Insulin costs continue to rise in the country resulting in many Americans being unable to afford the much-needed hormonal drug. Even with insurance costs it can be so high that hundreds are spent for just a month supply. As the monthly cost of insulin continuously rises, “as many as one in four people with diabetes are skimping on or skipping” doses, Vox reports. The U.S. is reported to have the highest cost for insulin in the world.
Earlier this year, the Health Care Cost Institute (HCCI) released a report that depicted the increased price of insulin between 2012 to 2016, using healthcare claims data to research spending costs associated with individuals who had type 1 diabetes. According to the report, spending doubled in the four-year period.
According to the HCCI, an estimated 1.5 million Americans are said to have type 1 diabetes. There are two different types of diabetes, type 1 and type 2. While those with type 1 diabetes do not produce insulin, those with type 2 can be insulin resistant or not as responsive to the hormone as they should be. The institute defines insulin as a “hormone that breaks down sugar in the blood so that it can be used by the body’s other cells as fuel.” Those with “type 1 diabetics must adhere to a lifelong insulin regimen that includes administering insulin through either injections or an insulin pump,” the institute said in their report.
They added that since insulin is a complex drug, it is not available in generic form and with there being no cure to diabetes, the hormonal drug is necessary. “There has been a flurry of news reports sharing stories of individuals with diabetes rationing their insulin because they cannot afford higher and higher prices. These anecdotes are consistent with findings of researchers documenting price increases on diabetic therapies, specifically insulin, over the last several years,” the report read.
Various state Congress members have drafted bills to address the issue of insulin costs and are working to pressure drug companies to control costs. Last year, Sen. Elizabeth Warren and Rep. Jan Schakowsky introduced the Affordable Drug Manufacturing Act that aimed to lower prices and increase completion for essential drugs like insulin. It also authorized the Office of Drug Manufacturing to create generic versions, however, the bill did not pass.
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Before that, another bill, the Capping Prescription Costs Act of 2018 was introduced to “cap the monthly prescription-drug cost-sharing permitted under qualified health plans and group health plans. This bill, too, did not go anywhere according to the official congressional website.
There are three main insulin manufacturers, Eli Lilly, Novo Nordisk, and Sanofi. “The manufacturers make the drug, set the price and negotiate with pharmacy benefit managers, the companies hired by health insurers to manage prescription-drug benefits for beneficiaries,” USA Today reported. No generic version has ever been made, causing the three manufacturers to control the market.
Reuters reports that at the start of 2019, “Sanofi raised prices on some insulin products between 4.4 percent and 5.2 percent, while Novo Nordisk raised prices on some of its insulins by 4.9 percent,” at the time of the article. Eli Lilly had not raised prices, they said.
Last month, Rep. Beth Liston of Ohio introduced the Insulin Affordability Act which focuses on capping the price of insulin to $100 a month with a healthcare plan. It requires the state attorney general to recommend insulin pricing for the state, USA Today reported. Two similar acts were introduced this year, the Insulin Affordability Data Collection Act introduced in Nov. by Sen. Tina Smith of Minnesota and the Affordable Insulin Act introduced by Rep. Peter Welch of Vermont in February. All three have been referred to the subcommittee on health, education, labor, and pensions.
The Senate Committee on Aging even held a meeting to address the costs and access of lifesaving medicines last year in lieu of reports, CBS said. The meeting led by Sen. Bob Casey discussed the congressional need to lower prescription drug prices. Casey emphasized the importance of access to affordable prescriptions. “It is unconscionable that some people with diabetes can’t afford their medications. We must do more on this front, including investing in community-based programs that educate people on how to manage their illness and live a healthy lifestyle, free from the burdensome expense of medication,” Casey said.
In June, the New York Times reported on a study conducted by Yale University in which they found “one in four patients admitted to cutting back on insulin use because of cost,” at a clinic in Connecticut. This isn’t the first study of its kind; the diabetes association had similar findings in a survey they conducted. According to CBS News, the survey found that 27% of those who participated in the survey said “cost had affected their use or purchase of insulin,” and many switched their usage without consulting a doctor.
Many face issues of diabetic ketoacidosis, a condition in which individuals experience high blood pressure and dehydration due to not having enough insulin. Facing more complications or even death due to unaffordable health care or lack of insulin is very tragic. As Nicole Smith-Holt, a woman who lost her son to diabetic ketoacidosis tells NPR, he lost his life “three days before his payday because he couldn't afford his insulin,” something that could have not occurred if insulin was more affordable.
Read Related: At least 25% of diabetes patients rationing insulin as drug costs continue to skyrocket
While discussions on costs of insulin continue to grow between lawmakers, a solution has not yet been secured federally. So far, only one state has passed a cap on insulin costs. Earlier this year, Colorado became the first state to pass legislation that caps monthly costs of insulin for diabetic patients. The law signed by Gov. Jared Polis is to go into effect next month and limits copayments of insulin to $100 a month despite the amount needed by insurance subscribers.
It seems that until federal legislation is passed to address the accessibility of medicine, Americans will continue to risk their health by skimming medications to avoid costs. Pharmaceutical company leaders alongside lawmakers play a role in reducing these prices, with the increasing need for insulin in the country a nationwide solution is needed to make the drug more affordable.