The global insulin market is controlled completely by 3 companies. Imagine the price of insulin if all 3 of these companies lost their patents worldwide and prescriptions on all insulin drugs were removed. Not only would the price of insulin fall, but the quantity manufactured would increase everywhere. Monopolies primarily have pricing power because of their tight hold around production quantities. I'd prefer those patents stripped away from these companies. It makes more sense than the government putting price controls on insulin companies which benefit by their keeping supply tight.
1.) Those same 3 companies, selling the same type of insulin, have prices that are a fraction of the US in other countries with better regulation.
2.) Almost every single parent relating to insulin has expired. Insulin is over 100 years old and there is nothing at all stopping many companies developing equivalent products to those around 10-20 years ago, that were fine.
3.) Patents are less of an issue, for modern insulin analog biologics, the issue is as much the manufacturing process; which is covered by trade secrets (that never expire) - doesn’t matter if a company no longer has a patent if everyone else has to spend billions figuring out how to make the thing. But again - not an issue with older insulin.
Not that patents aren’t an issue in general - but they aren’t really why the prices are high for insulin specifically.
4.) The underlying issue of price here, is because of free markets, it’s the result rather an aberration - one cannot have a system where groups compete with each other and expect it to go on forever without anyone winning. That’s the fundamental insanity of free market proponents. You either have to eventually live with regulation, or OCP.
There are three big companies primarily because they were the best at producing drugs, navigating the market and crushing or buying out the competition. They had plenty of competition and yet we are still here.
The fundamental error here is presuming that given that three companies who already mostly beat out the competition over the last 70 years, one can simply wave a wand and have new people to “compete” with a multi-billion dollar pharmaceutical company, on any basis. This is no longer guys in the lab with cow pancreas where you can just patch together to create a workable analog. It’s a mature market and a relatively advanced product that’s going to take hundreds of millions of dollars to set up even if the FDA just ran minimal established safety tests - the alternative, is to go for perfectly fine 10 year old technology that is almost but not quite as good - which there will be almost no market for.
The only ones that will be able to compete in that market are not plucky newcomers - it’s going to be other billion dollar pharmaceutical companies - and until we figure out that it’s really hard to drum up competition in mature tech based markets - round and round we will go.