The high cost of insulin for Jessica Price, diagnosed with type 1 diabetes mellitus as a child sometimes leaves her with difficult life choices, Wednesday, Sept. 6, 2017. Michelle Pemberton/IndyStar
Eli Lillyâ€™s Humalog debuted in 1996 at $21 a vial.Â Now it’s $275. Sanofiâ€™s Lantus was $35 a vial when it was introduced in 2001; itâ€™s now $270.Â Potential action includes price controls, profit limits.
Prescription insulin means the difference between years of life and a very quick death for more than a million Americans, including U.S. Supreme Court Justice Sonia Sotomayor and musician Bret Michaels. Both were diagnosed with Type 1 diabetes as children.
There is no cure for the disease. ChildrenÂ cannot diet or exercise or grow their way out of it. Type 1 has nothing to do with how much someone weighs or how much sugar they eat. Scientists have not figured out how to prevent a patient’sÂ immune system from destroying insulin-producing cells in the pancreas. Without artificial insulin,Â these diabetics die.
So the outrageous and escalating price of the drug feels criminal. Congress must finally intervene to get the cost under control.Â
Type 1 diabetics spent $5,705 per person on insulin in 2016, according to a new report from the nonprofit Health Care Cost Institute. That is double what they spent four years earlier, even though they’re using about the same amount of the liquid drug. The cost of onlyÂ insulin accounts for 30 percent of the total $18,494 per-person health care spending for these diabetics â€”Â more than is spent on supplies like test strips and syringes, hospitalizations or doctorâ€™s visits.Â
Between 2012 and 2016, the price of insulin increased from 13 cents a unit to 25 cents a unit. â€śThat translates to an increase from $7.80 a day in 2012 to $15 a day in 2016 for someone using an average amount of insulin,â€ť according to the report.
Such increases make no sense. Insulin was discovered 100 years ago by researchers who sold the patent to a university for $3. And though there are new forms of the drug, Eli Lillyâ€™s Humalog debuted in 1996 and was $21 a vial.Â Now the same vial is $275. Sanofiâ€™s Lantus was $35 a vial when it was introduced in 2001; itâ€™s now $270.Â
Of course thisÂ underscores the importance of health insurance in this country. While those with coverage may still have expensive co-payments, the hardest hit are people who are uninsured, have ultra-high-deductible plans, or fall into the Medicare prescription drug coverage gap known as the doughnut hole.Â But why should insurers, including government programs, continue to fork over so much money for drugs that are sometimes decades old?
The huge expense begs for congressional action. Elected officialsÂ have held hearings,Â asked questions and lamented a lack of transparency and accountability in the industry. But if lawmakers really cared about this issue, they could take meaningful action, including imposing price controls, limiting profits of manufacturers and funding â€śgenericâ€ť insulins.Â
Why donâ€™t they?
They must be aware of the many recent media reports about struggling diabetics. By now they know about Alec Smith of Minneapolis, who died in 2017 after trying to ration his insulin because of the high price. The 26-year-old had just aged out of being covered by his parentsâ€™ health insurance.Â
Without congressional intervention, manufacturers will continue to drive up prices in the quest for huge profits. Patients will continue to be held hostage. Some will continue to use less insulin than they need, which can result in high blood sugars and complications including blindness, kidney failure and amputations. That ruins lives and costs our health care system more.
Type 1 diabetics use an average of 60 units of insulin a day, administered with syringes, insulin pumps or pre-filled pens. Being healthy and productive means carefully balancing medications, diet and exercise. It means regularly monitoring blood sugars with expensive test strips, visiting the doctor for blood work every few months, and annual eye exams. It means never going anywhere without glucose to remedy a low blood sugar that can lead to a coma.Â
These Americans have more than enough to worry about just to stay alive each day. Itâ€™s about time Congress stoodÂ up for them.Â
Difference between Type 1 and Type 2
Both Type 1 and Type 2 diabetes involve an imbalance of insulin, a hormone that helps regulate blood glucose levels. With Type 2, which accounts for about 95 percent of diabetes diagnoses, the body has become resistant to insulinâ€™s effects. These people may be able to control blood sugar levels with oral medications, though some may need insulin. Type 1 diabetes, which is much less common, is frequently diagnosed in children. All Type 1 diabetics need to take insulin. Without it, they mayÂ die within days or weeks.
Tell us your stories about insulin
Congressional hearings about the high cost of insulin, reports about escalating prices, and a Type 1 diabetic from Minneapolis who died after rationing insulin have put a spotlight on the issue of insulin cost. The Registerâ€™s editorial board is seeking Iowans who are willing to publicly share their stories aboutÂ access to the drug and its price. Please contact editorial writer Andie Dominick at [email protected]
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