The One-Dollar
Patent.

In January 1922, in a Toronto hospital, a fourteen-year-old boy named Leonard Thompson received an injection of a cloudy pancreatic extract. He was dying of diabetes, as every child with his diagnosis did. Within weeks it was clear that he would not.

What happened next is one of the most generous decisions in the history of medicine. And what happened a century later is one of the clearest warnings I know.

A dollar for the world.

Frederick Banting did not want his name on a patent. He believed that owning a medicine went against the Hippocratic Oath he had sworn as a physician: a doctor's knowledge is for healing, not for sale. The team filed one anyway, for a single reason: if they did not, someone else could piece together their method, patent it, and lock everyone else out.

So the patent was taken in order to be given away. Banting, Charles Best and James Collip assigned their rights to the University of Toronto for one dollar. The intention could not have been plainer. Nobody may own this, so that it can reach everyone.

They patented it so that no one could ever fence it in. Then they sold it for a dollar.

The gift had teeth.

A discovery in a laboratory is not yet a medicine on a shelf. Toronto could make insulin by the flask; the world needed it by the ton. The university turned to Eli Lilly and Company, which brought real industrial skill to the problem. Its chief chemist, George Walden, found a way to purify insulin at scale. Within about a year, there was enough for North America.

The university was careful. Lilly received one year of exclusivity, and a request for a second was refused. When Lilly sought a broad American patent on its purification process — broad enough, Toronto feared, to hand it control of insulin manufacture in the United States — the university pushed back. The application was rewritten, and Toronto made it a rule: any licensee that improved the process had to assign those patents back, so that every other licensee could use them too.

In my note Patent to Free, Not to Fence, I called this a pledge with teeth. Toronto practiced it a century before I wrote it down. And for a while, it worked.

A century later.

Patents expire, and Toronto's did long ago. But a medicine is never only its first molecule. Over the decades, value moved into everything around it: new formulations, longer-acting and faster-acting versions, pens and devices, each one patentable, each one a new fence around a gift that had been meant to have none.

In the United States, the result became hard to look at. Lilly's Humalog, launched in 1996 at roughly twenty-one dollars a vial, cost around two hundred and seventy-five dollars by 2018. Three companies, moving prices largely in step, supplied most of the world's insulin, inside a system of rebates and middlemen that rewarded a higher list price. Patients without good insurance began rationing a medicine discovered so that no one would ever have to.

It changed in 2023, when Lilly cut its prices by seventy percent and capped what most patients pay at thirty-five dollars a month. That deserves credit. It also took a hundred years, and a great deal of public anger, to get back to something close to what three men in Toronto had intended for a dollar.

Nobody stole the gift. It was simply left unguarded for a hundred years, and the incentives did the rest.

What a dollar cannot buy.

The inventors did everything right. They gave the discovery away, and they protected the gift for as long as their protection lasted. What they could not do was stand guard over it for a century. A patent expires. A university committee moves on. A good intention does not transfer with a license.

They gave away the house. Nobody was left to look after the neighborhood.

A photograph from Toronto.

While writing this, I found a photograph I had almost forgotten. Ron, in Toronto, deep in conversation with our friend Professor Laszlo Radvanyi, then President of the Ontario Institute for Cancer Research. Two men with Hungarian roots, in the city that gave insulin away. Behind them, in large letters: Insulin: Toronto's Gift to the World.

Ron would have loved this story. And he would have asked the one question at the heart of it, the kind nobody else in the room wanted to ask: who is still standing guard?

Why this story is ours.

BioFund cannot change what happened to insulin. But we can learn from it, and we are unusually well placed to.

Our disciplines on openness come straight out of this history. We decide before we speak. We publish the neighborhood, not just the house, so the obvious next steps stay open too. And when we patent to protect the commons, our licenses require that improvements come back to it.

Above all, we were built not to leave. Seven families, no exit, a clock measured in decades. The one thing Toronto could not give insulin was a guardian who would still be there in fifty years. That, perhaps, is the most useful thing a family office like ours can offer: not just a gift, but someone who stays to make sure it remains one.

It is what a lighthouse does. It does not sail off once the first ships have found their way through. It stays at the edge of the known, night after night, long after the people who lit it are gone, and keeps the light on for whoever comes next.

A discovery given to the world deserves more than a dollar. It deserves someone who stays.