WEBVTT - The Bastards That Kill Diabetics for a Profit

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<v Speaker 1>M everybody. I'm Robert Evans, and this is Behind the Bastards,

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<v Speaker 1>the show where we tell you everything you don't know

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<v Speaker 1>about the very worst people in all of history. And

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<v Speaker 1>this was the highest energy introduction I've ever done. Sophie

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<v Speaker 1>is laughing at me over in the corner. I don't

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<v Speaker 1>understand why I thought it sounded pretty cool, fonds esque.

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<v Speaker 1>This is a show where I read a terrible story

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<v Speaker 1>about history, about someone bad, or someone's bad, or usually

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<v Speaker 1>a bunch of bad people doing bad things to a

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<v Speaker 1>guest who is coming in cold and today that very

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<v Speaker 1>cold guest is Katie Golden. Might be Katie coming in

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<v Speaker 1>Colden anyway. She's birds rights activists on Twitter, where she

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<v Speaker 1>advocates for birds even though as I understand that millennials

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<v Speaker 1>are saying birds aren't real, those are lies, Those are

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<v Speaker 1>communist lives, communists lies. She's also the host of another

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<v Speaker 1>podcast on This Stuff Network, Creature feature great podcast about

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<v Speaker 1>animals doing weird ass shit science and stuffy science. Step. Yeah,

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<v Speaker 1>we talked about animals and drugs. It's great to do drugs.

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<v Speaker 1>It is great to do drugs. Uh. Speaking of drugs

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<v Speaker 1>that are great to do today we're talking about insulin,

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<v Speaker 1>which is not a well, I mean, it's fun and

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<v Speaker 1>that if you need to take it, you die not

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<v Speaker 1>taking it, right, I think it's fun not to die.

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<v Speaker 1>It is fun not to die, relatively fun not to die.

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<v Speaker 1>Yet it was fun not to die of insulin shock

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<v Speaker 1>or diabetic comas and stuff. Not fun. So I'm just

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<v Speaker 1>going to get into it. On November seventeen, several parents

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<v Speaker 1>brought the ashes of their dead children to the doorstep

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<v Speaker 1>of the offices of Santa Fee, a pharmaceutical company that

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<v Speaker 1>produces insulin. Sanofie and other insulin producers like Eli Lily

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<v Speaker 1>have been steadily raising the prices of their insulin for years.

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<v Speaker 1>Because of this, insulin can cost as much as a

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<v Speaker 1>thousand dollars a month for people without decent insurance. Oh

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<v Speaker 1>my god, that's I I can't imagine spending a thousand

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<v Speaker 1>dollars a month on anything of there than like rent,

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<v Speaker 1>I guess, but even even a pretty expensive town. So

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<v Speaker 1>you're essentially renting your own body, like you want to

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<v Speaker 1>keep living in your body. A thousand bucks rent, yeah,

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<v Speaker 1>get you a decent place like in Culver City. I

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<v Speaker 1>feel like when I lived in Culver my rent was

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<v Speaker 1>about thousand months. Yeah, so it's it's frustrating, right, it's

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<v Speaker 1>a little frist It's a little frustrating because clearly, I mean,

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<v Speaker 1>no country on Earth can afford something like single pair

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<v Speaker 1>of healthcare anywhere. It never be done. Um, and our

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<v Speaker 1>government needs its money for stuff like I did you

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<v Speaker 1>hear about when that hurricane hit the East coast the

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<v Speaker 1>military forgot to remove like eleven two and they all

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<v Speaker 1>got destroyed. That was one point four billion dollars. Well,

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<v Speaker 1>they gotta could have bought a lot. They gotta put

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<v Speaker 1>another billion dollar coin in the f twenty seven vending machines.

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<v Speaker 1>The funniest thing is there's no vending machine. We can't

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<v Speaker 1>make the parts for them anymore, stop manufacturing any of

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<v Speaker 1>the things that they are placeable. So, oh good, but

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<v Speaker 1>we can't afford to help people with here. I'm sure

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<v Speaker 1>we'll find a way to dig deep into the earth

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<v Speaker 1>and find things that will destroy our planet that can

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<v Speaker 1>make new airplanes. Yeah, I'm sure we will. Now, people

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<v Speaker 1>with type one diabetes do not naturally produce insulin, which

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<v Speaker 1>is a magical substance that lets sugar not kill us

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<v Speaker 1>instead of be delicious. I'm a fan of insulin yeah,

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<v Speaker 1>I'm a big fan. Now, when insulin costs as much,

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<v Speaker 1>if not more than rent, many people stopped taking it

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<v Speaker 1>as often as they should and ration their precious supply

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<v Speaker 1>so that they can afford to do things like exist

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<v Speaker 1>in a capitalist society and pay the aforementioned rent that

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<v Speaker 1>we've been talking right. Also, um food, because here's the thing.

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<v Speaker 1>Here's the thing is like insulin is basically useless if

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<v Speaker 1>you don't eat, if right, because then you don't get

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<v Speaker 1>any sugar, which without insulin. You know, it's like, well,

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<v Speaker 1>I mean, Katie, I was really sympathetic with these people,

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<v Speaker 1>but I think you've identified a way that they could

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<v Speaker 1>not need insulin, which is the no eat diet. And

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<v Speaker 1>you won't of insulent shock. You'll just die of starvation.

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<v Speaker 1>I do think they'll die. Oh yeah, you're right, probably

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<v Speaker 1>medically speaking. Yesterday, Well, neither of us are doctors. No,

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<v Speaker 1>you're not a doctor. No, I'm not a doctor. Fantastic,

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<v Speaker 1>but I do read web and b like a lot. Well,

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<v Speaker 1>then you're basically a doctor, fantastic now. Alec Rashawn Smith

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<v Speaker 1>was one of the young people who got caught in

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<v Speaker 1>this deadly dance with a necessary drug. When he was

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<v Speaker 1>twenty six, he aged out of his mother's health insurance.

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<v Speaker 1>One month after his birthday, he died of diabetic shock.

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<v Speaker 1>Smith's mom, Nicole, was one of the grieving parents who

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<v Speaker 1>brought her son's ashes to Santa Fee that November day.

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<v Speaker 1>She told the Boston Globe she wanted the company to quote, no,

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<v Speaker 1>the price of their product is killing people when it's

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<v Speaker 1>intended to save lives. Antoinette Worsham, whose twenty two year

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<v Speaker 1>old daughter Antavia died last year while rationing insulin, told

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<v Speaker 1>another interviewer that for people like her daughter, it's either

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<v Speaker 1>pay your rent, pay your car payment, or get your medication.

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<v Speaker 1>Diabetes is currently the seventh leading cause of death in

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<v Speaker 1>the United States. I heard this story of this guy

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<v Speaker 1>who because like I've heard this thing where people say, well,

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<v Speaker 1>just go fund me if you can't afford your medication

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<v Speaker 1>instead of healthcare. Yeah, there was a guy who did

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<v Speaker 1>that very thing and he short, yeah, fifty dollars short

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<v Speaker 1>of reaching his goal in the way. It was his

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<v Speaker 1>monthly calls, right, and he needed insulin to survive, and

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<v Speaker 1>he didn't have the money to pay for it, and

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<v Speaker 1>he was like taking care of his ailing mom too.

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<v Speaker 1>So that's part of the reason. He didn't have that

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<v Speaker 1>high of an income, so like he tried to get it.

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<v Speaker 1>He was fifty dollar short of reaching his goal. So

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<v Speaker 1>you know how go fund me works. Then you get

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<v Speaker 1>none of that money and he died. Yeah he should.

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<v Speaker 1>We will be talking about him a little bit later.

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<v Speaker 1>Oh good. So clearly this situation is fucked right that

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<v Speaker 1>it seems fun. Seems like we can all get on

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<v Speaker 1>the same page. There, it's like a little like just

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<v Speaker 1>maybe a smidge fun the old F bomb. Yeah, so

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<v Speaker 1>what is fun? Why is this so messed up? People

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<v Speaker 1>are dying? Well, I'm saying that that's why it's messed up,

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<v Speaker 1>Like why why would because insulin is not a new drug. Usually,

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<v Speaker 1>when you've got like a case of this where something

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<v Speaker 1>is incredibly expensive, it's number one, a drug that very

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<v Speaker 1>few people need, and number two a drug that's really new.

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<v Speaker 1>Because then you know, that's the way that these patents work.

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<v Speaker 1>For most medicines, After about twenty years after their invention,

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<v Speaker 1>a generic patent comes out that's fairly affordable, right, right,

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<v Speaker 1>That's one of the ways our system is supposed to work,

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<v Speaker 1>so that that keeps drugs affordable for normal people, but

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<v Speaker 1>also gives an incentive for companies to invest in research

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<v Speaker 1>and whatnot. Right, that is the promise in our capitalist

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<v Speaker 1>system is that you will get better medicine under this system,

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<v Speaker 1>because companies will find new medicines, you know, essentially due

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<v Speaker 1>to the profit motive, but because of the way that

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<v Speaker 1>this generic drug like that. That's the idea, Right, that's

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<v Speaker 1>the promise that we've all bought in this system. Otherwise

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<v Speaker 1>poor people are middle class people would never be able

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<v Speaker 1>to afford medicine exactly. Insulin has existed for nearly a century,

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<v Speaker 1>but there is no cheap generic insulin available in the

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<v Speaker 1>United States today. We're going to talk talk about why.

