaker 1: they were like, we don't actually know how to like
Speaker 1: produce a medicine for a shipload of people were just
Speaker 1: torturing dogs over here. Although at some point there's a
Speaker 1: horrible note in the story. I was reading it like
Speaker 1: they were using cows at one point and they needed
Speaker 1: like the fetuses of young cows to get the pancreases out,
Speaker 1: and they were like, thankfully, lots of slaughterhouses get the
Speaker 1: cows pregnant before they kill them to make them fatter.
Speaker 1: So there's tons of cow fetuses. Well, isn't that nice
Speaker 1: worked out? We're swimming in cow fetuses who are eyeballs
Speaker 1: and cow fetuses. Three dollar dogs. They just have cow
Speaker 1: fetuses in the bullet like the front desk of these farms,
Speaker 1: like take a cow, cow fetus, too many cow fetus.
Speaker 1: Fetus just going to be going into sausage. It is sausages.
Speaker 1: It's just cow fetuses and pig assholes. That does seem
Speaker 1: like a like turn of the century movie like Too
Speaker 1: Many Cow Too Many cow fetuses, starring Jamis and Jimson
Speaker 1: speaking of cow fetuses. Uh, wonderful products that help people.
Speaker 1: It's ADS time. We're back. We're back. ADS are done.
Speaker 1: As has happened? ADS has happened back to insulin banting.
Speaker 1: Call Up and Best were awarded a patent on January three.
Speaker 1: They did not give their patent to the public domain
Speaker 1: as a gift demand kind, but they did sell it
Speaker 1: for a dollar each to the Board of Governors of
Speaker 1: the University of Toronto. Their goal bargain. That's bargain, great
Speaker 1: price for all of insulin solid. Their goal was for
Speaker 1: the medicine itself to be used for the benefit of
Speaker 1: mankind and not pure profit. They deserve credit for getting
Speaker 1: all all getting on the same page about one thing,
Speaker 1: which is that insulin is too vital to be something
Speaker 1: that's purely a profit thing right now. They basically gave
Speaker 1: the patent to the university so they could restrict the
Speaker 1: production of insulin to reputable pharmaceutical companies. They wanted to
Speaker 1: stop quacks from trying to make their own products and
Speaker 1: then selling people poison Brandon as right, just like liquefied dog. Yeah,
Speaker 1: we're just killing out. The pan also made it impossible
Speaker 1: for drug companies to produce a weaker version of the
Speaker 1: drug and still use the name insulin, So that's good.
Speaker 1: As messy as they were, it does seem like these
Speaker 1: guys Hearts were in the right place. Eli Lily got
Speaker 1: a non exclusive licensing contract and for a while insulin
Speaker 1: was a reasonably affordable medicine. After a couple of decades,
Speaker 1: the University Toronto's patent expired and any pharmaceutical company was
Speaker 1: allowed to produce it. This is the point at which
Speaker 1: the market should have been flooded with cheap generic versions
Speaker 1: of insulin, but something else happened instead, Eli, Lily and
Speaker 1: other pharmaceutical companies started tweaking insulin, making minor improvements or
Speaker 1: alteration through the delivery system, tiny changes that maybe maybe
Speaker 1: it work slightly better here and there. Uh the time,
Speaker 1: these updates strategically so that insulin has remained for all
Speaker 1: these different companies a patented medication from right today right
Speaker 1: Because so I used to do medical learning materials for
Speaker 1: pharmaceutical companies, and one of the things I learned is
Speaker 1: about the process of doing generic medications. So, if you
Speaker 1: have a patent and you want to extend it beyond
Speaker 1: what the law intake, right, what you do is you
Speaker 1: can tweak it very slightly, make like you said, minor improvements,
Speaker 1: or you can even not tweak it, but say it's
Speaker 1: useful for something else like um like antidepressant medication and
Speaker 1: being used for postpartum depression or PMS. Well that's clearly different, right,
Speaker 1: And then then you can cling on to that patent
Speaker 1: long for a much longer than what is the spirit
Speaker 1: of the law, which is right right, which is a
Speaker 1: long time too. So it's and that prevents other companies
Speaker 1: from creating biosimilars which are like, not the exact same formulation,
Speaker 1: but kind of a similar one. And it's really terrible
Speaker 1: because it can well, let's continue with your horrible story. Now,
Speaker 1: it's not impossible. It's some point to say. One of
Speaker 1: the differences with the case of insulin is that it's
Speaker 1: not impossible for a company to go back to the
Speaker 1: original recipe and make a generic version of insulin. That
Speaker 1: is something that's totally possible. To what these companies are
Speaker 1: doing is that they're just never releasing a generic. They
Speaker 1: just keep tweaking their insulin. Every time it comes up.
