
The Cost Of Insulin
The price of insulin has more than tripled in ten years. Not everybody pays full price, but many find the cost of insulin complicates their life. This week, we’ll cover why insulin prices are so high. Next week, we’ll address what to do about it. According to this story on CBS News, people with diabetes are “cutting back [on their insulin doses] or even going without the drug,” putting them at greater risk for complications. Insulin costs have soared from $100–$200 per month a few years ago to $400–$500 a month now. CBS News quotes a college student saying her bill for insulin has risen from $130 to $495 per month. She has given up her insulin pump and gone back to injections because of expense. One of her friends has cut her dose down to 80% of what’s ordered to save money. This has become common practice for many. A doctor in Montana reported that insulin prices greatly complicate people’s care. “I have patients who tell me that they have to make a decision between food and insulin, and their rent and insulin.” Why is this happening? When insulin was discovered the 1920s, the doctors who found it gave it away. It immediately started saving lives for people with Type 1 diabetes. Now insulin has become a $24-billion-a-year market globally and is predicted to pass $48 billion in only five more years. And people around the world who need it can’t afford it. There are several causes for the price spikes, but many of them come down to America’s pretend “free market” approach to health care. We are seeing these problems now with the controversy over one brand of epinephrine injections, whose manufacturer increased their price by 500% and then paid their CEO a nearly $19 million salary. Here are some ways American economics are making insulin unaff Continue reading >>

Paying The Price For Insulin
he debate about drug costs can be hard to follow because it is both broad and deep. Between patients not being able to afford their medication, the role of middlemen (pharmacy benefit managers), and lawyers filing class-action lawsuits, the topic is complex and can be emotional for many. Id like to put it into perspective with insulin , a lifesaving drug used by most of my patients and millions of Americans that is a perfect case study of the drug pricing issue. My patient, Jeanne (not her real name) was almost embarrassed to mention that her insulin cost $300 for a single vial that lasts about five days. Thats more than $21,000 a year. Did I have any ideas that might help? I did, and directed Jeanne and her husband to places where they could buy insulin at a discount. Even then, it would cost $1,800 each year but it would be a slower insulin that isnt quite as good as what she was used to. This scenario must have Canadians Frederick Banting and Charles Best spinning in their graves. They discovered insulin one of the most important discoveries of the past century in 1921 and sold the original patent to the University of Toronto for $1, believing that a drug this important should always be available and affordable to individuals who needed it. That ideal got lost along the way. Accounting for inflation, a vial of insulin that cost $1 in 1967 should cost $16.43 today not the $300 it cost my patient. To be fair, the quality of insulin is better today, but not by nearly twentyfold. In the diabetes belt, a small town grapples with growth of the worlds largest insulin maker Many of my patients struggle to pay for insulin. Some of them dont use the full dose each day so they can make it last the month until insurance covers it again. The high cost has been especially onerous Continue reading >>
- Insulin price spike leaves diabetes patients in crisis
- Relative effectiveness of insulin pump treatment over multiple daily injections and structured education during flexible intensive insulin treatment for type 1 diabetes: cluster randomised trial (REPOSE)
- Price controls on diabetes drugs, licenses for sales reps key features of pharmaceutical bill

Research: Buying Insulin Out Of Pocket Without Insurance
Research: buying insulin out of pocket without insurance There is nothing that worries me more than thinking that my son may one day (when I am dead) be without insurance. @Sam also felt that we would not be #UNLIMITED if we did not feel able to work through lack of insurance. @Sam approached me, and we decided to work together to look into the best ways to buy analog insulin without insurance in the US. The bulk of the research was done by @Sam . My portion was largely that of fact-checker and number-cruncher. First we investigated US prices in different locations and for different insulins. We quickly found out that using GoodRx negotiated prices was always cheaper than the listed price we got on the phone or in person. So we switched to using GoodRx for pricing info. We also found out that one has to be very thorough and careful when investigating GoodRx pricing, because there are several dropdowns with search options for every med, and one has to check every combination of options to get to the best prices. GoodRx is an organization that negotiates prices of (prescription) medicines with retailers and issues any internet user with coupons that will provide discounts on medicine prices. To obtain GoodRx pricing, search for the medicine you need on the GoodRx web site, print the coupon and present it to the pharmacy chain for which it applies (or simply show that coupon to the pharacy on your phone) A note: GoodRX pricing online is not accurate. Though they will tell you it is a negotiated price and is accurate, it depends on pharmacy and region. I use it often and find the price with GoodRx discount, at Walgreens, is usually less than they show. And in my travels, I have found the prices vary by region in the app. That said, I will call you guys out for faulty resea Continue reading >>

