For the last 15 years I have practiced medicine in Klamath Falls. Most of my patients suffer from diabetes and need to take insulin on a regular basis.

Let me take you back in time. In 2008, one vial of insulin cost $45 at the local Walmart. Most patients need two to three vials per month. So while it wasn’t ideal for patients who didn’t have insurance, for most it didn’t break the bank.

Fast forward to today. The price of one vial? $450. That’s a 1,000 percent increase.

Now contrast that with countries outside the U.S.: In that same timeframe, the price has barely changed.

Why?

Some people argue that capitalism is important because it encourages healthy competition and results in lower prices for consumers. But that doesn’t seem to work in the pharmaceutical world. In this world, we have three companies making almost identical insulin products, yet all three raise their prices by exactly the same amount, at exactly the same time. And they’ve been doing this for years.

In fact, when one of the herd gets out of bounds, the others work quickly to bring it back in. In 2006, the drug maker Aventis launched Apidra, a new-ish insulin product, and initially undercut the price of its two competitors (Eli Lilly and Novo Nordisk). However, within 90 days, perhaps sensing the dreaded downward pricing spiral that would ensue, it quickly raised the price back to match that of the other two (Humalog and Novolog).

This isn’t how fair competition is supposed to work, for the benefit of patients. Why isn’t there a market “brake” on these price increases? Over the past four years, I’ve asked Greg Walden repeatedly to investigate this — or to ask the FDA to open an investigation into these horrendous price increases. After all, he’s the chair of the powerful Energy and Commerce Committee, the one that oversees the agency that regulates pharmaceutical manufacturers.

And what’s happened? Absolutely nothing. In the meantime, my patients are the ones losing out.

Only a lucky few have top-of-the-line health care coverage. Most are struggling to make ends meet and many are relying on Medicaid or Medicare. One of my patients travels — three times a year — to Surrey, British Columbia, to purchase insulin there for $50 a vial, a discount of nearly 90 percent to the exact same product produced in Eli Lilly’s factory in Indianapolis and sold at our local Walmart for $450.

Some argue that these high prices paid by U.S. consumers (or in most cases, U.S. taxpayers) are necessary because they fund important medical research. But consider this: Novo Nordisk (which is based in Denmark) spends significantly more on diabetes research than does U.S.-based Eli Lilly. In Africa, a vial of its insulin costs less than $10 U.S., yet Novo Nordisk is still making enough profit on each vial to fund the largest diabetes research facility in the world.

Even more egregiously, Eli Lilly testified to Congress that it spends over $1 billion dollars per year on research, yet investigations have shown that 85 percent of the research dollars were spent on Madison Avenue for advertising, not in its labs in Indianapolis.

In the current congressional election for Oregon District 2, Greg Walden has amassed over $4.2 million in his campaign war chest, of which over 15 percent comes from pharmaceutical companies and medical device manufacturers. It appears that Greg Walden is more concerned about the profits in Indianapolis than about his constituents in Oregon.

That’s why I’ll be voting for Jamie McLeod-Skinner in November.

— Ralph P. Eccles is a former speaker of the house of delegates for the Oregon Medical Association and a retired OHSU professor.