Why Insulin is So Expensive in America

The high cost kills diabetics in the tens of thousands. But that may be about to change.

Rita McGrath
Marker
Published in
10 min readJan 28, 2022

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A photograph of an insulin vial and syringes
Photo by Mykenzie Johnson on Unsplash

Some settings create ripe conditions for a business-model destroying inflection point. Unhappy customers, favoring one stakeholder group at the extreme expense of others and operating in such a way that even your allies can’t defend you are all early warnings that change is afoot.

An inflection point?

It looks as though an inflection point for the current insulin business model may be underway. On July 28, the FDA approved an interchangeable biosimilar drug, Semglee. More importantly, a fourth company, Viatrus, will begin to compete in the U.S. insulin market. While the competitive effects are still going to be subject to negotiations among policymakers, PBM’s and the original manufacturers, the presence of potential competition is likely to at least moderate the most aggressive pricing maneuvers.

An even more substantial inflection point may be new developments that make insulin unnecessary for patients with Type 2 diabetes, who constitute 90% of the market. In 2019, the FDA approved oral tablets for the treatment of Type 2 diabetes.

Other efforts to treat diabetes range from cell editing, variations on immunotherapy…

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Rita McGrath
Marker

Columbia Business School Professor. Thinkers50 top 10 & #1 in strategy. Bestselling author of The End of Competitive Advantage & Seeing Around Corners.