Insulin Prices Overview: The ADA’s Efforts To Reduce Cost

It Costs To Stay Alive

The American Diabetes Association is taking a stance against expensive insulin treatments.  Since 2002, the price of insulin has tripled.

Pricing is set through a complex supply chain which includes manufacturers, wholesalers, pharmacy benefit managers (PBMs), insurers, and pharmacies.

Insulin is a life-saving drug that is necessary for people with diabetes. As the prices continue to rise across the boards, many diabetics can no longer afford it.  The prices for insulin in government programs, like Medicaid for example, have risen too.

A History Of Insulin Price Increases

Today, Humalog, a short-acting insulin costs nearly $275 for a 10mL bottle. That price reflects a 7.8% increase from July 2016 pricing. According to Business Insider last month, this price has risen steeply over the past 20 years.  In 1996, Humalog cost about $25. It doubled to $50 in 2003. In 2010, the price was $100. Then, in 2014 a Humalog prescription was about $200. And now it is $275.

Living conditions and expenses are compromised for those that are uninsured or, underinsured, and patients that need several daily doses.

Pricing is not set just by pharmaceutical companies. Manufacturing costs and health insurance plan discounts affect insulin drug costs too. It is difficult to find the prescription drug breakdowns since much of the information of manufacturers and health insurance companies is confidential. Drug wholesalers and distributors, PBMs, health plans and some retail pharmacy chains act as middlemen to negotiate prices and take a cut of the prices. Then, the middlemen increase the price of the drug. When the price cuts are not passed down to the consumers, medications like insulin are overpriced and often become too expensive for the patient to afford.

The Need For Insulin Is Undeniable

Without treatment through insulin, diabetics risk serious long and short term health complications. Without the required insulin, diabetics risk going blind, having amputations, failure of kidney functions, heart attack, stroke, and death.

The ADA Works To Reduce Costs of Insulin

The goal of the ADA is to increase transparency and get the petition spread across the country. Then, people requiring insulin can get their treatment at a more affordable rate.  Once signed, the petition will be sent to Congress.  In court, reasons for insulin price increases will need to be identified.

You can read and sign the petition today.

There needs to be assurance that all people needing insulin have affordable access to the medication.

Shopping Around To Save Money

If you go to Walmart to get your insulin, you may pay $25 out of pocket and not go through your insurance provider. However, not going through your health insurance provider could risk your health insurance thinking you are no longer on insulin. If that happens, the insurance company could stop paying for the strips, monitors, or pumps.  So, make sure to mention to your pharmacist that you’d like to have your insulin purchase put through their online billing system. This way, your health insurance provider will have your supplies covered at no charge.

Kara Stiles says, “There are “old school” insulins available at Walmart for $25/bottle. They’re not as good as the analogs, but they’ll save your life in a pinch.”

In European countries, diabetics pay about a sixth of what the US charges. This is because the US does not regulate prescription drug prices. Insulin treatment is commonly noted as one of the most expensive drugs on the market.  Allison Tsai says that in 2014 insulin was a $24 billion global industry and according to P&S Market Research, this number will double to $48 billion before or by 2020.

Regulating Costs

If the government could regulate how much insulin companies charge for insulin, patients would be more capable of buying their necessary medications.  The government could make efforts to reduce costs by having the private market set the prices. Then, Congress could work out a regulatory system like what was done with Medicare.