Why is insulin still so expensive for diabetes patients in the U.S.?


Why is insulin still so expensive for diabetes patients in the U.S.? Alec Smith-Holt, the son of Nicole Smith-Holt, passed away in 2017 as a result of diabetic ketoacidosis, a condition that takes place when the body does not have enough insulin.

Alec suffered from diabetes type 1. According to his mother, the 26-year-old man, who had recently been kicked off of his parents’ health insurance plan, had approximately $300 less than the required $1,300 to pay for the insulin medicine he required.

He divided up the insulin that he still had in order to make it last until his next paycheck, which would allow him to buy the medication he needed.

“Unfortunately, his body was located three days before payday,” stated Smith-Holt of Richfield, Minnesota. “Payday” refers to the day that workers receive their paychecks.

There hasn’t been much of a shift in the five years after Alec’s passing; the high cost of insulin continues to be a substantial barrier to care for many people in the United States.

14 percent of people who use insulin in the United States face what is described as a “catastrophic” level of spending on the medication, according to a study that was published this month in the journal Health Affairs. This means that after paying for other essentials, such as food and housing, they spend at least 40 percent of their remaining income on insulin.

The estimate provided by the study, which covered 2017 and 2018, did not take into account any additional expenditures associated with the management of diabetes, such as the expense of glucose monitors, insulin pumps, or other prescriptions.

Despite the fact that many pharmaceutical companies have patient assistance programmes that can reduce the out-of-pocket cost of insulin for individuals who are either insured or uninsured, the financial strain can still be devastating for some people.

According to Dr. Robert Gabbay, chief scientist for the American Diabetes Association, an advocacy group for patients with diabetes, people without insurance can expect to pay hundreds of dollars or more per month for the medication, which typically requires multiple vials per month. This information was provided by Dr. Robert Gabbay.

According to Krutika Amin, associate director of the Affordable Care Act programme at the nonprofit KFF, commonly known as the Kaiser Family Foundation, some patients would restrict their medication or miss doses in order to save money. Amin noted that this practice is not uncommon. But in the end, she added, this strategy ends up leading to higher expenditures since patients end up having to be hospitalized or taken to emergency rooms.

Why insulin continues to be prohibitively expensive.

But why is it that insulin, a prescription that has been around for more than a century, is still out of reach for a significant portion of the population in the United States?

According to Dr. Kevin Riggs, a physician at the University of Alabama at Birmingham Heersink School of Medicine, the high cost can be attributed in part to “evergreening,” a process in which drug companies make incremental improvements to their products in order to extend the life of their patents. Evergreening is one of the factors that contribute to the high cost. He was a co-author on a research that was published in the New England Journal of Medicine in 2015 and it detailed the history of the medicine going back over a hundred years.

The enhancements might involve fiddling with a chemical or modifying the delivery system, such as switching to insulin pens from vials as the administration method.

According to Riggs, extending patents can be a disincentive for the development of generic medications, which enables pharmaceutical companies that have exclusive rights to their insulin to charge whatever the market will pay for it. In addition, prices have skyrocketed throughout the years as a direct result of the increased complexity of supply networks.

He went on to say that this indicated that the prices had significantly increased.

And even when the patents do expire — as many already have — Riggs said that the significant expenditure it takes to get insulin manufactured and licenced by authorities in the United States may make the venture less tempting to generic drugmakers. This is because many patents have already expired.