How To Get Insulin At A Cheaper Price
Insulin can be expensive. If you’re one of the 6 million Americans with diabetes relying on this main-stay treatment, you could be paying out-of-pocket costs anywhere from $120 to $400 per month, according to a 2015 New England Journal of Medicine commentary. Drugs such as Lantus (insulin glargine) and Levemir (insulin detemir) have seen significant cost increases, according to a recent trend report by pharmacy benefit manager Express Scripts. One reason for the high prices is the lack of generic options for insulin. So for now, you’re stuck having to search around to find affordable options. Where do you shop for more affordable insulin? For some people though, high drug costs can mean making difficult financial choices. Our national polls show people might cut back on groceries and paying bills to pay for their medications. To minimize your costs, consider these options: Prescription Assistance Programs If you don’t have health insurance or are without drug coverage, look into applying for a patient assistance program (PAP). Through the nonprofit NeedyMeds, you can find some programs that offer free or low-cost insulin as long as you meet the eligibility requirements. Those are usually based on your insurance status, income, and diagnosis. You might also qualify for a diagnosis-specific program that can help you save on syringes, pumps, and other diabetes supplies. Pharmacists are also a great resource and can help you find a PAP that meets your financial needs. Switch Drugs Another way to save is by asking your doctor whether there’s a lower-priced insulin that’s right for you. While “long-acting” is a more popular type of insulin, it's also more expensive, but that doesn’t necessarily mean it works better. “It’s mostly a marketing ploy,” says M Continue reading >>

The Prices For Life-saving Diabetes Medications Have Increased Again
A Type 1 diabetes patient holds up bottles of insulin. Reuters/Lucy Nicholson Insulin prices have been rising — increases that mean some people are spending as much on monthly diabetes-related expenses as their mortgage payment. It's led some people living with diabetes to turn to the black market, crowdfunding pages, and Facebook pages to get access to the life-saving drug. At the same time, the companies that make insulin have faced pressure from politicians including Senator Bernie Sanders, class-action lawsuits that accuse the companies of price-fixing, and proposed legislation in Nevada. Even in the face of this criticism, two of those drugmakers — Eli Lilly and Novo Nordisk — raised the list price of their insulins again in 2017. Diabetes is a group of conditions in which the body can't properly regulate blood sugar that affects roughly 30 million people in the US. For many people living with diabetes — including the 1.25 million people in the US who have type-1 diabetes — injecting insulin is part of the daily routine. Insulin, a hormone that healthy bodies produce, has been used to treat diabetes for almost a century, though it's gone through some modifications. As of May 2, the list price of Humalog, a short-acting insulin, is $274.70 for a 10 ml bottle, an increase of 7.8% from what the list price had been since July 2016. On May 2, Lilly also took a 7.8% list price increase to Humulin, an older form of insulin. Novo Nordisk, which also makes a short-acting insulin, increased its prices to the drug in 2017. In February, the drugmaker raised its price to $275.58 for a 10 ml bottle, up 7.9% from what the list price had been since July 2016. In December, Novo Nordisk committed to limiting all future drug list price increases from the company to single d Continue reading >>