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<v Speaker 1>But first we are going to talk about the invention

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<v Speaker 1>of insulin as a medicine. Most cursory coverage of this

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<v Speaker 1>will give credit to Dr Frederick Banting, some mention a

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<v Speaker 1>small team of scientists who work with him. When I

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<v Speaker 1>decided to look into it this story, it's because I

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<v Speaker 1>ran across a tweet about Banting. It stated that he

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<v Speaker 1>had given the invention of medical insulin to the world,

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<v Speaker 1>put it in the public domain, essentially as a gift

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<v Speaker 1>to humanity, because he didn't want to profit off and

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<v Speaker 1>he wanted people to be able to get medicine, and

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<v Speaker 1>so the tweet was basically like this wonderful founder gave

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<v Speaker 1>insulin to the world and wanted people to have it

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<v Speaker 1>for free, and then the evil pharmaceutical companies fucked it up,

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<v Speaker 1>which is true, but not detailed enough. So I wanted

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<v Speaker 1>to know what that story was. Let's get the details.

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<v Speaker 1>So let's get the diets. That's what we are going

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<v Speaker 1>to be talking about today. Now, like most things you

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<v Speaker 1>find on social media, that version of events is not

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<v Speaker 1>quite accurate. Insulin did not have a single inventor, and

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<v Speaker 1>while pharmaceutical companies are the ultimate bastards here, the full

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<v Speaker 1>story is weirder, sadder, and more infuriating than that. In

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<v Speaker 1>Dr Frederick Banting was the first person to isolate secretions

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<v Speaker 1>from isolate cells, the cells that make insulin. He suggested

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<v Speaker 1>these might hold a treat for diabetes, and he was

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<v Speaker 1>basically right. He came up with a plan to tie

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<v Speaker 1>up the pancreatic ducts of laboratory dogs and make their

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<v Speaker 1>pancreases overproduce the cells that contain insulin until everything else

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<v Speaker 1>in the pancreas dies. That was the idea, right, we

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<v Speaker 1>did dogs die. The hope was they wouldn't. This is

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<v Speaker 1>actually initially envision is like its beautiful one to punch

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<v Speaker 1>because we make these dogs pancreases overproduced the cells. They

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<v Speaker 1>didn't really know. Insulin was like insulin was a theoretical

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<v Speaker 1>substance they called, I think insuline. There was an e.

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<v Speaker 1>I don't know how they pronounced it, but it was

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<v Speaker 1>spelled insuline. And the theory was like, if we make

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<v Speaker 1>these dogs pancreases produce a bunch of these cells, we

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<v Speaker 1>can take the pancreases out and they will contain concentrated

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<v Speaker 1>versions that then we can extract whatever in the pancreas

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<v Speaker 1>shoot it into a diabetic It will make them better.

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<v Speaker 1>So the idea was, we gotta take these dogs pancreases

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<v Speaker 1>out in order to do this thing, but then we

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<v Speaker 1>can just give them what we make from it, and

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<v Speaker 1>if it works, it's a beautiful one too. Thing we

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<v Speaker 1>don't have to kill the dogs will know that we've

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<v Speaker 1>got a treatment for diabetes because these dogs won't be

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<v Speaker 1>able to pre sinsulin. After we stuck up their pancreases.

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<v Speaker 1>Seemed like it was like a nice circle that they

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<v Speaker 1>had that they had developed um Now, the problem with

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<v Speaker 1>Banting's plan is that he was not up to date

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<v Speaker 1>on the work other scientists were doing testing blood sugar

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<v Speaker 1>to find diabetes and patients Banting did urine testing to

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<v Speaker 1>find out blood sugar levels, which is not just did

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<v Speaker 1>you just like taste it, because I know I just

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<v Speaker 1>tasting their well, one of the one of the things

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<v Speaker 1>is like, um, if you taste your urine or smell

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<v Speaker 1>your urine, it tastes sweet. It's a sign of diabetes

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<v Speaker 1>because it's like I think it's called hyperkalemia, and it's

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<v Speaker 1>because you're finding more sugars in your urine. You know,

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<v Speaker 1>I've only drank my pea once. Uh for my book

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<v Speaker 1>A Brief History advice, because I was I was trying

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<v Speaker 1>an ancient Meso American treatment where you mix tobacco, garlic

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<v Speaker 1>and urine as a treatment for constipation. It works, it

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<v Speaker 1>makes you very ill, but functions and its intended purpose.

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<v Speaker 1>I was not paying attention to how sweet it was.

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<v Speaker 1>There was a lot of garlic in there too, right,

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<v Speaker 1>The garlic is well, the garlic is going to cut

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<v Speaker 1>the sweetness as it's cooking. You know it's gonna But

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<v Speaker 1>it sounds like what you're saying is that we should

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<v Speaker 1>all be drinking r P every morning to learn if

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<v Speaker 1>we are just a little bit a little bit. Just

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<v Speaker 1>don't drink a lot of don't drink a lot of

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<v Speaker 1>your taste a sample. That's the new behind the bastard's motto.

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<v Speaker 1>Sample your own, sample your P, sample your P. Right,

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<v Speaker 1>this will be marketable. Let's get a T shirt going,

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<v Speaker 1>sample pie. Start that process. Okay, So if he's shaking

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<v Speaker 1>her head, she's not happy with that. All right, let's

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<v Speaker 1>move on to talking about diabetes some more. So. Banny

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<v Speaker 1>was the first guy to start isolating the slate cells

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<v Speaker 1>that contain the hormone insulin, but the amounts he was

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<v Speaker 1>able to get were too small to really be useful

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<v Speaker 1>in his His work had a bunch of holes in it.

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<v Speaker 1>You know, he was good at a couple of things,

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<v Speaker 1>but he was almost taking a lot of other areas.

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<v Speaker 1>So we had to partner with other scientists. Professor John

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<v Speaker 1>James Rickard McLeod was the head of physiology at the

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<v Speaker 1>University of Toronto. McLeod agreed to give him laboratory space

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<v Speaker 1>for his experiments, and he also served as sort of

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<v Speaker 1>the manager in over. So you're for the whole project

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<v Speaker 1>because Banting was an unstable personality of an asshole. So McLeod,

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<v Speaker 1>you means some scientists are assholes. Yes, really, the kind

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<v Speaker 1>of guy who would who would poison the dog's pancreas

0:11:13.160 --> 0:11:15.040
<v Speaker 1>in order to try to solve it as ease isn't

0:11:15.040 --> 0:11:19.520
<v Speaker 1>great at working with other people. Interesting, I mean er intuitive,

0:11:19.559 --> 0:11:21.760
<v Speaker 1>but you know you need to do the research. This

0:11:21.880 --> 0:11:23.920
<v Speaker 1>horrible thing has to happen. But the kind of guy

0:11:23.920 --> 0:11:25.600
<v Speaker 1>who's like, oh, yeah, what if we just toward your

0:11:25.600 --> 0:11:27.960
<v Speaker 1>dogs to figure this out, it's probably not fun to

0:11:28.000 --> 0:11:30.760
<v Speaker 1>work with. And he wasn't maybe just a little too.

0:11:31.080 --> 0:11:34.640
<v Speaker 1>He's got tunnel vision there. He's just so focused on

0:11:34.679 --> 0:11:37.600
<v Speaker 1>that insulin. Everyone else is like, but dogs, there's just

0:11:37.920 --> 0:11:42.760
<v Speaker 1>dead dogs everywhere. I know. I'm almost corpses, just crumpled

0:11:42.840 --> 0:11:45.240
<v Speaker 1>up dog. We get it right, the dogs won't die.

0:11:45.400 --> 0:11:47.559
<v Speaker 1>He's just at his desk and he's like, damn it,

0:11:47.600 --> 0:11:51.000
<v Speaker 1>and he crinkles up another dog and tossed it. Just

0:11:51.120 --> 0:11:54.640
<v Speaker 1>the trash can full of dead dogs. Sophie is really

0:11:54.679 --> 0:11:57.720
<v Speaker 1>not loving this conversation. There is a dog in the room,

0:11:57.760 --> 0:12:01.000
<v Speaker 1>but because Anderson is a dog, does not understand what

0:12:01.000 --> 0:12:04.240
<v Speaker 1>we're talking about which is the mercy of being a dog.

0:12:05.040 --> 0:12:08.439
<v Speaker 1>Now back to the story. Banting came to hate McLeod

0:12:08.559 --> 0:12:11.240
<v Speaker 1>because McLeod was good at talking and explaining their work

0:12:11.280 --> 0:12:13.960
<v Speaker 1>to other people at conventions. Uh well, Banting was an

0:12:14.000 --> 0:12:16.320
<v Speaker 1>introvert and a big old nerd. So Banting started to

0:12:16.320 --> 0:12:18.120
<v Speaker 1>worry that like McLeod was going to outshine him and

0:12:18.160 --> 0:12:20.199
<v Speaker 1>get credit, even though remything I've been able to read,

0:12:20.240 --> 0:12:22.160
<v Speaker 1>McLeod was just about, oh, yeah, this is a really

0:12:22.200 --> 0:12:24.400
<v Speaker 1>important cause. I want to do everything I can do

0:12:24.480 --> 0:12:26.680
<v Speaker 1>to make sure that this research gets completely He goes

0:12:26.720 --> 0:12:28.880
<v Speaker 1>like on Reddit to complain about him, like what a

0:12:28.920 --> 0:12:32.400
<v Speaker 1>stupid science child, Banting? Would a thousand percent be a

0:12:32.440 --> 0:12:35.480
<v Speaker 1>Reddit dude? Although we'll get to yeah a second. So

0:12:35.559 --> 0:12:38.640
<v Speaker 1>Banting had an assistant, a guy named Charles Herbert Best,

0:12:38.640 --> 0:12:43.120
<v Speaker 1>who did Charles Charles though I thought this is a

0:12:43.160 --> 0:12:50.080
<v Speaker 1>fancy form of you know, Charles Charlie char No, No,

0:12:50.120 --> 0:12:53.760
<v Speaker 1>not at all, plain old Charles like an American reading

0:12:53.800 --> 0:12:58.840
<v Speaker 1>podcast for three hours. So Charles Herbert Best was his assistant,

0:12:58.880 --> 0:13:01.240
<v Speaker 1>and Best did a lot of crucial work in the process.

