The incredible history of insulin, a lifesaving diabetes drug that was discovered almost a century ago and is now at the center of drug pricing outrage

Nicole Smith-Holt from Richfield, MN holds a vial with the ashes of her son Alec, who died at the age of 26 from insulin rationing, during a protest against the high price of insulin outside the offices of drug giant Sanofi in Cambridge, MA on Nov. 16, 2018.

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Nicole Smith-Holt from Richfield, MN holds a vial with the ashes of her son Alec, who died at the age of 26 from insulin rationing, during a protest against the high price of insulin outside the offices of drug giant Sanofi in Cambridge, MA on Nov. 16, 2018.
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John Tlumacki/The Boston Globe via Getty Images

  • For the 1.25 million Americans living with Type 1 diabetes, insulin is a life-saving drug that helps them process the sugar in their blood.
  • Price increases for insulin have put pressure on people living with diabetes who don’t have insurance, or whose insurance plans require them to pay the full price of the medication.
  • Here’s the history of how insulin was discovered and how a treatment discovered almost a century ago became a target of public and political outrage in 2019.
  • Visit BusinessInsider.com for more stories.

Diabetes, a group of conditions in which the body can’t properly regulate blood sugar, affects roughly 30 million people in the US.

And for many people living with diabetes – including the 1.25 million people in the US who have Type 1 diabetes – injecting insulin is part of the daily routine.

Insulin, a hormone that healthy bodies produce, has been used to treat diabetes for almost a century, though it’s gone through some modifications.

In the past decade, the list prices of insulin have risen about 300%. This has drawn criticism from patients who have to pay the high cost as well as from politicians, who are going after drugmakers over their prices.

Here’s the story of how the critical diabetes medicine became what it is today.

This article was initially published in 2016 and has been updated.


Insulin is an integral part of the human body. It’s a hormone that’s produced in the pancreas to help regulate our blood sugar levels. For those living with Type 1 diabetes, the pancreas doesn’t make any insulin, which can cause blood sugar levels to rise too high.

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Wikimedia Commons

In the 1920s, researchers figured out that the pancreas was an important part of what was making diabetics so sick and got to work figuring out if they could make a treatment. Pictured here is an inflamed pancreas alongside other organs, from a rhesus monkey.

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CDC/ Francis W. Chandler, DVM, PhD (CDC PHIL #15341)

Dr. Frederick Banting, a Toronto-based surgeon, along with medical student Charles Best, started by testing out what happens when you remove a dog’s pancreas. When they did, the dog developed diabetes. Next, they found that if you inject insulin back into the dog, it went back to normal.

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Dr. Frederick Banting
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Wikimedia Commons

Banting and Best then began injecting insulin from animal pancreases into people to treat their diabetes. In 1922, a person with diabetes was given the first insulin injection. The team went on to win the Nobel Prize for the discovery of insulin in 1923, and later sold the patent for $3 to the University of Toronto.

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Wikimedia Commons

Source: NobelPrize.org, Clinical Chemistry


For a long time, these animal insulins were used to treat people with diabetes. In the 1970s, scientists found that they could use recombinant DNA to manufacture real human insulin.

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NIH

These human insulins (also known as regular insulin) are still in use, although starting in the 1990s, a third wave of insulin came on the scene. These analogue insulins built on the human insulins, but had slight variations that make them act more like the insulin naturally produced and regulated by the body.

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Reuters/Lucy Nicholson

A 2011 World Health Organization review didn’t find that analogue insulins had any advantage over human insulins. The newer insulins also come at about twice the price as human insulins, which the WHO said was not worth it.

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A diabetic applies an Insulin pen injection in Vienna
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Thomson Reuters

Source: World Health Organization


Most people who need insulin either inject it with a syringe, a pen, or an insulin pump (pictured here) that can deliver insulin as needed throughout the day.

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An insulin pump.
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Alden Chadwick/Flickr

Since the first analog insulin was approved (Humalog), the list price of a vial has steadily increased in step with its competitor, Novolog. In the last decade, the price has gone up 300%. A vial of insulin now costs close to $300.

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Andy Kiersz/Business Insider

The price of insulin continues to be a concern for those living with diabetes along with their families. With the rise in high deductible plans, some are paying as much as a mortgage payment for a month’s supply of the medication.

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Insulin pens
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Reuters

Source: Business Insider


Research into finding newer insulins, or better ways to deliver insulin, continues. In 2016, the FDA approved the first “artificial pancreas,” a device that can both monitor glucose levels and deliver insulin.

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Medtronic

Sources: Business Insider, PhRMA


In December 2016, the FDA approved Basaglar, which came at a slight discount to some of the other long-acting insulins on the market.

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Insulin is injected with a “pen” like this one.
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Flickr/pkuhnke

Source: Business Insider


The cost of insulin has attracted the attention of lawmakers, who at the state level have initiated new laws that require transparency around insulin prices.

Source: Business Insider


For instance, Andrew, a 22-year-old college student with Type 1 diabetes saw the price he paid for insulin over the course of a year jump 150% for the same amount of medication. No one could explain why that happened.

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Andrew B.
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Courtesy Carole Andrew

Source: Business Insider


In response to the criticism, drugmaker Eli Lilly in March debuted an “authorized generic” version of its short-acting insulin Humalog, cutting the price by half to $137. But many noted that the price was still unaffordable.

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Laura Marston holds up a vial of Humalog, a type of insulin she takes for type 1 diabetes at her home in Washington, DC September 27, 2016. When she was first diagnosed at 14, the list price for the drug was $21 per vial.
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Jorge Ribas, The Washington Post via Getty Images

Source: Business Insider


Other insulin makers have taken steps to increase their patient assistance programs. Sanofi in April updated its program so patients with diabetes can buy up to 10 boxes of insulin for $99 a box. Some have said they’d cap future list price increases.

Source: Business Insider, Business Insider


In 2019, insulin-makers Lilly, Sanofi, and Novo Nordisk testified at a Congressional hearing. “I don’t know how you people sleep at night,” Rep. Jan Schakowsky of Illinois told the executives. “Your days are numbered.”

Source: Business Insider