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Texas man was hospitalized with diabetes. 3 years later, he's a lawmaker fighting insulin costs.

James Talarico/Twitter

The difference between a politician and a public servant may be a matter of semantics, but when it comes to getting legislation passed that actually helps people, the contrast is stark.

Texas Representative James Talarico is on a mission to get his constituents the life-saving medicine they need. The 31-year-old lawmaker has just introduced legislation that would cap the price of insulin—a medicine people with type 1 diabetes need to live, which has become unaffordable for many—at $50 a month.

The mission is personal for Talarico, as he nearly died three years ago when he was diagnosed with type 1 diabetes.

He shared his story on Twitter:

"In May 2018, I was a healthy 28-year-old running for the Texas House. I decided to walk the entire length of my district and hold town halls along the way. I hike Big Bend every year, so I wasn't concerned about a 25 mile walk...

But halfway through the walk, I began feeling nauseous and fatigued. Before the town hall in Hutto, I vomited in the bathroom."

Taralico assumed he was dehydrated, so he changed his shirt, drank some water, and kept walking. He threw up four more times in the last 12 miles of the walk, but finished it.

"After the walk, I went to bed thinking I needed a good night's sleep," he wrote. "But I slept for 36 hours."

"My parents rushed me to the hospital where nurses checked my blood sugar. A normal blood glucose level is below 100. Mine was 900. I was immediately diagnosed with type 1 diabetes."

Type 1 diabetes is an autoimmune disease with an unknown cause. It can come on at any time but is usually diagnosed before age 40. (Most type 1 diabetics are diagnosed between ages 4 and 14.) Unlike type 2 diabetes, which can generally be controlled with dietary changes, type 1 diabetics must inject themselves with insulin because their pancreas can't produce it.

Talarico was in diabetic ketoacidosis (DKA), which will lead to a coma and death unless the person is given insulin. He spent five days in the ICU.

"Now I have a glucose monitor on my arm & take shots of insulin every day," he wrote. "As long as I take care of myself, I'll live a long life."

However, he discovered firsthand how the cost of insulin can be life-threatening for people. He pointed out that in the last 20 years, insulin prices have shot up 1200% while manufacturing costs have stayed relatively constant.

"Even with health insurance, I paid $684 for my first 30-day supply of insulin—the medicine I need to live," he wrote. "I had to put it on a credit card.

Now that I'm a legislator, I have excellent state health insurance to cover my insulin. Every Texan should be entitled to the same."

As Talarico explains it, there are three primary reasons for the price hike:

1) The $27 billion global insulin market is a monopoly controlled by three companies: Sanofi, Eli Lilly, and Novo Nordisk. They can fix their prices, and appear to increase them in lockstep with one another.

2) There's no generic option. Because insulin is a biological product and not a chemical one, it's harder to produce a generic version. "The big three companies enter into 'pay for delay' schemes where they pay potential biosimilar manufacturers not to enter the market," he wrote.

3) These companies have no competition. "The big three companies surround their insulin patent with lots of other patents to make the original patent last longer (known as 'evergreening')," he wrote. "Then they spend millions in lobbying to prevent policymakers from closing any of these loopholes."

"Putting profits over people has deadly consequences," Taralico added, pointing out that Texans with diabetes fund their necessary medicines with GoFundMe pages or resorting to the black market. "And in the richest country in the world, 1 in 4 diabetics risk their lives by rationing insulin."

Taralico's legislation would cap out-of-pocket costs for insulin at $50 per month, in addition to requiring the Attorney General to investigate rising prices. His bill in the House and a complementary bill in the Senate make up "a bipartisan, bicameral effort" Talarico says. If passed, the legislation would make Texas the 16th state—and the largest one—to put a cap on insulin prices.

"Insulin should be free, because insulin is a human right," Talarico wrote. "This is an idea that's time has come."

Here's hoping that the Texas legislature supports Talarico's efforts and makes this life-saving medicine affordable for all diabetics. And here's hoping that more states follow suit.


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Let's take a moment to honor the unsung Moderna vaccine trial volunteer who died of COVID-19

The Independent/Twitter, Kai Kupferschmidt/Twitter

It's been nine months since we found ourselves thrust into a global pandemic the likes of which the world hasn't seen in a century. Now here we are on the precipice of administering vaccines that will hopefully put an end to it, many months ahead of the expected schedule.

The speed with which scientists and pharmaceutical companies have raced to figure out how to make a novel virus vaccine both safe and effective has been impressive to say the least. It's a testament to modern medicine, innovation, and dedication on the part of the scientists who have worked tirelessly to bring it to fruition.

As of today, Moderna is asking for FDA approval of its mRNA vaccine, which trials show to be 94.1% effective in preventing coronavirus infection and 100% effective at preventing severe cases. Pfizer's vaccine has shown similar effectiveness.

While many people may be skeptical of a vaccine created in such a short period of time, experts have expressed confidence in the safety data that's been released so far. But there's one big element to the safety data that doesn't get focused on nearly as much as it should—the courageous volunteers who literally risked their lives so that scientists could learn whether their work actually works and the rest of us can feel safe (or at least safer) getting a new vaccine.

When people volunteer to test new vaccines, they're not only agreeing to whatever surprise side effects the vaccine might cause, but they're also at a higher-than-average risk of being exposed to the disease the trial is testing for. And since trial participants don't know if they are receiving the actual vaccine or a placebo, there is very real risk of having no protection whatsoever from said disease.

While the numbers from the Moderna trial indicate a resounding success, it came with a tragic-but-necessary cost. The way a trial works is that some participants receive the vaccine being tested, and others receive a placebo that doesn't do anything. While none of the actual vaccine recipients became severely ill with COVID-19 in the Moderna trial—which vaccine researcher Paul Offit says is "absolutely remarkable"—30 of the 185 people who contracted symptomatic cases of the virus in placebo group did develop severe cases. And one person in the placebo group died what Moderna has called "a COVID-19-related death."

We don't know the name of the individual who died. But we do know that they knowingly and willingly risked their own life to save millions more, and such a sacrifice should not go unrecognized. Whoever this nameless, unsung hero was, we salute them.

Our gratitude must also extend to those who became severely ill from the virus in the trial, as well as everyone who volunteered to take on the risks to help science do its thing.

So far, there are reported side effects that one might expect from any vaccine—tenderness in the injection spot as well as some people reporting flu-like symptoms for a day or so as the vaccine kicked their body into fighting gear—but they didn't know what unexpected reactions there might be going into it. Volunteers get compensated for travel and time they have to take off of work to go to appointments, but it's not like they're making real money. It's a real sacrifice with an unknown outcome, and many volunteers express that they signed up because they wanted to do something to be helpful.

So thank you to the tens of thousands of people who volunteered to take one for the team, putting their own health on the line to save us from further pandemic suffering. While we celebrate the scientists whose knowledge and skill and collaboration have brought us vaccines in record time, let's also cheer for the everyday folks who offered up themselves as guinea pigs to help us move past the pandemic and help humanity return to normal life. We owe them an enormous debt of gratitude.

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