Speaker 1: It gets old enough. So basically, any pharmaceutical company could
Speaker 1: try to make their own insulin, but any organization that
Speaker 1: could afford to do so would be a pharmaceutical money
Speaker 1: And in that case, why not just whip up their
Speaker 1: own kind of insulin? Twigg a little bit, the charge
Speaker 1: a lot of money. Why make a generic? Why help people?
Speaker 1: Why help people? As a pharmaceutical Now, this is the
Speaker 1: conclusion reached by doctors Jeremy Green and Kevin Riggs, who
Speaker 1: published a study in the New England Journal of Medicine
Speaker 1: accusing the pharmaceutical industry of using a process called evergreening
Speaker 1: to extend their patents, particularly the patents. For instance, this
Speaker 1: is the name of what you were just explaining. I'd
Speaker 1: like to quote from a summary of their article in
Speaker 1: Medicine Express. This keeps older versions off the generic market,
Speaker 1: the authors say, because generic manufacturers have less incentive to
Speaker 1: make a version of insulin that doctors perceived as obsolete.
Speaker 1: Newer versions are somewhat better for patients who can afford them,
Speaker 1: say the authors, but those who can't suffer painful, costly complications.
Speaker 1: We see generic drugs as a rare success story, providing
Speaker 1: better quality at a cheaper price, says Green, an associate
Speaker 1: professor of the history of medicine at Johns Hopkins University
Speaker 1: School of Medicine and a practicing internist. And we see
Speaker 1: the progression from patent to drug to generic drug is
Speaker 1: almost automatic. But the history of insulin highlights limits of
Speaker 1: generic competition. Is a framework for protecting the public health now.
Speaker 1: Riggs and Green were both inspired to study this problem
Speaker 1: because so many patients were coming into their Baltimore area
Speaker 1: clinics with blurred vision, weight loss, thirst, and other symptoms
Speaker 1: of unmedicated diabetes. They realized that a ton of people
Speaker 1: who should have been on insulin were opting to suffer
Speaker 1: instead of go broke. Green and Riggs set out to
Speaker 1: learn why generic insulin wasn't a thing, and they traced
Speaker 1: out a legacy of evergreening. In the nineteen thirties and forties,
Speaker 1: pharmaceutical companies developed long acting forms that allowed most patients
Speaker 1: to take a single daily injection. In the nineteen seventies
Speaker 1: and eighties, manufacturers improved the purity of cow and pig
Speaker 1: extracted insulin. Since then, several companies who developed synthetic analogs
Speaker 1: biotech insulin is now the standard in the US. The
Speaker 1: authors say patents on the first synthetic insulin expired in
Speaker 1: two thousand and fourteen, but these newer forms are harder
Speaker 1: to copy, so the unpatented versions will go through a
Speaker 1: lengthy Food and Drug Administration approval process and cost more
Speaker 1: to make. When these insulins come off the market, they
Speaker 1: may cost just less than the patented versions. Riggs and
Speaker 1: Green right now, generic versions of medication often bring the
Speaker 1: price down to something like cheaper, so when cheaper insulin
Speaker 1: comes in, it's going to be this kind of biotech
Speaker 1: insulin that's just cheaper as opposed to so essentially still
Speaker 1: twice as much as at least so like, so companies
Speaker 1: could be making these generics, but there's just no monetary
Speaker 1: incentive for them, so it's not profitable, right right, I
Speaker 1: mean you might get a profit, is not as profit
Speaker 1: right because if you're a small enough company that you
Speaker 1: would want to maybe do it, like, then you couldn't.
