In the U.S., the high cost of insulin, with some diabetics paying hundreds or even thousands of dollars for a month’s supply, has long been a symbol of our broken health care system. Too many people with diabetes are forced to ration their insulin — taking dangerously low doses to keep the drug going while leaving themselves in poorer health and, in some cases, poverty.

Despite recent incremental changes — some states have put caps on the cost of insulin, the Affordable Insulin Act now includes a proposed nationwide cap, and some manufacturers and payers have created their own rebates Programs, coupons or caps. But it’s not enough for the uninsured and underinsured.

The complexity of the U.S. insulin market is puzzling. Manufacturers, pharmacy benefit managers, wholesalers, retailers, payers and employers have created an intricate, opaque, rebate-driven rat’s nest where patients have to pay. This is confusing. It’s expensive. This is wrong. Over the past 20 years, the average list price of insulin has increased by 11% per year, bringing the cost of insulin per capita to nearly $6,000 per year. While this structure is not unique to the insulin market, it forces too many insulin-dependent diabetics to choose between paying for their medicines, household bills or food.

Time to try something different. Fresh stuff.

Civica Rx, a nonprofit with a mission to make essential, high-quality medicines affordable and accessible to everyone, recently announced a partnership with GeneSys Biologics to develop and commercialize three biosimilar versions of insulin-glycan in the U.S. Insulin Serum, Insulin Lispro, and Insulin Aspart.

Civica will launch its insulin at a sustainable minimum price, significantly reducing the market price of insulin. Not only will Civica announce its wholesale prices, it plans to set a suggested price to consumers of no more than $30 per bottle and $55 per box of five pen holders, which is a significant increase from the prices charged to uninsured individuals today. Discount.

Expected to be available as early as 2024, Civica insulin will be available to U.S. pharmacies and other distributors at the same wholesale price and on the same commercial terms, regardless of the size of wholesaler or retail pharmacy or purchase.

Perhaps most importantly, Civica does not participate in any rebate programs. Both rapid-acting insulin and basal insulin are among the most tax-refundable drugs in the United States. Every year, people with diabetes pay billions more than they should for insulin. These systematic overpayments are collected by the PBM at the retail pharmacy counter and “returned” to wholesalers, payers, and employers at the back end, with every link in the supply chain getting a piece of the action. These “middlemen” in the current insulin market, who have opened up the highway between drug manufacturers and patients, after consolidating market power, become “highway men”, extracting more and more from desperate patients and families tolls.

Civica will put an end to this form of road robbery.

We intend to democratize insulin and ensure that this essential drug is affordable for all Americans. The Civica Foundation has raised more than two-thirds of its $125 million funding goal for the development of Civica insulin, and these fundraising efforts will continue as we work with the wider diabetes and charities community.

For many of us involved in creating a new market for insulin, this is a highly personal endeavor. We believe that an organizational model like Civica can open up new markets and fix old, seemingly intractable market glitches. The return sought is not a direct financial return to a small group of shareholders. Our goal is to generate social returns, improve affordability, and reduce human suffering, while demonstrating that market solutions exist that can help moderate the effects of capitalism, unconstrained by perceptions of right and wrong—models that always put the needs of the patient first.