July & August 2016: Diabetes and Generic Insulin

posted Jul 24, 2016, 3:30 PM by PC/SM Chief Resident   [ updated Aug 20, 2016, 4:23 PM ]
Facilitator: Marce Abare

The goal of this CMJC is to review the history of insulin, the concept of "incremental innovation" and discuss the reasons for why we lack of a generic option.  We will also touch upon the subsequent public health implications and how this might affect caring for our patients with diabetes.

Please read the entire article, but come prepared to talk about your assigned section. Please review the questions. 

1. The origins of insulin - Cedric
2. Improving the product - Claude, 
3. Copying larger molecules - Blaney, Liz
4. The paradox of incremental innovation - Jules

*Louisa and Justine, you have no assignment because you have RSCE that day

Questions for discussion:
1. How do patents affect drug prices? How do patents distort R&D?
2. How much money does pharma make and where does it go?
3. Are high profits necessary for future research and development of life-saving drugs?
4. What are the major reasons why insulin, despite its public health significance, remains prohibitively expensive?
5. Greene writes that the "history of insulin highlights the limits of generic competition as a public health framework..." What are those limits? What are examples of other public health frameworks for drug pricing and access?
6. In adults with T2DM requiring basal insulin formulation, are long-acting insulin analogues superior to NPH insulin in controlling glycemia?
7. What are avenues for clinicians to influence drug pricing? the development pipeline?
8. How do price differentials affect your clinical practice?

Other references:

PC/SM Chief Resident,
Jul 25, 2016, 11:18 AM
PC/SM Chief Resident,
Jul 24, 2016, 3:30 PM