Speaker 1: You don't have the resources. You don't have the resources.
Speaker 1: So if you're a bigger company, you're like, well, there's
Speaker 1: more demand than would mean, like people wouldn't be voting
Speaker 1: with their wallets, so they'll still sell it. Yeah, and uh,
Speaker 1: you know, insulin has improved a lot over the years,
Speaker 1: you know, to give some credit to the pharmaceutical companies.
Speaker 1: We no longer have to torture dogs to make it.
Speaker 1: It's not all derived from animals anymore. Human insulin can
Speaker 1: be produced using recompetent DNA technology that basically turns bacteria
Speaker 1: and insulin factories. It's pretty cool. The they deserve to
Speaker 1: be rewarded for the innovations, or at least the scientists
Speaker 1: do for the innovations that have been made to insulin. UM.
Speaker 1: But with each innovation, essentially older but still working forms
Speaker 1: of insulin UH stop being used as opposed to just
Speaker 1: being sold as generics because it's not profitable to run them.
Speaker 1: I read a Business Insider article on exactly this problem.
Speaker 1: It notes that the number of Americans with diabetes has
Speaker 1: tripled since nineteen eighty. You might expect that to make
Speaker 1: insulin cheaper, since it's now easier to make and being
Speaker 1: produced on an economy of scale. Instead, the prices sword astronomically.
Speaker 1: Some insulin products have seen their price triple since two
Speaker 1: thousand two. Yeah. Levi Mere, one popular medication made by
Speaker 1: Novo Nordisk, cost a hundred and twenty dollars for a
Speaker 1: hundred units two twelve. Today, the same amount costs three
Speaker 1: hundred dollars. Now, as we know, a generic versions of
Speaker 1: medication often helpfully, you could buy so many dogs with that.
Speaker 1: You could you could buy three dollar dogs even, yeah,
Speaker 1: even a three dollar dog, which is an expensive dog.
Speaker 1: In the insulin, you could buy a hundred your own
Speaker 1: yeah yeah. Now, as we noted earlier, generic versions of
Speaker 1: medication can lower the price by as much as eight percent.
Speaker 1: This would be life changing for someone with diabetes. Struggling
Speaker 1: to deal with an extra five hundred and seventy dollars
Speaker 1: a month insulin bills. That's what the average diabetic American
Speaker 1: past Jesus Christ. So you're talking four hundred bucks that
Speaker 1: could be back on the can be spent on dogs,
Speaker 1: could be spent on dogs, or maybe food and your
Speaker 1: or maybe food and rent. But yeah, there is no
Speaker 1: generic insulin, and Riggs and Green suspect that this is
Speaker 1: because no pharmaceutical company considers making such a product to
Speaker 1: be a worthwhile investment. On February two thousand seventeen, Shane
Speaker 1: Patrick Boyle posted a go fund Me to raise enough
Speaker 1: money from one month of Inceland. For him. This meant
Speaker 1: seven hundred and fifty dollars. As we already discussed, he
Speaker 1: came up fifty dollars short, and he died a couple
Speaker 1: of weeks later of diabetic keto acidosis. The current Secretary
Speaker 1: of Health and Human Services, appointed by Donald Trump and
Speaker 1: confirmed by Congress is Alex Azar. Before he got into politics,
Speaker 1: Mr Azar had a different job. He worked for Eli
Speaker 1: Lily from two thousand seven to two thousand seventeen. Starting
Speaker 1: in two twelve, he was the president of Lily USA.