Diabetics Protest Rising Insulin Prices At Drug Company Headquarters
More than half a million Hoosiers have been diagnosed with diabetes, and many of them rely on insulin to live healthy lives. But patients say the skyrocketing price of the medicine ‒ which more than doubled from 2002 to 2013 ‒ is squeezing them to the point of outrage. The frustration bubbled over at a rally in front of Eli Lilly headquarters in downtown Indianapolis Saturday. Protestors held signs reading “Insulin for All” and “Insulin = Life.” The protest of a few dozen people comprised what organizers believe is the first demonstration of its kind. Insulin’s rapidly-rising cost ‒ and lack of an affordable, generic option ‒ is putting people’s health at risk, protestors say, and making them a slave to the price of the vital hormone. Mike Hoskins, a Type 1 diabetic, said he has good health insurance, but still goes without insulin sometimes to save money. “I don’t use it as much,” he said, “Sometimes, I adjust what I’m eating or my routine so I don’t have to spend as much on insulin.” Horror stories abound of diabetics skimping on injections ‒ or even intentionally slipping into a coma to receive doses of insulin inside the ER. Some diabetics can’t function without insulin, and in some cases, not taking enough can be life-threateningly dangerous. The Indianapolis-based Lilly was the first company to mass-produce insulin in the 1980s. The company is now one of three manufacturers, along with the European companies Sanofi and Novo Nordisk, that dominate the market for the hormone. The trio is now facing a class-action lawsuit accusing them of price-fixing. According to the lawsuit, the list price of Lilly’s drug, called Humalog, has doubled in the past five years. In the mid-‘90s, when the drug was first launched, it cost $21 a v Continue reading >>

Why Walmart Insulins Aren’t The Answer To High Insulin Prices
A diabetes advocate contrasts the performance of generic insulins versus the more popular brands. Commentary Some people don’t understand why people with diabetes get upset at the price of insulin. They see insulin for sale at a relatively reasonable price in Walmart and don’t see the problem. What they don’t know is that these Walmart insulins just don’t perform nearly as well as the more expensive insulins, and that gap in performance can have a very negative effect on the health of people with diabetes. There are three insulins available at Walmart for the price of $25 – NPH, Regular, and 70/30 (a mix of the two). NPH was first approved by the FDA in 1950, Regular was approved in 1982, 70/30 in 1989. That means NPH has been around for 66 years, Regular for 33 years, 70/30 for 27 years. Take a moment and think about what healthcare was like in 1950. Now, I’m sure someone is saying, “Well, they must still work if they are still being sold.” And they do, but they don’t work in the same way. These insulins are not interchangeable. If a person with Type 1 diabetes were to switch from a Humalog/Lantus insulin regimen to Regular and NPH, it would drastically alter their lifestyle, making blood sugar control more irregular and raising A1C scores. The biggest issue is that whereas Lantus is steady, NPH peaks. A person using NPH must keep a very set dietary schedule, making sure to eat meals and snacks at certain times to correspond with peak times of an insulin dose. The strict schedule is difficult for everyone, but especially for children. They are unable to alter their daily schedules and must always be sure to eat at specific times. Even if they’re not hungry, they must eat to avoid low blood sugar. And if they are hungry, they often cannot have more t Continue reading >>

When You Can't Afford The Insulin That You Need To Survive | How To Use The Cheap "old-school" Insulin
Note: BootCamp for Betics is not a medical center. Anything you read on this site should not be considered medical advice, and is for educational purposes only. Always consult with a physician or a diabetes nurse educator before starting or changing insulin doses. Did you know that all type 1 diabetics and some type 2 diabetics need injectable insulin in order to live? Put another way, if a diabetic needs insulin in order to live, and the diabetic does not get insulin, the diabetic will die. Diabetic death from Diabetic Ketoacidosis is a grisly process, during which acid starts running through your bloodstream, searing your vessels and organs while your body shrivels up in dehydration as it tries to push the acid out of your body through your urine and lungs, and, left untreated, the condition shuts down your organs one by one until you are dead. If you're lucky, your brain will be the first thing to swell itself into a coma and you'll be unconscious for the remainder of the organ failures. In some cases, this grisly diabetic death can take a few days or weeks to complete its process. Or, if you're one of the luckier less-resistant insulin-dependent type 2 diabetics, you may actually get away with staying alive for quite a few years and suffer only some heart disease, stroke, kidney damage/failure, neuropathy, limb amputations and blindness. (my intent in describing how lack of insulin leads to death is not to cause fear in people with diabetes or their loved ones; rather, my intent is to make clear the reality that injectable insulin is absolutely vital to diabetics who depend on injectable insulin to live) While I'd love to go off on a political rant about how insulin should be a basic human right for all insulin-dependent diabetics (and why the hell isn't it?), that' Continue reading >>