0:13:01.240 --> 0:13:03.280
<v Speaker 1>And it seems fair to say in general that all

0:13:03.280 --> 0:13:05.640
<v Speaker 1>three men were critical parts of the development of insulin

0:13:05.640 --> 0:13:08.199
<v Speaker 1>as an effective medication. When they started their work, the

0:13:08.240 --> 0:13:10.960
<v Speaker 1>existence of insulin was still not a confirmed fact. We

0:13:11.040 --> 0:13:13.240
<v Speaker 1>knew that the islets of linger Hends, which is the

0:13:13.320 --> 0:13:16.520
<v Speaker 1>name of those little cells, produced something that helped regulate sugar.

0:13:16.559 --> 0:13:18.360
<v Speaker 1>Insulin was at this point still just the name of

0:13:18.360 --> 0:13:21.720
<v Speaker 1>a hypothetical substance scientist thought existed. So just as a

0:13:21.760 --> 0:13:25.480
<v Speaker 1>quick side note, the islets of Lingerham, imagine them as

0:13:25.559 --> 0:13:31.640
<v Speaker 1>like these little islands, that little British islands microbial size.

0:13:32.120 --> 0:13:35.920
<v Speaker 1>Langerham expedition goes out and discovers like little white blood

0:13:35.920 --> 0:13:39.120
<v Speaker 1>cells and naval hats. Sorry that I just had to

0:13:39.120 --> 0:13:43.719
<v Speaker 1>get that image, Duke. Yeah, you're right, that's yeah, that's

0:13:43.720 --> 0:13:48.760
<v Speaker 1>how it was discovered. Tiny tiny explorers, tiny explorers. Banting,

0:13:48.840 --> 0:13:52.480
<v Speaker 1>McLeod and Best started work in May nine. It did

0:13:52.520 --> 0:13:54.319
<v Speaker 1>not go well at first. I found an article in

0:13:54.360 --> 0:13:56.760
<v Speaker 1>the Journal of Clinical Chemistry that went into the discovery

0:13:56.760 --> 0:13:59.800
<v Speaker 1>of insulin in exhausting detail. Here's how they described the

0:13:59.840 --> 0:14:02.880
<v Speaker 1>few months of work. After legation of the ducts, the

0:14:02.920 --> 0:14:05.120
<v Speaker 1>dogs were expected to recover from the surgery and live

0:14:05.200 --> 0:14:07.719
<v Speaker 1>more or less normally. After several weeks, the pancreas and

0:14:07.800 --> 0:14:10.640
<v Speaker 1>able to secrete fluid into the duadendum would gradually atrophy

0:14:10.679 --> 0:14:13.680
<v Speaker 1>and would be removed in process to extract the internal secretion.

0:14:14.040 --> 0:14:16.160
<v Speaker 1>The extract would then be administered to other dogs made

0:14:16.200 --> 0:14:18.840
<v Speaker 1>diabetic by removal of the pancreas. It was a laborious

0:14:18.880 --> 0:14:21.080
<v Speaker 1>task for someone with no experience and animal work, and

0:14:21.120 --> 0:14:23.080
<v Speaker 1>it did not go well at first his Banting struggle

0:14:23.160 --> 0:14:25.240
<v Speaker 1>to improve his surgical technique. By the end of the

0:14:25.320 --> 0:14:27.840
<v Speaker 1>second week, seven of their tin dogs had died. To

0:14:27.960 --> 0:14:30.680
<v Speaker 1>resupply the animal cages, they resorted to buying dogs in

0:14:30.720 --> 0:14:33.960
<v Speaker 1>the streets of Toronto. The three dollars with no questions asked,

0:14:36.640 --> 0:14:40.000
<v Speaker 1>we need dogs, We need a lot of dogs. It's

0:14:40.040 --> 0:14:42.320
<v Speaker 1>just some guy with an overcoat, Like, hey, I heard

0:14:42.360 --> 0:14:45.360
<v Speaker 1>you was looking for dogs. This doctors never worked on dogs.

0:14:45.400 --> 0:14:47.560
<v Speaker 1>He's killing the left and right. It's just like opening

0:14:47.640 --> 0:14:52.360
<v Speaker 1>up the trench coat and I'll give you nine dollars.

0:14:52.480 --> 0:14:57.440
<v Speaker 1>Is that enough for three dogs? They're like off brand dogs,

0:14:57.560 --> 0:15:00.360
<v Speaker 1>Like no, no, these are dogs. Three of these are cats.

0:15:02.560 --> 0:15:09.440
<v Speaker 1>Sophie really not happy with me right now. We should

0:15:09.440 --> 0:15:13.560
<v Speaker 1>be good. We should be good. Sorry, we had to

0:15:13.600 --> 0:15:16.480
<v Speaker 1>deal with some noise. We also learned something that I'm

0:15:16.520 --> 0:15:19.360
<v Speaker 1>just coming into which is that the guy have been

0:15:19.400 --> 0:15:23.960
<v Speaker 1>calling McLeod is is McLeod So everybody have a good

0:15:24.240 --> 0:15:29.520
<v Speaker 1>real mcclaude, aren't you. Everybody have a good laugh, good

0:15:29.560 --> 0:15:33.720
<v Speaker 1>old laugh at old old Robert Evans's expense not knowing

0:15:33.840 --> 0:15:38.400
<v Speaker 1>enough about scotsman. Uh so, Um, you may have already

0:15:38.440 --> 0:15:40.360
<v Speaker 1>noticed that this is horrible because dogs are good, and

0:15:40.440 --> 0:15:42.480
<v Speaker 1>medically torturing them to death is bad. But the world

0:15:42.560 --> 0:15:44.840
<v Speaker 1>is a gigantic wheel of pain and brutal crush and cruelty,

0:15:44.920 --> 0:15:47.680
<v Speaker 1>and sometimes is sometimes necessary in order to save the

0:15:47.760 --> 0:15:50.720
<v Speaker 1>lives of billions of diabetics. Uh so, yeah, that's just

0:15:50.760 --> 0:15:53.320
<v Speaker 1>the way the world works. Sometimes dogs continue to diet

0:15:53.400 --> 0:15:55.600
<v Speaker 1>rapid rates throughout the research, but Banting and Best were

0:15:55.640 --> 0:15:58.040
<v Speaker 1>eventually successful in creating an extract that seemed to work

0:15:58.080 --> 0:16:00.080
<v Speaker 1>at regulating the blood sugar of dogs who'd had their

0:16:00.080 --> 0:16:02.840
<v Speaker 1>appendix is removed. They debuted their work to an audience.

0:16:03.000 --> 0:16:04.400
<v Speaker 1>It was one of those things you've seen on TV

0:16:04.520 --> 0:16:06.840
<v Speaker 1>where the doctors do their work in like a big

0:16:06.880 --> 0:16:09.320
<v Speaker 1>pit surrounded by an auditorium full of other doctors and

0:16:09.320 --> 0:16:13.360
<v Speaker 1>pharmaceutical industry people. Old timey thanks they had like they

0:16:13.400 --> 0:16:16.440
<v Speaker 1>had instead of bags of popcorn was like bags dead dogs,

0:16:16.480 --> 0:16:18.760
<v Speaker 1>bags of dead dogs, and those little circle things on

0:16:18.800 --> 0:16:22.120
<v Speaker 1>their heads that old timey doctors wore. One man present

0:16:22.200 --> 0:16:25.160
<v Speaker 1>at this early insulin demo was George H. A. Cloud's,

0:16:25.240 --> 0:16:29.400
<v Speaker 1>a research director for Eli Lily, the pharmaceutical company. After

0:16:29.440 --> 0:16:31.680
<v Speaker 1>the presentation, he sidled up to McLoud and asked if

0:16:31.720 --> 0:16:33.640
<v Speaker 1>his company could work with the scientists in order to

0:16:33.680 --> 0:16:36.280
<v Speaker 1>get a product on the market sooner. McLeod turned him down,

0:16:36.320 --> 0:16:38.440
<v Speaker 1>claiming that the work was not far enough along yet.

0:16:38.720 --> 0:16:41.320
<v Speaker 1>This seems to have pissed Banting off, largely because McLoud

0:16:41.400 --> 0:16:44.240
<v Speaker 1>had spoken for the group. Banting was also frustrated by

0:16:44.280 --> 0:16:46.120
<v Speaker 1>the fact that McLoud was a much better presenter than

0:16:46.200 --> 0:16:48.600
<v Speaker 1>he was, which made Banting worry that other scientists would

0:16:48.640 --> 0:16:51.400
<v Speaker 1>get the credit and popular acclaim Banting felt he deserved.

