Why is there no generic insulin? Historical origins of a modern problem
Open accessAbstract
Six million U.S. patients with diabetes take insulin, which was discovered in 1921 — yet is available only in brand-name forms. The reasons why an agent discovered almost 100 years ago is still unavailable as a low-priced generic have implications for policy and practice.
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In resource-limited settings, people still die from lack of insulin access.
“yet, people in resource-limited environments continue to die because they have no access to insulin.172”
From Type 1 diabetes (2018) · cites this paper as [172]
The opening section says insulin is too expensive for many uninsured patients and describes diabetes before insulin as a fatal affliction. It does not report that people currently die because they lack insulin access in resource-limited settings; its discussion of present-day access focuses on North America (The Paradox of Incremental Innovation; page not provided). (LLM, conf=0.84)
Experimental — accuracy not yet measuredAt insulin's discovery, the University of Toronto granted a free licence to manufacture it.
“When insulin was discovered, the University of Toronto freely licensed the right to manufacture the drug;”
From Type 1 diabetes (2018) · cites this paper as [172]
The “Insulin’s Origins” section says the Toronto team licensed insulin-production rights to numerous companies. It does not say those licences were free of charge, and it places the patent and subsequent licensing after insulin’s 1921 discovery, not at the time of discovery. Our copy provides no page number for this passage. (LLM, conf=0.85)
Experimental — accuracy not yet measured
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- Authors
- Greene, J. A., & Riggs, K. R.
- Affiliations
- Johns Hopkins University (US)
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2015-03-19
- Volume
- 372
- Issue
- 12
- Pages
- 1171-1175
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- PMC
- PMC13118486
- OpenAlex
- W1968620668
- Cited by
- 81
- References
- 29
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 1 · 2023: 7 · 2022: 8 · 2021: 7 · 2020: 10 · 2019: 5 · 2018: 13 · 2017: 7 · 2016: 11 · 2015: 8
- FWCI
- 31.30
- Type
- journal article
- Language
- en
- Open access
- Licence
- cc-by-nc-nd
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- Funders
- National Institutes of Health (5t32hl007180-45)
- National Heart, Lung, and Blood Institute (T32-HL-007180)
- U.S. National Library of Medicine (G13LM010890)
- Topics
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Pharmaceutical Economics and Policy
- Life Sciences › Immunology and Microbiology › Immunology › Biosimilars and Bioanalytical Methods
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Keywords
- insulin, generic drugs, brand-name drugs, drug pricing, diabetes mellitus, insulin analogues, pharmaceutical policy, history of insulin
- MeSH terms
- Drug Industry, Humans, Insulin, Patents as Topic, Drugs, Generic, History, 20th Century, History, 21st Century, Drug Discovery, Biosimilar Pharmaceuticals, Insulin, Regular, Human
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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