Whats Going On With The Price Of Insulin?
And the prices of other medications in the US Type 1 diabetes is an autoimmune disease . That means that the persons immune system attacks and destroys the cells in the pancreas (beta cells) that make insulin. Once those cells are destroyed, they dont grow back. Type 1 diabetes is usually diagnosed in young people, before the age of 30, and most often is diagnosed in children between 10 and 14 years of age. It runs in families but can happen to anyone. Around 10% of people with diabetes have Type 1. Teddy Ryder age 5. Ryder weighed 27 pounds when he was brought to Banting. He lived a long life- dying in 1993 age 76. Before 1922, the only treatment for people diagnosed with type 1 diabetes was an extremely low calorie dietas low as 400 calories a day. The treatment extended life but often resulted in death by starvation. Then in 1920, a physician named Frederick Banting pitched the idea of isolating the secretions of the islets of Langerhansin the pancreas to John Macleod, Canadas leading researcher of diabetes at the University of Toronto. Years later, Banting wrote,I told him [John Macleod] that I had given up everything I had in the world to do the research, and that I was going to do it, and that if he did not provide what I asked I would go some place where they would. The story goes that Mcleod gave Banting a lab with minimum equipment , the summer, 10 dogs and an assistant, Charles Best. By summers end, the two men had isolated isletin and reversed the effects of diabetes in dogs. Their experiments convinced Macleod to add personnel, specifically a biochemist named Bertram Collip, and money. By January 1922, insulin had saved the life of a 14-year old boy, Leonard Thompson. In May 1922, Eli Lilly received exclusive rights to manufacture insulin in the US for a ye Continue reading >>

Heres Why Insulin Is So Expensive And What You Can Do About It
The numbers are in: U.S. spending on diabetes drugs increased from $10 billion to $22 billion per year between 2002 and 2012, according to a recent study . And most of that cost was due to skyrocketing prices for one diabetes medication: insulin. Take, for example, Lantus , one of the most popular insulins on the market. The price of a 10-milliliter vial has shot up from under $40 in 2001 to around $275 today. And these costs are hitting more people every year. About 30 million people in the U.S. have diabetes up from 10 million 20 years ago with another 89 million experiencing prediabetes. One study estimates that up to one-third of Americans could have diabetes by 2050. With so many people affected by rising insulin costs, it makes sense to wonder why prices are so high. Today there are two major categories of insulin. Synthetic human insulin was introduced in the early 1980s and appears under brand names like Humulin R and Novolin 70/30 . Genetically modified analog insulin was developed in the 1990s to provide several benefits over human insulin. Analog insulins take effect more quickly, their effects are more consistent and predictable, and they reduce the frequency of low and high blood sugar. Popular analog insulins are Lantus , Humalog , and Novolog . The prices for both types of insulin have risen over the years, but analog insulin is often much more expensive (compare $25 for Novolin 70/30 versus $323 for Humalog 50/50 ). Due to the added convenience and benefits of analog insulin, 96% of insulin prescriptions in the U.S. are now for analogs. However, a growing body of research suggests that synthetic human insulin is just as effective for managing diabetes. Get the best ways to save on your prescriptions delivered to your inbox. Producing insulin is more exp Continue reading >>