0:16:51.640 --> 0:16:54.360
<v Speaker 1>So like Banting is like watching as McLeod is like

0:16:54.640 --> 0:16:57.440
<v Speaker 1>riding in on a skateboard and like hey dudes, and

0:16:57.640 --> 0:17:02.160
<v Speaker 1>like like he's just like curing and he's too nervous

0:17:02.240 --> 0:17:04.359
<v Speaker 1>to talk to anyone, so we can't answer the questions

0:17:04.400 --> 0:17:07.160
<v Speaker 1>which McLeod can. But then he's like he's taking credit

0:17:07.240 --> 0:17:10.240
<v Speaker 1>for me. He's getting shoved in science lockers. He totally

0:17:10.280 --> 0:17:13.840
<v Speaker 1>would be an in cell. I'm calling it now. The

0:17:13.880 --> 0:17:17.240
<v Speaker 1>inventor of insulin is an in cell. Yeah, yeah, perfect

0:17:17.320 --> 0:17:24.520
<v Speaker 1>involuntary cellular biologist. Nice, nice, nice, really good. Uh So

0:17:24.840 --> 0:17:26.320
<v Speaker 1>it took a lot more work and a lot more

0:17:26.359 --> 0:17:28.480
<v Speaker 1>dead dogs before Banting and his team made more progress

0:17:28.600 --> 0:17:31.000
<v Speaker 1>on insulin. By nine two, they were close to a breakthrough,

0:17:31.080 --> 0:17:33.600
<v Speaker 1>and Banting decided that McLeod was the center of a

0:17:33.680 --> 0:17:36.320
<v Speaker 1>gigantic conspiracy to steal the credit for their immediate breakthrough.

0:17:36.800 --> 0:17:38.800
<v Speaker 1>Banting and his team started to work with another scientist

0:17:38.920 --> 0:17:41.399
<v Speaker 1>named colep Colip had figured out how to actually purify

0:17:41.440 --> 0:17:44.439
<v Speaker 1>the pancreatic extracts that they were making and create usable insulin.

0:17:44.720 --> 0:17:47.399
<v Speaker 1>In January of n the group carried out a clinical

0:17:47.440 --> 0:17:50.160
<v Speaker 1>test of their new extract that failed disastrously. The bad

0:17:50.240 --> 0:17:52.919
<v Speaker 1>results sparked a fight, and during a heated exchange, Colip

0:17:53.040 --> 0:17:55.720
<v Speaker 1>threatened to leave the band and take his purification method

0:17:55.800 --> 0:17:57.680
<v Speaker 1>with him. He threatened to patent it's that they'd have

0:17:57.760 --> 0:18:00.200
<v Speaker 1>to pay him to use it. So was Eli only

0:18:00.280 --> 0:18:03.440
<v Speaker 1>the yoko oh no of the situation or they were

0:18:03.480 --> 0:18:06.440
<v Speaker 1>just sparking a fight, Yes, but they didn't They hadn't

0:18:06.480 --> 0:18:09.840
<v Speaker 1>done anything yet. Calyp was kind of the well, no

0:18:10.440 --> 0:18:13.840
<v Speaker 1>Banting was, the Banting was the Yoko was both Yoko

0:18:14.080 --> 0:18:18.680
<v Speaker 1>and Lennon Ouch. That's a that's a harsh personality to have.

0:18:19.840 --> 0:18:22.399
<v Speaker 1>He seems like a rough guy to work with. So

0:18:22.880 --> 0:18:26.080
<v Speaker 1>uh yeah. Here's a quote from that journal article about

0:18:26.119 --> 0:18:28.200
<v Speaker 1>the invention of insulin. This was a breach of the

0:18:28.240 --> 0:18:30.919
<v Speaker 1>agreement between Calyp, Banting, and Best to exchange all results.

0:18:31.000 --> 0:18:33.680
<v Speaker 1>Banting never showed a righteous anger or noted for meekness

0:18:33.720 --> 0:18:36.760
<v Speaker 1>or restraint. When he felt wronged, exploded with clinched fists,

0:18:37.160 --> 0:18:39.040
<v Speaker 1>and in a moment Calyp was laying dazed on the

0:18:39.080 --> 0:18:42.040
<v Speaker 1>floor of the laboratory. Fortunately he was not seriously hurt.

0:18:42.080 --> 0:18:44.919
<v Speaker 1>There are no contemporary records of this encounter, no reference

0:18:45.000 --> 0:18:47.080
<v Speaker 1>by Colip, and only two accounts, neither of which, according

0:18:47.119 --> 0:18:49.919
<v Speaker 1>to Bliss, should be considered entirely reliable. One was by

0:18:49.920 --> 0:18:52.480
<v Speaker 1>Banting and his unpublished nineteen forty memoir, the other by

0:18:52.520 --> 0:18:54.840
<v Speaker 1>Best in a letter to Sir Henry Dale dated February

0:18:54.920 --> 0:18:58.040
<v Speaker 1>twenty nine. So he like beat him with his fists,

0:18:58.119 --> 0:19:00.520
<v Speaker 1>but he didn't hurt him at all. He beat him

0:19:00.560 --> 0:19:02.520
<v Speaker 1>with his fist and I think it probably hurt pretty bad,

0:19:02.680 --> 0:19:05.560
<v Speaker 1>but calyp was too felt bashful about it and didn't

0:19:05.760 --> 0:19:07.680
<v Speaker 1>write about it. Banting is the only one who wrote

0:19:07.680 --> 0:19:09.920
<v Speaker 1>about it, because I'm thinking maybe his fists were like

0:19:10.160 --> 0:19:12.600
<v Speaker 1>soft and small as apricots, and it's just like that,

0:19:12.760 --> 0:19:18.800
<v Speaker 1>like I solved as small as acot oh apricot apricot

0:19:18.880 --> 0:19:22.000
<v Speaker 1>handed Banting. That's it's possible too. It's possibly just sucked

0:19:22.040 --> 0:19:24.800
<v Speaker 1>it punching right, But either way, I just liked this

0:19:24.880 --> 0:19:27.399
<v Speaker 1>story of like these genius scientists creating one of the

0:19:27.440 --> 0:19:30.880
<v Speaker 1>most valuable medicines in history, fist fighting each other over

0:19:30.920 --> 0:19:34.240
<v Speaker 1>the credit at one point. It's beautiful. Now, the four

0:19:34.280 --> 0:19:36.840
<v Speaker 1>scientists did eventually work out their disagreements enough to allow

0:19:36.920 --> 0:19:38.640
<v Speaker 1>them to get back to work. Banting and Best would

0:19:38.640 --> 0:19:42.000
<v Speaker 1>de pancreatized dogs, Colip wouldn't extract insulin, and McCloud would

0:19:42.080 --> 0:19:46.200
<v Speaker 1>coordinate everyone's research, everybody doing playing to their strengths, play

0:19:46.240 --> 0:19:50.600
<v Speaker 1>into their strength, like you're great at deep pancretize deep pancretizing.

0:19:50.680 --> 0:19:54.159
<v Speaker 1>Is that he was the best to pancretizer. Nobody's questioning

0:19:54.200 --> 0:19:57.160
<v Speaker 1>Banting's ability to take out dogs. You can PANCRETI tin

0:19:57.280 --> 0:20:00.119
<v Speaker 1>pancreas as a per minute. If you're if you've had

0:20:00.119 --> 0:20:02.760
<v Speaker 1>a dog with too many pancreai, this is your man.

0:20:02.880 --> 0:20:10.919
<v Speaker 1>He's got ten ppm. So um. Banting developed a hatred

0:20:10.960 --> 0:20:14.080
<v Speaker 1>for the professor that made his life unbearable. Banting became

0:20:14.080 --> 0:20:17.639
<v Speaker 1>an alcoholic, regularly drinking himself to sleep. Since it was prohibition,

0:20:17.840 --> 0:20:20.360
<v Speaker 1>he had to steal liquor hundred and ninety proof alcohol

0:20:20.440 --> 0:20:23.200
<v Speaker 1>from the laboratory. He later said, I do not think

0:20:23.240 --> 0:20:25.240
<v Speaker 1>there was one night during the month of March nineteen

0:20:25.280 --> 0:20:28.280
<v Speaker 1>two when I went to bed sober. Well, that seems

0:20:28.359 --> 0:20:30.680
<v Speaker 1>like a not great practice. It just seems like March.

0:20:32.440 --> 0:20:34.800
<v Speaker 1>I mean, March is my birthday months, so I rarely

0:20:34.880 --> 0:20:37.840
<v Speaker 1>go to bed sober on March. And he says he

0:20:37.920 --> 0:20:40.800
<v Speaker 1>was making life like unbearable for the other scientists. Was

0:20:40.880 --> 0:20:44.080
<v Speaker 1>he like playing drunken pranks on them? Like, no, he's

0:20:44.119 --> 0:20:48.720
<v Speaker 1>just being a really angry as I throwing dogs at

0:20:48.800 --> 0:20:53.400
<v Speaker 1>the crossing dog corpses left and right. You sons of bitches. Yeah,

0:20:54.359 --> 0:20:57.840
<v Speaker 1>but their work bore fruit. On May third, Cloud presented

0:20:57.840 --> 0:21:00.679
<v Speaker 1>a paper to the Association of American Physicians The Effect

0:21:00.760 --> 0:21:04.480
<v Speaker 1>produced on diabetes by extracts of pancreas the paper described

0:21:04.520 --> 0:21:07.119
<v Speaker 1>their discovery of insulin and it's by now clear therapeutic

0:21:07.200 --> 0:21:10.600
<v Speaker 1>success on treating diabetes. The Cloud received a standing ovation,

0:21:10.760 --> 0:21:12.639
<v Speaker 1>the first one given in the entire history of the

0:21:12.720 --> 0:21:15.560
<v Speaker 1>society's existence. Banting and Best weren't there to see it.

