By: Joshua Kalter
It’s time to talk about diabetes.
In a recent video short, the New York Times detailed the lengths that many adults with Type I diabetes must go to just to purchase insulin, a lifesaving drug. Online marketplaces, illicit drug deals, and even trips to Mexico were necessary to acquire the exorbitantly priced drug. The human price of high insulin prices are far costlier, with stories of individuals dying while trying to stretch their insulin doses between paydays becoming more and more common.
From 2007 to 2016, Medicare spending on insulin per user has more than quadrupled, with average annual costs totaling $3,949. Out-of-pocket costs for insulin users with Medicare spiked over this same time period, with many users paying more than double for their products of choice.
Those that do not qualify for prescription drug coverage under Medicare Part D are left in a far more financially precarious situation. A vial of Lantus, which constitutes a 28-day supply of the popular form of insulin, has an average retail cost of $326 according to GoodRx. This cost is a huge increase from the average cost in 2012 of $123.
Despite being invented in 1923, there are no generic or low cost alternative insulins. Incremental changes to drug formulations allow large pharmaceutical companies to extend their old patents and continue dominating the market. This has allowed these companies to use the American marketplace to generate half of their global profits, even though the US accounts for a 15% share of the global marketplace.
Insulin is not even the only expense for diabetics. Those who monitor their blood sugar must spend hundreds of dollars per year on glucose monitoring strips. This sets up another opportunity for an illicit marketplace to reduce the out-of-pocket costs for low-income Americans.
Not only do lower-income patients have to pay more to manage their diabetes, they also are at higher risk for developing Type II diabetes. Studies have found that in the United States there is a strong link between low socioeconomic status and diabetes prevalence. Closer examination into some of the causal factors of diabetes, like poor diet and lack of exercise, also shows a link to socioeconomic status and diabetes. American households that are food insecure have higher rates of diabetes.
This trend is not solely specific to the United States. This same trend exists in Canada, a nation with universal health care where citizens at risk for developing diabetes have access to health care, regardless of income status. Large-scale studies have linked low socioeconomic status to diabetes prevalence. Social determinants of health like poor neighborhood walkability and food insecurity are linked to diabetes in Canada. The Canadian single payer system can’t mitigate the socioeconomic drivers of diabetes development.
The population with the highest risk of developing diabetes also feels the heaviest burden of managing their condition. How can someone be expected to manage their blood sugar when they have to struggle to put food on the table? Or spend hundreds of dollars on glucose test strips and insulin? How can they even fathom to pay for the costly comorbidities of uncontrolled diabetes?
While an overhaul of our current health system could certainly address more than just diabetes care, lawmakers can make real steps to lessen the economic burden felt by patients. The solutions to the absurd pricing of diabetes care don’t have to be transformative. Colorado recently capped insulin pricing, so that no residents will pay more than $100 per month for insulin, and individuals with pharmacy drug benefit plans with Express Scripts will have their spending capped at $25 per month.
With both private insurers and state lawmakers leading the way, it is not unfathomable to see real progress made here in Florida. Tallahassee could legislate a similar price cap, or offer tax incentives to insurers that cap insulin pricing. Lawmakers could even offer tax incentives to pharmacy retail chains who sell insulin at similar costs to uninsured patients. These solutions cannot begin to address the socioeconomic burdens affecting patients, nor can they improve access to medical care for the more than 2 million Floridians living with diabetes. But these changes can help Floridians live healthier lives, without having to skip meals or medications.
No American should die because of an inability to afford their medicine. If you feel the same way, email and call your Hillsborough County state legislators and ask for their support of similar measures.
Picture Credits: https://www.healthline.com/health/diabetes