RKS 2023 Film: “Pay or Die”: You Will Understand Big Pharma Profiteering on Insulin in The United States: The Solution Seems Typically American

Those who suffer from Type 1 diabetes require multiple daily insulin injections failing which diabetic ketoacidosis sets in and death ensues. Quite simple isn’t it? A vial of insulin currently sells for $10 in Italy, $12 in Canada and $14 in Japan. In the United States when the film was produced $300. Three Pharma’s control most of the U.S. market in a happy oligopoly quite like gas for automobiles except without gasoline for your car you can’t drive. Without insulin a Type 1 diabetic dies.

Thirty-seven million Americans suffer from diabetes with 7 million being insulin dependent.

Why the high prices? Huge profits in a market that is swelling with obesity and Type 2 diabetes. Through interviews with parents whose children died due to an inability to afford insulin once the age of 26 is attained at which time the children can’t be beneficiaries under the parent’s health insurance , with physicians, community health activists, Canadian pharmacists and sufferers of Type 1 diabetes, both adults and children, you will witness the horrific grief lock-stepped to the unaffordability of insulin for Type 1 diabetes.

Canadians Best and Banting at the University of Toronto ,15 minutes from my home, discovered insulin in 1921 and sold the patent for $1 stating that insulin does not belong to us, it belongs to the world. What would have Banting and Best thought about “medical refugees” bussing it up north to Canada to buy insulin and other medications because of their expense in the United States?

We can applaud warriors for insulin price affordability such as Nicole Holt-Smith and her husband James after their son Alec Smith suffering from Type 1 diabetes was found dead on his bedroom floor from diabetic ketoacidosis shortly after losing coverage under his mother’s health insurance and was forced to ration his insulin supply. Nicole and her husband fought like lions to have the State of Minnesota pass the Alec Smith Insulin Affordability Act (“Act”) in 2020 which based on inability to afford insulin passed the cost back to Pharma’s manufacturing it. The Act has been influencing other states in face of fierce Big Pharma lobbying to defeat the passage of such progressive legislation. And in January 2023 people covered by Medicaire had their co-pay costs for insulin limited to $35 benefitting over 3 million Americans.

So if you have an employer sponsored health benefit plan all is well? Not really as that depends on the deductible paid and the amount of the copay.

The United States has the most expensive health care in the world. When reading Dr. John Abramson’s “sickening: How Big Pharma Broke American Health Care and How We Can Repair It” the shocking statistic is that between 2000- 2019 healthy life expectancy fell in the United States from 38th to 68^th place right behind Jamaica. You can read my review of Dr. Abramson’s book here https://setthebarlifestyle.wordpress.com/2023/01/13/rks-book-review-sickening-how-big-pharma-broke-american-health-care-and-how-we-can-repair-it-by-john-abramson-md-msc/

Bravo to the Smiths in the insulin affordability battle. Strange (for me as a Canadian) though in the struggle the anger and effort was levelled towards Big Pharma pricing with nary a suggestion of socialized medicine or a rigorous pharmacare programme. Nicole Holt-Smith helps me to comprehend this by saying, “I have always thought that our country would benefit from a form of socialized health care, I absolutely believe that we as a country should have the ability to negotiate drug prices. I see that these systems work in other countries and believe that they would work here as well, the problem is our government doesn’t see it as a system that would work. Unfortunately until we have our legislators believing that health care is a human right we won’t see a health care system in the US that is not a for profit system”.  So many Americans I know, usually covered by generous employer health benefit plans, have dissed our socialized Canadian medical system as communist and socialist. Fighting Big Pharma to lower prices may be better replaced by a universal health care and pharmacare regime. ”Pay or Die” sets forth a scenario of stay in bed with the devil as opposed to knocking Big Pharma out of the bed. Apparently a freefall in medical care has done little to spark any serious governmental moves to emulate the Canadian approach of universal health care. Is pricing control simply a stopgap measure as opposed to an overhaul of the American system?

You can see the trailer here https://www.youtube.com/watch?v=F1M2_TK7aWQ

Directed by Scott Alexander Ruderman and Rachel Dyer. Opens theatrically in New York City on 1November2023 and then a U.S. national rollout after the Los Angeles opening on 10November2023 then on 14November2023 (World Diabetes Day) will commence streaming on Paramount.

RKS 2023 Film Rating 93/100.

P.S. Pay or Die…that expression reeks of blackmail!