0:21:15.760 --> 0:21:18.480
<v Speaker 1>Banting had refused to go because he's a caddy bitch

0:21:18.880 --> 0:21:21.119
<v Speaker 1>and badgered his colleague and not going as well as

0:21:21.119 --> 0:21:25.040
<v Speaker 1>a protest against McCleod. Yeah, it's it's pretty missed. That

0:21:25.280 --> 0:21:29.440
<v Speaker 1>rare scientist standing ovation, which are radical because they're just

0:21:29.560 --> 0:21:33.840
<v Speaker 1>like air horns. Belas so uh. At this point, via

0:21:34.040 --> 0:21:36.560
<v Speaker 1>the team reached out to Elit Lily for help figuring

0:21:36.560 --> 0:21:38.959
<v Speaker 1>out how to produce insulin in large quantities. So they

0:21:39.080 --> 0:21:41.560
<v Speaker 1>figured out how to extract insulin, they could prove that

0:21:41.640 --> 0:21:43.440
<v Speaker 1>it was a thing that had a therapeutic effect, but

0:21:43.480 --> 0:21:45.480
<v Speaker 1>they were like, we don't actually know how to like

0:21:45.880 --> 0:21:47.840
<v Speaker 1>produce a medicine for a shipload of people were just

0:21:47.920 --> 0:21:50.920
<v Speaker 1>torturing dogs over here. Although at some point there's a

0:21:50.960 --> 0:21:52.720
<v Speaker 1>horrible note in the story. I was reading it like

0:21:53.000 --> 0:21:55.200
<v Speaker 1>they were using cows at one point and they needed

0:21:55.240 --> 0:21:58.240
<v Speaker 1>like the fetuses of young cows to get the pancreases out,

0:21:58.280 --> 0:22:01.560
<v Speaker 1>and they were like, thankfully, lots of slaughterhouses get the

0:22:01.600 --> 0:22:03.520
<v Speaker 1>cows pregnant before they kill them to make them fatter.

0:22:03.640 --> 0:22:07.600
<v Speaker 1>So there's tons of cow fetuses. Well, isn't that nice

0:22:08.800 --> 0:22:12.480
<v Speaker 1>worked out? We're swimming in cow fetuses who are eyeballs

0:22:12.520 --> 0:22:17.960
<v Speaker 1>and cow fetuses. Three dollar dogs. They just have cow

0:22:18.080 --> 0:22:21.000
<v Speaker 1>fetuses in the bullet like the front desk of these farms,

0:22:21.080 --> 0:22:25.159
<v Speaker 1>like take a cow, cow fetus, too many cow fetus.

0:22:25.880 --> 0:22:30.639
<v Speaker 1>Fetus just going to be going into sausage. It is sausages.

0:22:30.680 --> 0:22:33.520
<v Speaker 1>It's just cow fetuses and pig assholes. That does seem

0:22:33.600 --> 0:22:35.960
<v Speaker 1>like a like turn of the century movie like Too

0:22:36.040 --> 0:22:39.240
<v Speaker 1>Many Cow Too Many cow fetuses, starring Jamis and Jimson

0:22:39.920 --> 0:22:44.920
<v Speaker 1>speaking of cow fetuses. Uh, wonderful products that help people.

0:22:45.520 --> 0:22:54.480
<v Speaker 1>It's ADS time. We're back. We're back. ADS are done.

0:22:54.640 --> 0:22:59.879
<v Speaker 1>As has happened? ADS has happened back to insulin banting.

0:23:00.000 --> 0:23:03.600
<v Speaker 1>Call Up and Best were awarded a patent on January three.

0:23:03.640 --> 0:23:05.480
<v Speaker 1>They did not give their patent to the public domain

0:23:05.520 --> 0:23:07.520
<v Speaker 1>as a gift demand kind, but they did sell it

0:23:07.600 --> 0:23:09.320
<v Speaker 1>for a dollar each to the Board of Governors of

0:23:09.320 --> 0:23:12.359
<v Speaker 1>the University of Toronto. Their goal bargain. That's bargain, great

0:23:12.400 --> 0:23:16.440
<v Speaker 1>price for all of insulin solid. Their goal was for

0:23:16.480 --> 0:23:18.159
<v Speaker 1>the medicine itself to be used for the benefit of

0:23:18.240 --> 0:23:20.760
<v Speaker 1>mankind and not pure profit. They deserve credit for getting

0:23:20.760 --> 0:23:22.600
<v Speaker 1>all all getting on the same page about one thing,

0:23:22.680 --> 0:23:25.240
<v Speaker 1>which is that insulin is too vital to be something

0:23:25.359 --> 0:23:29.680
<v Speaker 1>that's purely a profit thing right now. They basically gave

0:23:29.720 --> 0:23:31.879
<v Speaker 1>the patent to the university so they could restrict the

0:23:31.920 --> 0:23:35.080
<v Speaker 1>production of insulin to reputable pharmaceutical companies. They wanted to

0:23:35.119 --> 0:23:37.240
<v Speaker 1>stop quacks from trying to make their own products and

0:23:37.280 --> 0:23:42.040
<v Speaker 1>then selling people poison Brandon as right, just like liquefied dog. Yeah,

0:23:42.080 --> 0:23:45.200
<v Speaker 1>we're just killing out. The pan also made it impossible

0:23:45.240 --> 0:23:47.119
<v Speaker 1>for drug companies to produce a weaker version of the

0:23:47.160 --> 0:23:49.160
<v Speaker 1>drug and still use the name insulin, So that's good.

0:23:49.560 --> 0:23:51.239
<v Speaker 1>As messy as they were, it does seem like these

0:23:51.240 --> 0:23:53.520
<v Speaker 1>guys Hearts were in the right place. Eli Lily got

0:23:53.560 --> 0:23:56.400
<v Speaker 1>a non exclusive licensing contract and for a while insulin

0:23:56.480 --> 0:23:59.399
<v Speaker 1>was a reasonably affordable medicine. After a couple of decades,

0:23:59.400 --> 0:24:02.600
<v Speaker 1>the University Toronto's patent expired and any pharmaceutical company was

0:24:02.600 --> 0:24:04.440
<v Speaker 1>allowed to produce it. This is the point at which

0:24:04.480 --> 0:24:06.920
<v Speaker 1>the market should have been flooded with cheap generic versions

0:24:06.920 --> 0:24:10.560
<v Speaker 1>of insulin, but something else happened instead, Eli, Lily and

0:24:10.640 --> 0:24:14.600
<v Speaker 1>other pharmaceutical companies started tweaking insulin, making minor improvements or

0:24:14.600 --> 0:24:18.160
<v Speaker 1>alteration through the delivery system, tiny changes that maybe maybe

0:24:18.200 --> 0:24:20.800
<v Speaker 1>it work slightly better here and there. Uh the time,

0:24:20.880 --> 0:24:24.080
<v Speaker 1>these updates strategically so that insulin has remained for all

0:24:24.160 --> 0:24:29.000
<v Speaker 1>these different companies a patented medication from right today right

0:24:29.040 --> 0:24:32.960
<v Speaker 1>Because so I used to do medical learning materials for

0:24:33.080 --> 0:24:35.720
<v Speaker 1>pharmaceutical companies, and one of the things I learned is

0:24:35.760 --> 0:24:39.320
<v Speaker 1>about the process of doing generic medications. So, if you

0:24:39.760 --> 0:24:43.359
<v Speaker 1>have a patent and you want to extend it beyond

0:24:44.000 --> 0:24:47.080
<v Speaker 1>what the law intake, right, what you do is you

0:24:47.359 --> 0:24:51.440
<v Speaker 1>can tweak it very slightly, make like you said, minor improvements,

0:24:51.560 --> 0:24:54.080
<v Speaker 1>or you can even not tweak it, but say it's

0:24:54.200 --> 0:25:00.040
<v Speaker 1>useful for something else like um like antidepressant medication and

0:25:00.280 --> 0:25:04.840
<v Speaker 1>being used for postpartum depression or PMS. Well that's clearly different, right,

0:25:06.119 --> 0:25:09.840
<v Speaker 1>And then then you can cling on to that patent

0:25:10.119 --> 0:25:14.119
<v Speaker 1>long for a much longer than what is the spirit

0:25:14.160 --> 0:25:17.240
<v Speaker 1>of the law, which is right right, which is a

0:25:17.359 --> 0:25:21.240
<v Speaker 1>long time too. So it's and that prevents other companies

0:25:21.320 --> 0:25:25.920
<v Speaker 1>from creating biosimilars which are like, not the exact same formulation,

0:25:26.000 --> 0:25:29.439
<v Speaker 1>but kind of a similar one. And it's really terrible

0:25:29.520 --> 0:25:34.280
<v Speaker 1>because it can well, let's continue with your horrible story. Now,

0:25:34.600 --> 0:25:36.200
<v Speaker 1>it's not impossible. It's some point to say. One of

0:25:36.240 --> 0:25:38.080
<v Speaker 1>the differences with the case of insulin is that it's

0:25:38.080 --> 0:25:40.080
<v Speaker 1>not impossible for a company to go back to the

0:25:40.119 --> 0:25:42.720
<v Speaker 1>original recipe and make a generic version of insulin. That

0:25:43.040 --> 0:25:45.959
<v Speaker 1>is something that's totally possible. To what these companies are

0:25:46.000 --> 0:25:48.199
<v Speaker 1>doing is that they're just never releasing a generic. They

0:25:48.280 --> 0:25:50.639
<v Speaker 1>just keep tweaking their insulin. Every time it comes up.

