DIY medicine: The rebellion against Big Pharma

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  Quantumrun Foresight
• June 16, 2022

The rising cost of essential medications such as insulin and chenodeoxycholic acid (CDCA) has given rise to Do-It-Yourself (DIY) medicine, where scientists and health professionals manufacture drugs and treatments and sell them to patients at cost. 

DIY medicine context

Rising prices of critical medicines and treatments have led members of scientific and healthcare communities to manufacture these treatments (if possible) so that a patient’s health is not placed at risk due to cost factors. In the European Union, hospitals can produce certain drugs if they follow specific rules. However, if healthcare facilities are primarily motivated to reproduce drugs due to high prices, they reportedly face increased scrutiny from healthcare regulators, with inspectors vigilant for impurities in the raw materials used to make these drugs. For example, in 2019, regulators banned CDCA production at the University of Amsterdam due to impure raw materials. However, in 2021, the Dutch Competition Authority imposed a $20.5 million USD fine on Leadiant, the world’s leading manufacturer of CDCA, for abusing its market position by employing excessive pricing strategies   

A 2018 study at the Yale School of Medicine found that one in four diabetes patients limited their insulin usage due to the drug’s costs, increasing their risk of kidney failure, diabetic retinopathy, and death. In the United States, Baltimore Underground Science Space founded the Open Insulin Project in 2015 to replicate the insulin manufacturing process of big pharmaceutical companies in protest against the industry’s excessive pricing practices. The project’s work allows diabetic patients to purchase insulin for $7 a vial, a marked reduction from its 2022 market price of between $25 and $300 a vial (market depending). 

Disruptive impact

Civil society groups partnering with universities and independent drug manufacturers to produce medicines to treat severe illnesses at a lower cost than large pharmaceutical manufacturers may encourage major drug companies to change their pricing strategies. Public campaigns could be launched or intensified against these companies, damaging their public reputations and negatively impacting drug sales. Further, civil society groups may petition their national governments to support local drug manufacturing to reduce supply chain risk and build healthcare product resilience in their economies. 

Major drug manufacturers who hold dominant market positions may reduce the price of specific drugs in reaction to public pressure or seek to do so proactively to improve their public standing. Lawmakers worldwide may introduce regulations that cap the price of specific drugs so that their local populations can access them at a reasonable price. 

Implications of the growing DIY medicine industry 

The wider implications of civil society and its social partners manufacturing life-saving drugs at lower prices compared to large drug companies may include: 

• Major producers of insulin, such as Eli Lilly, Novo Nordisk, and Sanofi, lowering insulin prices, thereby reducing their profit margins. 
• Major pharmaceutical companies lobbying state and federal governments to aggressively regulate (and outlaw) the manufacture of select drugs by organizations outside the traditional pharmaceutical industry.
• Treatments for a variety of conditions (such as diabetes) becoming more readily available in low-income communities, leading to improve healthcare outcomes in these areas.  
• Increased interest in and sales of pharmaceutical manufacturing equipment to civil society groups and independent drug production companies. 
• New medical technology startups being founded specifically to reduce the cost and complexity of manufacturing a range of drugs.

Questions to comment on

• Do you think the price of insulin should be regulated worldwide? 
• What are the potential disadvantages of specific medicines being manufactured locally versus large pharmaceutical companies?