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Life with T1D

The Rising Cost of Insulin in the United States – A Change is Gonna Come

The three pharmaceutical companies, Sanofi, Nordisk and Eli Lilly, produce over 80 percent of the world’s insulin supply and have exploited the limited market. As insulin prices skyrocketed due to the lack of government regulations, their actions appeared justified. Heartbreakingly, it took several individuals' deaths for people to demand an end to this injustice. 

The Rising Cost of Insulin in the United States – A Change is Gonna Come

When physician and scientist Frederick Banting invented insulin in 1923, he and his co-inventors, James Collip and Charles Best, made it clear they wanted the drug to be affordable for everyone. The three men declined to have their names on the packaging, as they felt it would be unethical to profit off a lifesaving medicine.

So why is it that 100 years later, people are still skipping doses and, in some cases, dying because the drug price has tripled over the past decade? Why isn’t this medicine available and affordable to the masses, as Banting intended?

The simple answer is greed. According to the Diabetes Research Institute, over 37 million Americans have diabetes, and 1.45 million live with T1D. An article by the University of Carolina cited approximately 7.4 million are insulin-dependent, and since the COVID-19 pandemic, the death rate of people with diabetes has grown 50 percent higher. 

What’s going on with the Insulin Cost Crisis?

Over the years, a few members of Congress have tried to lower insulin prices; however, it was in no way an easy battle for them. Senator Elizabeth Warren (D-Mass.) and Senator Richard Blumenthal (D-Conn.) sought to ratify the outrageous overcharging through failed legislation. 

Since joining Congress in 2013, Warren has advocated for lowering prescription drug prices. In 2018, she and Representative Jan Schakowsky introduced The Affordable Drug Manufacturing Act to allow the government to develop generic drugs. Unfortunately, the bill didn’t pass. They tried to re-introduce it in 2019 without success. 

In 2019, after public indignation, the manufacturers finally agreed to reduce patients’ insulin costs by introducing a generic insulin. Eli Lilly promised their generic version of Humalog, “Insulin Lispro,” would be available in pharmacies nationwide. Regrettably, at the time, this so-called generic never came to fruition. 

Warren and Blumenthal investigated the availability claim by surveying over 400 pharmacies nationwide. The report “Inaccessible Insulin: The Broken Promise of Eli Lilly’s Authorized Generic” proved that the drug was unobtainable to the masses. 

And then in 2022, as part of the Inflation Reduction Act, Congressman Dan Kildee (D-Mich.), whose daughter has type 1 diabetes, passed a new law to cap insulin prices at $35 for seniors on Medicare. The $35 out-of-pocket expense covered the Medicare Part D participants. Last August, Republicans blocked the bill’s provision to cap out-of-pocket costs for everyone on private insurance. 

Most people with Diabetes Didn’t Benefit from the Inflation Reduction Act

In 2022, Kildee introduced the Affordable Insulin Now Act to cap the insulin cost to all Americans, regardless of their insurance coverage. Senators John Kennedy, Jr. (D-LA) and Raphael Warnock (D-GA) recently re-introduced The Affordable Insulin Now Act of 2023. The bipartisan bill would keep insulin prices at $35 for a 30-day supply for all patients, including the uninsured. Under the bill, group or individual plans would cover insulin vials, pump or inhaler dosages, whatever the insurer needs. Insurers’ $35 payment would apply toward their deductible. And then, in April 2023, Senators Jeanne Shaheen (D-N.H.) and Susan Collins (R-Maine) introduced the INSULIN Act of 2023, a bill extending the $35 cap to people with private insurance. 

It’s hard to follow the vast amount of senators introducing insulin-cost-saving bills and even harder to find any that have passed into law.  

While achieving affordable insulin through federal government support has been a long, frustrating battle, several states’ efforts have been more promising. For instance, Colorado was the first state to cap insulin prices at $100 per prescription. Since the Colorado law passed in 2020, other states like Illinois, Connecticut, Delaware, Maine, Minnesota, New Mexico, New York, Utah, West Virginia and Washington approved similar bills. 

Finally, a Break!

In March 2023, Eli Lilly, Novo Nordisk and Sanofi announced they would slash insulin costs in response to the growing pressure. Eli Lilly offered to cut costs by 70%, cap out-of-pocket expenses at $35 for individuals without private insurance, and reprice their generic Lispro vials at $25, Novo Nordisk followed Lily by slashing costs up to 75% in the U.S. Lastly, Sanofi will cut the insulin prices of its most prescribed brand by 78% and cap vial costs at $35 for people with private insurance. These changes will go into effect on January 1, 2024. 

It’s been a long time coming for insulin-dependent individuals. Still, by pressuring senators and hammering state and local officials - the labor and efforts of those demands will soon bear fruit. May the stories of our lost loved ones never be forgotten. 

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