0:25:50.840 --> 0:25:54.240
<v Speaker 1>It gets old enough. So basically, any pharmaceutical company could

0:25:54.280 --> 0:25:58.000
<v Speaker 1>try to make their own insulin, but any organization that

0:25:58.000 --> 0:26:00.280
<v Speaker 1>could afford to do so would be a pharmaceutical money

0:26:00.480 --> 0:26:02.080
<v Speaker 1>And in that case, why not just whip up their

0:26:02.119 --> 0:26:04.400
<v Speaker 1>own kind of insulin? Twigg a little bit, the charge

0:26:04.400 --> 0:26:07.840
<v Speaker 1>a lot of money. Why make a generic? Why help people?

0:26:08.000 --> 0:26:12.560
<v Speaker 1>Why help people? As a pharmaceutical Now, this is the

0:26:12.600 --> 0:26:15.359
<v Speaker 1>conclusion reached by doctors Jeremy Green and Kevin Riggs, who

0:26:15.400 --> 0:26:17.440
<v Speaker 1>published a study in the New England Journal of Medicine

0:26:17.480 --> 0:26:21.159
<v Speaker 1>accusing the pharmaceutical industry of using a process called evergreening

0:26:21.520 --> 0:26:24.280
<v Speaker 1>to extend their patents, particularly the patents. For instance, this

0:26:24.440 --> 0:26:26.480
<v Speaker 1>is the name of what you were just explaining. I'd

0:26:26.520 --> 0:26:28.359
<v Speaker 1>like to quote from a summary of their article in

0:26:28.440 --> 0:26:32.320
<v Speaker 1>Medicine Express. This keeps older versions off the generic market,

0:26:32.359 --> 0:26:35.480
<v Speaker 1>the authors say, because generic manufacturers have less incentive to

0:26:35.520 --> 0:26:37.960
<v Speaker 1>make a version of insulin that doctors perceived as obsolete.

0:26:38.200 --> 0:26:40.679
<v Speaker 1>Newer versions are somewhat better for patients who can afford them,

0:26:40.720 --> 0:26:43.840
<v Speaker 1>say the authors, but those who can't suffer painful, costly complications.

0:26:44.440 --> 0:26:46.919
<v Speaker 1>We see generic drugs as a rare success story, providing

0:26:46.960 --> 0:26:49.560
<v Speaker 1>better quality at a cheaper price, says Green, an associate

0:26:49.680 --> 0:26:52.520
<v Speaker 1>professor of the history of medicine at Johns Hopkins University

0:26:52.560 --> 0:26:55.400
<v Speaker 1>School of Medicine and a practicing internist. And we see

0:26:55.400 --> 0:26:57.560
<v Speaker 1>the progression from patent to drug to generic drug is

0:26:57.560 --> 0:27:00.399
<v Speaker 1>almost automatic. But the history of insulin highlights limits of

0:27:00.440 --> 0:27:03.760
<v Speaker 1>generic competition. Is a framework for protecting the public health now.

0:27:03.960 --> 0:27:06.040
<v Speaker 1>Riggs and Green were both inspired to study this problem

0:27:06.080 --> 0:27:08.360
<v Speaker 1>because so many patients were coming into their Baltimore area

0:27:08.440 --> 0:27:11.600
<v Speaker 1>clinics with blurred vision, weight loss, thirst, and other symptoms

0:27:11.600 --> 0:27:14.560
<v Speaker 1>of unmedicated diabetes. They realized that a ton of people

0:27:14.560 --> 0:27:16.879
<v Speaker 1>who should have been on insulin were opting to suffer

0:27:16.920 --> 0:27:19.480
<v Speaker 1>instead of go broke. Green and Riggs set out to

0:27:19.560 --> 0:27:22.160
<v Speaker 1>learn why generic insulin wasn't a thing, and they traced

0:27:22.200 --> 0:27:25.920
<v Speaker 1>out a legacy of evergreening. In the nineteen thirties and forties,

0:27:25.920 --> 0:27:29.360
<v Speaker 1>pharmaceutical companies developed long acting forms that allowed most patients

0:27:29.400 --> 0:27:31.959
<v Speaker 1>to take a single daily injection. In the nineteen seventies

0:27:31.960 --> 0:27:34.200
<v Speaker 1>and eighties, manufacturers improved the purity of cow and pig

0:27:34.280 --> 0:27:38.000
<v Speaker 1>extracted insulin. Since then, several companies who developed synthetic analogs

0:27:38.359 --> 0:27:40.399
<v Speaker 1>biotech insulin is now the standard in the US. The

0:27:40.440 --> 0:27:43.359
<v Speaker 1>authors say patents on the first synthetic insulin expired in

0:27:43.400 --> 0:27:45.560
<v Speaker 1>two thousand and fourteen, but these newer forms are harder

0:27:45.640 --> 0:27:47.560
<v Speaker 1>to copy, so the unpatented versions will go through a

0:27:47.600 --> 0:27:50.239
<v Speaker 1>lengthy Food and Drug Administration approval process and cost more

0:27:50.280 --> 0:27:52.520
<v Speaker 1>to make. When these insulins come off the market, they

0:27:52.560 --> 0:27:55.879
<v Speaker 1>may cost just less than the patented versions. Riggs and

0:27:55.960 --> 0:28:00.280
<v Speaker 1>Green right now, generic versions of medication often bring the

0:28:00.320 --> 0:28:04.560
<v Speaker 1>price down to something like cheaper, so when cheaper insulin

0:28:04.680 --> 0:28:07.000
<v Speaker 1>comes in, it's going to be this kind of biotech

0:28:07.119 --> 0:28:12.240
<v Speaker 1>insulin that's just cheaper as opposed to so essentially still

0:28:12.280 --> 0:28:15.000
<v Speaker 1>twice as much as at least so like, so companies

0:28:15.200 --> 0:28:18.240
<v Speaker 1>could be making these generics, but there's just no monetary

0:28:18.280 --> 0:28:21.680
<v Speaker 1>incentive for them, so it's not profitable, right right, I

0:28:21.720 --> 0:28:23.359
<v Speaker 1>mean you might get a profit, is not as profit

0:28:23.520 --> 0:28:25.520
<v Speaker 1>right because if you're a small enough company that you

0:28:25.520 --> 0:28:28.560
<v Speaker 1>would want to maybe do it, like, then you couldn't.

0:28:28.640 --> 0:28:30.320
<v Speaker 1>You don't have the resources. You don't have the resources.

0:28:30.800 --> 0:28:32.920
<v Speaker 1>So if you're a bigger company, you're like, well, there's

0:28:32.960 --> 0:28:36.680
<v Speaker 1>more demand than would mean, like people wouldn't be voting

0:28:36.720 --> 0:28:41.040
<v Speaker 1>with their wallets, so they'll still sell it. Yeah, and uh,

0:28:41.400 --> 0:28:43.760
<v Speaker 1>you know, insulin has improved a lot over the years,

0:28:43.920 --> 0:28:46.120
<v Speaker 1>you know, to give some credit to the pharmaceutical companies.

0:28:46.160 --> 0:28:48.200
<v Speaker 1>We no longer have to torture dogs to make it.

0:28:48.360 --> 0:28:51.600
<v Speaker 1>It's not all derived from animals anymore. Human insulin can

0:28:51.640 --> 0:28:55.480
<v Speaker 1>be produced using recompetent DNA technology that basically turns bacteria

0:28:55.520 --> 0:28:59.000
<v Speaker 1>and insulin factories. It's pretty cool. The they deserve to

0:28:59.080 --> 0:29:01.600
<v Speaker 1>be rewarded for the innovations, or at least the scientists

0:29:01.640 --> 0:29:04.480
<v Speaker 1>do for the innovations that have been made to insulin. UM.

0:29:04.880 --> 0:29:09.440
<v Speaker 1>But with each innovation, essentially older but still working forms

0:29:09.480 --> 0:29:12.720
<v Speaker 1>of insulin UH stop being used as opposed to just

0:29:12.800 --> 0:29:15.680
<v Speaker 1>being sold as generics because it's not profitable to run them.

0:29:17.080 --> 0:29:19.720
<v Speaker 1>I read a Business Insider article on exactly this problem.

0:29:19.960 --> 0:29:22.160
<v Speaker 1>It notes that the number of Americans with diabetes has

0:29:22.200 --> 0:29:24.760
<v Speaker 1>tripled since nineteen eighty. You might expect that to make

0:29:24.800 --> 0:29:27.440
<v Speaker 1>insulin cheaper, since it's now easier to make and being

0:29:27.480 --> 0:29:31.080
<v Speaker 1>produced on an economy of scale. Instead, the prices sword astronomically.

0:29:31.240 --> 0:29:33.640
<v Speaker 1>Some insulin products have seen their price triple since two

0:29:33.680 --> 0:29:38.400
<v Speaker 1>thousand two. Yeah. Levi Mere, one popular medication made by

0:29:38.480 --> 0:29:41.000
<v Speaker 1>Novo Nordisk, cost a hundred and twenty dollars for a

0:29:41.120 --> 0:29:44.000
<v Speaker 1>hundred units two twelve. Today, the same amount costs three

0:29:44.040 --> 0:29:48.720
<v Speaker 1>hundred dollars. Now, as we know, a generic versions of

0:29:48.800 --> 0:29:51.440
<v Speaker 1>medication often helpfully, you could buy so many dogs with that.

