EPISODE 2: The Cost of Insulin

This is “The Diabetes Discourse,” keeping you updated on diabetes care, management, and concerns. I’m Samantha Albino, a student at the University of Florida and future physician assistant. In this episode, we will be discussing what insulin is, why insulin is so expensive and how pricing is affecting individuals diagnosed with diabetes. 

 

As Nicole ended in the previous episode, Karla received a prescription for analog insulin as a treatment for her Type 1 diabetes. 

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Insulin is a hormone that functions to regulate blood glucose levels. In a normal, healthy individual, insulin is constantly being created and broken down by the body in a matter of minutes. If someone with diabetes were to inject themselves with normal human insulin, it would be broken down quickly and ultimately have little to no effect. Analog insulin was created to prevent this rapid breakdown.

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Analog insulin is still human insulin, but it has been genetically modified by adding protein subunits to the insulin molecules. This engineered insulin is much more durable and can last for hours in the bloodstream.

Both normal human insulin and analog insulin are available for those with diabetes. Normal human insulin is cheap and available without prescription, but is ineffective. Analog insulin requires a prescription and is incredibly effective. However, analog insulin is very expensive, and prices only continue to rise.

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Analog insulin prices have skyrocketed over the past couple of decades. In 1996, one 10ml vial of Eli Lilly Humolog insulin was $21. By 2016, the same vial was $275. That price increased over twelve times its original in a twenty year period. This rise in price is due to a number of reasons.

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First, there are a limited number of manufacturers. There are only three manufacturers of analog insulin in the United States: Sanofi, Novo Nordisk, and Eli Lilly. Few manufacturers means that competition stakes are high. Insulin is in such high demand that these pharmaceutical companies keep raising the price. Once one manufacturer raises the price, the rest follow to keep up with their competitors, and ultimately this leaves little room for variety in price point.

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Furthermore, while many medications have a generic form, there are no generic forms of analog insulin available. This is due to patents on the insulin. The US insulin manufacturers have patents for their particular strands of insulin, and this prevents other companies from creating cheaper, generic forms of the insulin. Rather than create new forms of the insulin, manufacturers continue to modify their patented strands. By doing so, they prolong their exclusive rights to produce their patented insulin.

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With insulin prices on the rise and a lack of generic insulin available, many with diabetes have been forced to take drastic measures to meet their treatment needs.

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Ultimately, the high price of insulin has lead to dire access issues for Americans with diabetes.

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Some have been forced to ration their insulin supply, which leads to serious health complications and even death. 

When Type 1 Diabetes patient Alec Smith, turned 26, he was no longer able to be covered under his parents insurance, and could not afford health insurance of his own. His monthly spending for insulin was $1300, and he was forced to ration his insulin to get by financially. However, without full doses of insulin, his health began to suffer. In June of 2017, Alec was found dead in his apartment after falling into a diabetic coma.

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Insulin rationing is a severe health threat, and many suffer under these measures. When insulin rationing fails, some Americans have resorted to purchasing their insulin abroad. Americans have crossed over to Canada and Mexico to purchase a hefty supply of insulin at significantly reduced costs. The average cost for three months worth of insulin in the US is $3700; however, this same three-month supply of insulin is only $600 dollars in Mexico.

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While crossing US borders for insulin has helped alleviate some, many don’t have the means or lack the access to cross these borders.

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Today, I discussed with you what insulin is, why it is so expensive and how prices are affecting those who are insulin dependent. I hope you were able to get something from this informative podcast. I encourage you all to take action in helping to combat the rising prices of insulin.

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Once again, I’m Samantha and thank you for listening to “The Diabetes Discourse” If you enjoyed  today’s episode, be sure to check out Hannah’s episode as she discusses insulin abroad.