Insulin Is Too Expensive For Many Of My Patients. It Doesn’t Have To Be.
At age 15, I suddenly felt an unquenchable thirst and began urinating frequently. I lost 20 pounds. I had developed Type 1 diabetes, an autoimmune disease that destroyed my body’s ability to produce insulin. Without insulin, I would have eventually developed a condition called diabetic ketoacidosis, which is lethal without (and even sometimes with) treatment. Years later, I’m a practicing endocrinologist. I could never have imagined back when I first started taking insulin that one day I would have so many patients who could not afford the medication because of skyrocketing prices. When the drug was discovered in 1921, the original patent was sold to the University of Toronto for $1 so that no one else could patent it and “secure a profitable monopoly.” Numerous improvements later, insulin is produced by a three-company oligopoly. When the first of the newer insulin “analogs,” Humalog, hit the market in 1996, it sold for $21 a vial. Today, vials of analog insulins, including Humalog, sell for about $300 . Patients with Type 1 diabetes typically require two or three vials of insulin per month, but patients who are more resistant to insulin, such as those with Type 2 diabetes, may require six or more. A recent paper in the Journal of the American Medical Association found that insulin nearly tripled in cost from 2002 to 2013. A lawsuit filed in January accuses pharmaceutical companies of price collusion for allegedly raising insulin prices repeatedly and in lockstep to match their competitors. Prices have gotten so bad that the American Diabetes Association recently launched an online petition at MakeInsulinAffordable.org, which has been signed by more than 250,000 people. Because insulin is so expensive, some people take less than their prescribed dose, causi Continue reading >>

What’s Behind Skyrocketing Insulin Prices?
Here’s a sticking point for diabetics: the cost of insulin more than tripled — from $231 to $736 a year per patient — between 2002 and 2013, according to a new analysis. The increase reflected rising prices for a milliliter of insulin, which climbed 197 percent from $4.34 per to $12.92 during the same period. Meanwhile, the amount of money spent by each patient on other diabetes medications fell 16 percent, to $502 from $600, according to a research letter published Tuesday in the Journal of the American Medical Association. “Insulin is a life-saving medication,” said Dr. William Herman, a coauthor of the analysis and a professor of epidemiology at the University of Michigan School of Public Health. “There are people with type 1 diabetes who will die without insulin. And while there have been incremental benefits in insulin products, prices have been rising. So there are people who can’t afford them. It’s a real problem.” The analysis also found that the cost of various widely used oral diabetes drugs either dropped in price or did not rise nearly as significantly as insulin. Metformin, for instance, which is available as a generic, fell to 31 cents in 2013 from $1.24 per tablet in 2002. And the newer class of diabetes drugs known as DPP-4 inhibitors rose 34 percent since becoming available in 2006. The researchers analyzed data from nearly 28,000 diabetes found in the Medical Expenditure Panel, a database on health care costs maintained by the US Department of Health and Human Services. About 1 in 4 people used insulin and two-thirds took a pill. Toward the end of the study period, a small percentage began taking new injectable medicines that are designed to complement pills. There have been previous efforts to track insulin prices in recent years, bu Continue reading >>

How Insulin Became Unaffordable
Just before Alec Raeshawn Smith turned 24, he thought he had come down with the flu. When he went to the doctor a few days later, staff immediately tested his blood sugar levels. They were dangerously highSmiths body had stopped producing insulin, a vital hormone that allows the body to turn the glucose in food into usable energy. Like 1.25 million other Americans , Smith was diagnosed with Type 1 diabetes. Unlike Type 2, a more common condition sometimes linked to high body weight, Type 1 diabetes is an autoimmune disease caused when white blood cells attack the pancreas, killing insulin-producing cells. There is no cure for Type 1, and it cant be treated with pills or other noninvasive procedures; artificial insulin must be injected into the patient several times per day. Without insulin, people with Type 1 diabetes will die, said David Nathan, a professor at Harvard Medical School, in an interview with the HPR. And not over a long period of time, but over the course of a week. For Smith, then a server at Khans Mongolian Barbeque in Richfield, Minn., the diagnosis was life-changing. At first, he had trouble maintaining his active lifestyleSmith loved hiking, fishing, concerts, Minnesota sports, and playing with his young daughter Savannahbut in time his nutritionist and endocrinologist helped him bring his diabetes under control. For two years, Smith managed his condition relatively well. But it wasnt easy financially, even after he was promoted to manager. Doctor visits combined with the expensive life-preserving drugs added up, even with insurance. Copays usually totaled between $200 and $300 a month. Smith occasionally had to borrow money from his mother, Nicole Smith-Holt, to pay for his medication. On May 20, 2017, Smith turned 26, aging out of his parents insur Continue reading >>