0:29:51.800 --> 0:29:54.320
<v Speaker 1>You could you could buy three dollar dogs even, yeah,

0:29:54.400 --> 0:29:56.600
<v Speaker 1>even a three dollar dog, which is an expensive dog.

0:29:56.680 --> 0:30:01.080
<v Speaker 1>In the insulin, you could buy a hundred your own

0:30:01.800 --> 0:30:04.760
<v Speaker 1>yeah yeah. Now, as we noted earlier, generic versions of

0:30:04.800 --> 0:30:07.480
<v Speaker 1>medication can lower the price by as much as eight percent.

0:30:07.880 --> 0:30:10.280
<v Speaker 1>This would be life changing for someone with diabetes. Struggling

0:30:10.320 --> 0:30:12.400
<v Speaker 1>to deal with an extra five hundred and seventy dollars

0:30:12.400 --> 0:30:15.520
<v Speaker 1>a month insulin bills. That's what the average diabetic American

0:30:15.560 --> 0:30:18.480
<v Speaker 1>past Jesus Christ. So you're talking four hundred bucks that

0:30:18.560 --> 0:30:20.920
<v Speaker 1>could be back on the can be spent on dogs,

0:30:21.040 --> 0:30:23.640
<v Speaker 1>could be spent on dogs, or maybe food and your

0:30:24.080 --> 0:30:26.800
<v Speaker 1>or maybe food and rent. But yeah, there is no

0:30:27.080 --> 0:30:29.960
<v Speaker 1>generic insulin, and Riggs and Green suspect that this is

0:30:30.040 --> 0:30:33.200
<v Speaker 1>because no pharmaceutical company considers making such a product to

0:30:33.280 --> 0:30:39.080
<v Speaker 1>be a worthwhile investment. On February two thousand seventeen, Shane

0:30:39.120 --> 0:30:41.680
<v Speaker 1>Patrick Boyle posted a go fund Me to raise enough

0:30:41.720 --> 0:30:43.480
<v Speaker 1>money from one month of Inceland. For him. This meant

0:30:43.480 --> 0:30:45.840
<v Speaker 1>seven hundred and fifty dollars. As we already discussed, he

0:30:45.880 --> 0:30:48.200
<v Speaker 1>came up fifty dollars short, and he died a couple

0:30:48.280 --> 0:30:52.480
<v Speaker 1>of weeks later of diabetic keto acidosis. The current Secretary

0:30:52.680 --> 0:30:55.120
<v Speaker 1>of Health and Human Services, appointed by Donald Trump and

0:30:55.200 --> 0:30:58.760
<v Speaker 1>confirmed by Congress is Alex Azar. Before he got into politics,

0:30:58.880 --> 0:31:01.240
<v Speaker 1>Mr Azar had a different job. He worked for Eli

0:31:01.360 --> 0:31:05.320
<v Speaker 1>Lily from two thousand seven to two thousand seventeen. Starting

0:31:05.320 --> 0:31:07.840
<v Speaker 1>in two twelve, he was the president of Lily USA.

0:31:08.000 --> 0:31:10.920
<v Speaker 1>The company's largest division. I'd like to quote from an

0:31:11.000 --> 0:31:14.720
<v Speaker 1>article in the Nation. During Azar's tenure, Eli Lily raised

0:31:14.760 --> 0:31:16.880
<v Speaker 1>the prices on its insulence in the United States by

0:31:16.920 --> 0:31:19.920
<v Speaker 1>twenty point eight percent in two thousand fourteen, sixteen point

0:31:20.000 --> 0:31:22.640
<v Speaker 1>nine percent in two thousand fifteen, and seven point five

0:31:22.680 --> 0:31:25.640
<v Speaker 1>percent in two thousand and sixteen. Eli Lily's biggest seller,

0:31:25.720 --> 0:31:28.000
<v Speaker 1>humal log insulin, is now off patent, but rather than

0:31:28.040 --> 0:31:30.520
<v Speaker 1>becoming cheaper, Human Logue costs more now than when it

0:31:30.560 --> 0:31:33.560
<v Speaker 1>first came to market in nineteen ninety six. When Azar

0:31:33.640 --> 0:31:36.160
<v Speaker 1>started working at Eli Lily in June two thousand seven,

0:31:36.440 --> 0:31:38.120
<v Speaker 1>the list price for a vile of human Logue was

0:31:38.160 --> 0:31:41.440
<v Speaker 1>seventy four dollars. When he quit in January two thousand seventeen,

0:31:41.680 --> 0:31:43.880
<v Speaker 1>it was two hundred and sixty mine. So have they

0:31:43.960 --> 0:31:47.760
<v Speaker 1>made changes to human Logue. It's just they're just jacking

0:31:47.800 --> 0:31:51.880
<v Speaker 1>the price. Oh my god, It's like that's shouldn't that

0:31:51.920 --> 0:31:57.040
<v Speaker 1>be sort of like I'm murder I mean, the Health

0:31:57.080 --> 0:31:59.640
<v Speaker 1>and Human Service as secretary did it, So how could

0:31:59.640 --> 0:32:01.440
<v Speaker 1>it be that? Well, you know how people get so

0:32:01.520 --> 0:32:04.000
<v Speaker 1>worked up when they see stores jack up the prices

0:32:04.040 --> 0:32:08.640
<v Speaker 1>of water before disaster. This is like that every day,

0:32:08.840 --> 0:32:12.000
<v Speaker 1>every single year for twenty years, and then you become

0:32:12.360 --> 0:32:19.280
<v Speaker 1>a secretary at about Oh that is really depressing. It's horrible. Yeah,

0:32:20.480 --> 0:32:25.520
<v Speaker 1>oh that was That was a very sudden right into

0:32:25.560 --> 0:32:27.959
<v Speaker 1>the wall in there. No, I mean, there's not much

0:32:28.000 --> 0:32:29.720
<v Speaker 1>to say. I read the story about those parents bringing

0:32:29.720 --> 0:32:33.280
<v Speaker 1>their dead kids ashes to a pharmaceutical company and read

0:32:33.320 --> 0:32:36.320
<v Speaker 1>about it, and it's fucked up. That is so terrible

0:32:36.680 --> 0:32:39.360
<v Speaker 1>heavy I mean alex asar and everyone else involved in

0:32:39.440 --> 0:32:41.520
<v Speaker 1>these companies and changing the prices of them as a

0:32:41.520 --> 0:32:44.480
<v Speaker 1>piece of ship. Because I mean, so one thing is

0:32:45.160 --> 0:32:47.640
<v Speaker 1>to be clear about diabetes. There are two types. So

0:32:48.360 --> 0:32:53.680
<v Speaker 1>there's childhood diabetes where there's no lifestyle. Yeah, Type one,

0:32:54.320 --> 0:32:56.920
<v Speaker 1>they're born with it. You just random chance. Should he

0:32:56.960 --> 0:33:00.400
<v Speaker 1>spend that big roulette wheel mother nature just dick and around.

0:33:00.520 --> 0:33:03.920
<v Speaker 1>But I mean that's not to say people type two

0:33:04.960 --> 0:33:07.719
<v Speaker 1>deserve it or anything like that, because like I mean,

0:33:07.800 --> 0:33:11.280
<v Speaker 1>it's such an irony where we have such little restrictions

0:33:11.360 --> 0:33:13.520
<v Speaker 1>on all these foods that are high in sugar and

0:33:13.680 --> 0:33:18.640
<v Speaker 1>killing us with you know, just creating these high incidents

0:33:18.720 --> 0:33:23.320
<v Speaker 1>of diabetes, and then the medicine that can save your

0:33:23.400 --> 0:33:28.600
<v Speaker 1>life is also just the price is jacked of Jesus Christ.

0:33:28.920 --> 0:33:33.360
<v Speaker 1>That is, if that isn't an indictment of our society.

0:33:33.440 --> 0:33:37.480
<v Speaker 1>I don't know. Yeah, it's pretty pretty horrible and gross. Yeah.

0:33:38.480 --> 0:33:41.760
<v Speaker 1>So if you're diabetic, so are you're dealing with this?

0:33:42.400 --> 0:33:45.720
<v Speaker 1>If you happen to know where alex Asar's car is.

0:33:48.200 --> 0:33:51.520
<v Speaker 1>I'm not going to say, commit a crime on alex

0:33:51.560 --> 0:33:56.800
<v Speaker 1>Asar's car, but maybe do crimes? Do crimes? Not? Maybe

0:33:57.200 --> 0:34:02.240
<v Speaker 1>I'm just do crist generally, do cry generally do crimes?

0:34:02.400 --> 0:34:05.640
<v Speaker 1>I mean my goal is to train a flock of

0:34:05.760 --> 0:34:08.880
<v Speaker 1>birds to follow them around and give those birds a

0:34:08.960 --> 0:34:13.520
<v Speaker 1>really healthy but very high in fiber diet and just

0:34:13.719 --> 0:34:16.759
<v Speaker 1>have them follow car a lot of a lot of

0:34:16.920 --> 0:34:22.920
<v Speaker 1>like wheat husks, yeah, chia seeds. If you train birds

0:34:23.040 --> 0:34:25.680
<v Speaker 1>and live in the d C area, we have a

0:34:25.760 --> 0:34:28.640
<v Speaker 1>gig for you. We got a job. Listen, well, crowd

0:34:28.719 --> 0:34:31.600
<v Speaker 1>fund this like we would crowd fund someone's insulin payment. Yeah.

0:34:31.640 --> 0:34:34.600
<v Speaker 1>And if we fall fifty short, though, we won't die.