Speaker 1: The company's largest division. I'd like to quote from an
Speaker 1: article in the Nation. During Azar's tenure, Eli Lily raised
Speaker 1: the prices on its insulence in the United States by
Speaker 1: twenty point eight percent in two thousand fourteen, sixteen point
Speaker 1: nine percent in two thousand fifteen, and seven point five
Speaker 1: percent in two thousand and sixteen. Eli Lily's biggest seller,
Speaker 1: humal log insulin, is now off patent, but rather than
Speaker 1: becoming cheaper, Human Logue costs more now than when it
Speaker 1: first came to market in nineteen ninety six. When Azar
Speaker 1: started working at Eli Lily in June two thousand seven,
Speaker 1: the list price for a vile of human Logue was
Speaker 1: seventy four dollars. When he quit in January two thousand seventeen,
Speaker 1: it was two hundred and sixty mine. So have they
Speaker 1: made changes to human Logue. It's just they're just jacking
Speaker 1: the price. Oh my god, It's like that's shouldn't that
Speaker 1: be sort of like I'm murder I mean, the Health
Speaker 1: and Human Service as secretary did it, So how could
Speaker 1: it be that? Well, you know how people get so
Speaker 1: worked up when they see stores jack up the prices
Speaker 1: of water before disaster. This is like that every day,
Speaker 1: every single year for twenty years, and then you become
Speaker 1: a secretary at about Oh that is really depressing. It's horrible. Yeah,
Speaker 1: oh that was That was a very sudden right into
Speaker 1: the wall in there. No, I mean, there's not much
Speaker 1: to say. I read the story about those parents bringing
Speaker 1: their dead kids ashes to a pharmaceutical company and read
Speaker 1: about it, and it's fucked up. That is so terrible
Speaker 1: heavy I mean alex asar and everyone else involved in
Speaker 1: these companies and changing the prices of them as a
Speaker 1: piece of ship. Because I mean, so one thing is
Speaker 1: to be clear about diabetes. There are two types. So
Speaker 1: there's childhood diabetes where there's no lifestyle. Yeah, Type one,
Speaker 1: they're born with it. You just random chance. Should he
Speaker 1: spend that big roulette wheel mother nature just dick and around.
Speaker 1: But I mean that's not to say people type two
Speaker 1: deserve it or anything like that, because like I mean,
Speaker 1: it's such an irony where we have such little restrictions
Speaker 1: on all these foods that are high in sugar and
Speaker 1: killing us with you know, just creating these high incidents
Speaker 1: of diabetes, and then the medicine that can save your
Speaker 1: life is also just the price is jacked of Jesus Christ.
Speaker 1: That is, if that isn't an indictment of our society.
Speaker 1: I don't know. Yeah, it's pretty pretty horrible and gross. Yeah.
Speaker 1: So if you're diabetic, so are you're dealing with this?
Speaker 1: If you happen to know where alex Asar's car is.
Speaker 1: I'm not going to say, commit a crime on alex
Speaker 1: Asar's car, but maybe do crimes? Do crimes? Not? Maybe
Speaker 1: I'm just do crist generally, do cry generally do crimes?
Speaker 1: I mean my goal is to train a flock of
Speaker 1: birds to follow them around and give those birds a
Speaker 1: really healthy but very high in fiber diet and just
Speaker 1: have them follow car a lot of a lot of
Speaker 1: like wheat husks, yeah, chia seeds. If you train birds
Speaker 1: and live in the d C area, we have a
Speaker 1: gig for you. We got a job. Listen, well, crowd
Speaker 1: fund this like we would crowd fund someone's insulin payment. Yeah.
Speaker 1: And if we fall fifty short, though, we won't die.
Speaker 1: We won't die. His car will just not be filthy.
Speaker 1: Shirt will not be shipped on if you train birds
Speaker 1: in d C. Right, if you drop a line, if
Speaker 1: you practice falconry in the DC area, the greater metropolitan
Speaker 1: DC area. You know D M. Robert or if you're Oswald, Tomilkins,
Speaker 1: the greatest car here in the East Coast. Everybody knows Oswald. Yeah, absolutely,
Speaker 1: he's fantastic. Maybe key this guy's car, you know, to
Speaker 1: do it the I don't know, maybe key. In an
Speaker 1: image of an urn with a dead twenty seven year
Speaker 1: old diabetic dashes in it. It's so heavy because it's
Speaker 1: one of these things where we freaking found the cure
Speaker 1: to this. We found shouldn't be a problem. It shouldn't
Speaker 1: be a problem. You know. We talk about things like
Speaker 1: how terrible cancer is and how we crave a cure
Speaker 1: so much, and of course we do, because cancer is awful.