Insulin Prices Keep Rising – Pay For Insulin Or Groceries?
Twenty-nine million Americans have diabetes. Many take insulin. Most need it to survive. Few can afford it. Some are faced with difficult financial decisions each month. Pay for insulin or rent? Pay for insulin or utility bills? Pay for insulin or groceries? Many choose to go without insulin or take lower doses to save on cost. Some Americans with Type 1 Diabetes, an autoimmune condition in which the pancreas produces little or no insulin, have been hoarding insulin to safeguard against the prescription drug’s rising prices. Laura Marston of Washington D.C. is one such American. Without insurance, she was paying $140 for a vial of Humalog, a fast-acting insulin typically injected prior to meals (she needs three vials each month). She was able to get insurance with an expensive monthly premium but the insulin will still cost her about $200 out-of-pocket each month. Jump to Solutions for Saving on Insulin Abby Cope, a nurse out of Rochester, New York, pays $460 each month for her insulin. This is an out-of-pocket cost for her. She said she has considered rationing her insulin for the simple reason that she can’t afford it. As a nurse, Cope realizes the consequences of not following the prescribed regimen, but can’t imagine how it feels for those who don’t know and choose to go without due to the expense. In York, Pennsylvania, Robin Kann said she went to pick up her insulin at the usual pharmacy and found that it had increased from $106 to $593. She was shocked and questioned the pharmacy staff member about the price. The staff member replied, “Yes, all diabetes medicine jumped on September 30.” After the price hike, Kann will need to pay over $1,000 per month for two diabetes prescriptions. That is in addition to the $700 insurance premium she and her husband Continue reading >>

Lilly Insulin Prices Come Under Microscope
Home Lilly insulin prices come under microscope Lilly insulin prices come under microscope Medical device tax is history, ending years of frustration for Indiana companies Over the past 20 years, while the price of a gallon of milk climbed 23 percent and the sticker on a Dodge Caravan minivan rose 21 percent, the list price of the insulin Humalog, made by Eli Lilly and Co., shot up 1,157 percent. Other Lilly insulins saw hefty price increases, too, including Humulin, on the market since 1982. It has seen price increases totaling nearly 800 percent over the last two decades. The soaring prices at Indianapolis-based Lillyand two other insulin makers, whose prices are climbing at similar ratesare sending sticker shock through the diabetes community. In recent months, patients have filed lawsuits and called for congressional investigations, and now theyre planning a demonstration next month in front of Lillys headquarters on South Delaware Street. The actions are casting a bright glare on Lillys oldest and perhaps most famous franchise. The company was the first to mass produce insulin in the 1920s, a move that allowed it to attract scientists and make other breakthroughs in fields from cancer to depression. Its a critical time for Lilly, as it tries to increase its dominance in the $10 billion diabetes-drug market against chief rivals Sanofi of France and Novo Nordisk of Denmark. Lilly CEO David Ricks continues to point to diabetes as a key area for investment and growth, but the companys ability to keep patients and physicians satisfied could depend on how well it addresses their concerns over prices. Already, some physicians say high insulin prices across the industry are causing financially strapped patients to ration or discontinue their medicines, which could lead to Continue reading >>