0:34:34.920 --> 0:34:37.640
<v Speaker 1>We won't die. His car will just not be filthy.

0:34:38.160 --> 0:34:41.000
<v Speaker 1>Shirt will not be shipped on if you train birds

0:34:41.040 --> 0:34:43.960
<v Speaker 1>in d C. Right, if you drop a line, if

0:34:44.000 --> 0:34:47.800
<v Speaker 1>you practice falconry in the DC area, the greater metropolitan

0:34:47.880 --> 0:34:52.080
<v Speaker 1>DC area. You know D M. Robert or if you're Oswald, Tomilkins,

0:34:52.200 --> 0:34:56.719
<v Speaker 1>the greatest car here in the East Coast. Everybody knows Oswald. Yeah, absolutely,

0:34:56.760 --> 0:35:00.080
<v Speaker 1>he's fantastic. Maybe key this guy's car, you know, to

0:35:00.200 --> 0:35:03.799
<v Speaker 1>do it the I don't know, maybe key. In an

0:35:03.920 --> 0:35:06.359
<v Speaker 1>image of an urn with a dead twenty seven year

0:35:06.360 --> 0:35:09.200
<v Speaker 1>old diabetic dashes in it. It's so heavy because it's

0:35:09.320 --> 0:35:13.320
<v Speaker 1>one of these things where we freaking found the cure

0:35:13.640 --> 0:35:16.520
<v Speaker 1>to this. We found shouldn't be a problem. It shouldn't

0:35:16.520 --> 0:35:19.160
<v Speaker 1>be a problem. You know. We talk about things like

0:35:19.680 --> 0:35:22.839
<v Speaker 1>how terrible cancer is and how we crave a cure

0:35:22.920 --> 0:35:25.480
<v Speaker 1>so much, and of course we do, because cancer is awful.

0:35:26.080 --> 0:35:30.239
<v Speaker 1>But then we have a freaking cure for diabetes that

0:35:30.320 --> 0:35:35.279
<v Speaker 1>will keep people from dying, from imminently dying, and just

0:35:35.440 --> 0:35:38.359
<v Speaker 1>to dangle it above them like, oh, oh you want

0:35:38.400 --> 0:35:40.960
<v Speaker 1>this cure, Oh, try and get it. Oh, and the

0:35:41.040 --> 0:35:43.440
<v Speaker 1>people dangling and are only using one hand because they're

0:35:43.480 --> 0:35:46.880
<v Speaker 1>getting paid tens of millions of dollars and bonuses for

0:35:47.000 --> 0:35:51.400
<v Speaker 1>doing the dangling. What a great system, I know, super

0:35:51.440 --> 0:35:55.759
<v Speaker 1>gonna last forever and not collapse in fire and death. Yet, like,

0:35:56.200 --> 0:35:58.040
<v Speaker 1>you know, does it feel good when you get your

0:35:58.120 --> 0:36:01.480
<v Speaker 1>like second luxury. Yah, like you might as well just

0:36:01.680 --> 0:36:04.400
<v Speaker 1>why not skip all of the middleman stuff and just

0:36:04.560 --> 0:36:07.720
<v Speaker 1>make it out of dead diabet Just make a giant

0:36:09.000 --> 0:36:12.240
<v Speaker 1>bone yacht made out of the bones of dead diabetic people.

0:36:12.320 --> 0:36:15.640
<v Speaker 1>If Alex Asar was sailing up to Kinnebunkport, Maine in

0:36:15.719 --> 0:36:18.960
<v Speaker 1>a bone yacht, well, okay, he's terrible, but like, this

0:36:19.120 --> 0:36:22.239
<v Speaker 1>guy at least has some pane, at least he's forth right. Yeah,

0:36:22.440 --> 0:36:26.600
<v Speaker 1>he's honestly a bone merchant. Cut the metaphor. Hubbard would

0:36:26.600 --> 0:36:29.560
<v Speaker 1>have built a boat out of bones. Yeah, absolutely, Yeah,

0:36:30.080 --> 0:36:32.399
<v Speaker 1>either build a bone boat or I'm gonna keep telling

0:36:32.440 --> 0:36:35.320
<v Speaker 1>people to key your car, Alex has aer. That's my

0:36:35.440 --> 0:36:40.160
<v Speaker 1>threat to the Secretary of Human Services. We will train

0:36:40.239 --> 0:36:43.200
<v Speaker 1>a flock of birds. Train a flock of birds to

0:36:43.280 --> 0:36:47.720
<v Speaker 1>ship on your car. Constant flow stream of ship flowing

0:36:48.120 --> 0:36:51.759
<v Speaker 1>as much as insulin should be flowing patients. The bird

0:36:51.840 --> 0:36:54.800
<v Speaker 1>ship will flow like insulin until the insulin gets cheaper.

0:36:55.520 --> 0:36:58.280
<v Speaker 1>That is the terroristic threat we are making on this episode.

0:36:58.400 --> 0:37:01.360
<v Speaker 1>Behind the Bastards. Great cool. I'm glad you put a

0:37:01.480 --> 0:37:05.200
<v Speaker 1>label to it so it'll really make dhs. Uh. You's

0:37:05.200 --> 0:37:07.640
<v Speaker 1>gonna make it easy for those yes for their search

0:37:07.719 --> 0:37:10.359
<v Speaker 1>engine to go like, oh, there we go. I'm gonna

0:37:10.400 --> 0:37:12.640
<v Speaker 1>get an interview like like how many birds are in

0:37:12.719 --> 0:37:16.160
<v Speaker 1>your birds? You have? What kind? Let me see your

0:37:16.239 --> 0:37:20.440
<v Speaker 1>keys because there was their paint on them. Katie, you

0:37:20.480 --> 0:37:23.640
<v Speaker 1>got any plug plug? Well, of course, my show Creature

0:37:23.680 --> 0:37:27.360
<v Speaker 1>feature where we talk about creatures who are more human

0:37:27.440 --> 0:37:31.040
<v Speaker 1>like than you expect in humans who act in animal ways,

0:37:31.200 --> 0:37:36.200
<v Speaker 1>like the freaking barbaric animals who deny people insulin. Well, actually,

0:37:36.239 --> 0:37:38.800
<v Speaker 1>animals would never do anything that sucked up. No, they wouldn't.

0:37:38.840 --> 0:37:42.680
<v Speaker 1>I mean, animals do some fucked up things, like they'll

0:37:42.760 --> 0:37:47.960
<v Speaker 1>mind control of spiders into weaving them a little nest

0:37:48.080 --> 0:37:51.560
<v Speaker 1>and then killing them and get behind right right, there's

0:37:51.600 --> 0:37:55.640
<v Speaker 1>something like metal about that. There's there's nothing cool about

0:37:55.719 --> 0:38:00.640
<v Speaker 1>just depriving people of insulin. Uh And So you can

0:38:00.719 --> 0:38:05.120
<v Speaker 1>follow me at Katie Golden on Twitter. You can follow

0:38:05.440 --> 0:38:09.080
<v Speaker 1>my bird twitter at pro Burg writes uh and, Yeah,

0:38:09.160 --> 0:38:11.320
<v Speaker 1>please do check out my show. There's a great episode

0:38:11.400 --> 0:38:16.160
<v Speaker 1>with Robert Innett called uh Re for Madness for Madness.

0:38:16.200 --> 0:38:17.960
<v Speaker 1>There we go from the name of that movie, Yeah

0:38:18.160 --> 0:38:21.319
<v Speaker 1>for madness, madness All rightert Evans. This has been behind

0:38:21.360 --> 0:38:24.120
<v Speaker 1>the Bastards. You can find me on Twitter at I right, okay.

0:38:24.280 --> 0:38:28.319
<v Speaker 1>You can find us on Instagram and uh twitter at

0:38:28.360 --> 0:38:30.640
<v Speaker 1>at bastards pod. You can find us online with all

0:38:30.680 --> 0:38:33.440
<v Speaker 1>the sources for this article at behind the Bastards dot com.

0:38:33.640 --> 0:38:36.480
<v Speaker 1>We have a t shirt shop. You can buy cups there, mugs,

0:38:36.760 --> 0:38:40.400
<v Speaker 1>phone raps, and stuff with cool logos made up and

0:38:41.160 --> 0:38:43.560
<v Speaker 1>catch phrases and stuff from the show neat images. So

0:38:43.880 --> 0:38:47.000
<v Speaker 1>like taste your PA, sample your p that'll be coming

0:38:47.000 --> 0:38:49.040
<v Speaker 1>out soon, So go to t public, look up behind

0:38:49.080 --> 0:38:52.919
<v Speaker 1>the Bastards public. Hello, maybe this week instead of buying

0:38:52.920 --> 0:38:55.080
<v Speaker 1>a shirt, donate some money to somebody's go fund me

0:38:55.080 --> 0:38:57.280
<v Speaker 1>if they're trying to buy Incelin or something they clearly

0:38:57.360 --> 0:39:01.240
<v Speaker 1>need the help. Vote or vote. Hopefully you just voted.

0:39:01.440 --> 0:39:05.080
<v Speaker 1>There's no voting to do immediately. Well soon, keep voting, yeah,

0:39:05.120 --> 0:39:08.440
<v Speaker 1>I keep voting constantly. Look out for your your diabetic

0:39:08.480 --> 0:39:12.879
<v Speaker 1>friends because it's rough. Yeah, all right, I love about

0:39:12.960 --> 0:39:16.000
<v Speaker 1>three percent of you. H