Speaker 1: But then we have a freaking cure for diabetes that
Speaker 1: will keep people from dying, from imminently dying, and just
Speaker 1: to dangle it above them like, oh, oh you want
Speaker 1: this cure, Oh, try and get it. Oh, and the
Speaker 1: people dangling and are only using one hand because they're
Speaker 1: getting paid tens of millions of dollars and bonuses for
Speaker 1: doing the dangling. What a great system, I know, super
Speaker 1: gonna last forever and not collapse in fire and death. Yet, like,
Speaker 1: you know, does it feel good when you get your
Speaker 1: like second luxury. Yah, like you might as well just
Speaker 1: why not skip all of the middleman stuff and just
Speaker 1: make it out of dead diabet Just make a giant
Speaker 1: bone yacht made out of the bones of dead diabetic people.
Speaker 1: If Alex Asar was sailing up to Kinnebunkport, Maine in
Speaker 1: a bone yacht, well, okay, he's terrible, but like, this
Speaker 1: guy at least has some pane, at least he's forth right. Yeah,
Speaker 1: he's honestly a bone merchant. Cut the metaphor. Hubbard would
Speaker 1: have built a boat out of bones. Yeah, absolutely, Yeah,
Speaker 1: either build a bone boat or I'm gonna keep telling
Speaker 1: people to key your car, Alex has aer. That's my
Speaker 1: threat to the Secretary of Human Services. We will train
Speaker 1: a flock of birds. Train a flock of birds to
Speaker 1: ship on your car. Constant flow stream of ship flowing
Speaker 1: as much as insulin should be flowing patients. The bird
Speaker 1: ship will flow like insulin until the insulin gets cheaper.
Speaker 1: That is the terroristic threat we are making on this episode.
Speaker 1: Behind the Bastards. Great cool. I'm glad you put a
Speaker 1: label to it so it'll really make dhs. Uh. You's
Speaker 1: gonna make it easy for those yes for their search
Speaker 1: engine to go like, oh, there we go. I'm gonna
Speaker 1: get an interview like like how many birds are in
Speaker 1: your birds? You have? What kind? Let me see your
Speaker 1: keys because there was their paint on them. Katie, you
Speaker 1: got any plug plug? Well, of course, my show Creature
Speaker 1: feature where we talk about creatures who are more human
Speaker 1: like than you expect in humans who act in animal ways,
Speaker 1: like the freaking barbaric animals who deny people insulin. Well, actually,
Speaker 1: animals would never do anything that sucked up. No, they wouldn't.
Speaker 1: I mean, animals do some fucked up things, like they'll
Speaker 1: mind control of spiders into weaving them a little nest
Speaker 1: and then killing them and get behind right right, there's
Speaker 1: something like metal about that. There's there's nothing cool about
Speaker 1: just depriving people of insulin. Uh And So you can
Speaker 1: follow me at Katie Golden on Twitter. You can follow
Speaker 1: my bird twitter at pro Burg writes uh and, Yeah,
Speaker 1: please do check out my show. There's a great episode
Speaker 1: with Robert Innett called uh Re for Madness for Madness.
Speaker 1: There we go from the name of that movie, Yeah
Speaker 1: for madness, madness All rightert Evans. This has been behind
Speaker 1: the Bastards. You can find me on Twitter at I right, okay.
Speaker 1: You can find us on Instagram and uh twitter at
Speaker 1: at bastards pod. You can find us online with all
Speaker 1: the sources for this article at behind the Bastards dot com.
Speaker 1: We have a t shirt shop. You can buy cups there, mugs,
Speaker 1: phone raps, and stuff with cool logos made up and
Speaker 1: catch phrases and stuff from the show neat images. So
Speaker 1: like taste your PA, sample your p that'll be coming
Speaker 1: out soon, So go to t public, look up behind
Speaker 1: the Bastards public. Hello, maybe this week instead of buying
Speaker 1: a shirt, donate some money to somebody's go fund me
Speaker 1: if they're trying to buy Incelin or something they clearly
Speaker 1: need the help. Vote or vote. Hopefully you just voted.
Speaker 1: There's no voting to do immediately. Well soon, keep voting, yeah,
Speaker 1: I keep voting constantly. Look out for your your diabetic
Speaker 1: friends because it's rough. Yeah, all right, I love about
Speaker 1: three percent of you. H