The rising cost of insulin in the United States is among the most pressing challenges facing our healthcare system. Insulin is a hormone used to regulate blood sugar levels by enabling the transport of glucose from the bloodstream into cells. Individuals with diabetes either do not produce a sufficient amount or respond to insulin incorrectly, and thus need to take insulin to regulate their blood sugar levels.1 Approximately 10% of Americans are diabetics who will experience serious health complications or death without proper dosing and consumption of insulin.2,3

Even though the net cost of manufacturing insulin has decreased by 30.8% between 2014 and 2018, the average prices for one vial have increased by 40.1% for the 7.4 million Americans with diabetes who rely upon insulin.4,5 Meanwhile, the profit shares of pharmacy benefit managers increased by over 150%, the profits retained by pharmacies increased by over 200%, and the profit of wholesale shares increased by nearly 75%.4 Manufacturers and intermediaries are turning a steep profit on this life-saving drug. 

Figure 1. Changes in average price per 100 units of insulin (USD) from 2014-2018 in the United States. Net price in manufacturing of insulin compared with mean list price (wholesale acquisition cost) and the net expenditures across manufacturers and distributors. Adapted from Van Nuys et al. 2021.

The rising cost of insulin disproportionately impacts communities of color in the United States. In particular, Hispanic individuals in the U.S. are 66% more likely to be diagnosed with diabetes and 50% more likely to die of diabetes than white, non-Hispanic individuals.2,6 The high price of insulin exacerbates existing healthcare disparities and barriers such as the cost of healthcare and insurance, provider shortages in Latinx communities, and lack of culturally competent care in many healthcare spaces.7,8 

Our actions as chemists have consequences. As of May 2021, 14,560 chemists were employed in the pharmaceutical and drug manufacturing industry in the United States, comprising nearly 5% of the total pharmaceutical workforce.9 It is important to remember the effects that future careers in biochemical manufacturing and the pharmaceutical industry have on real people and communities. Recently, lawmakers have introduced the Affordable Insulin Now Act, a bill that would cap insulin prices under both private insurance and Medicare.10 This bill has passed in the House and as of October 2022 it is awaiting a vote in the Senate.10,11 More information about the Affordable Insulin Now Act (S.3700) is available at Congress.gov. 

Further Reading:

“The High Cost of Insulin in the US: An Urgent Call to Action”, Dr. S. Vincent Rajkumar

https://www.mayoclinicproceedings.org/article/S0025-6196(19)31008-0/fulltext

“The Real Silent Killer: Insulin Prices, Especially for Latino Communities”

“S.3700 – Affordable Insulin Now Act”

https://www.congress.gov/bill/117th-congress/senate-bill/3700

References:

  1. Insulin: What Is It, How Do You Take It, Side Effects. Cleveland Clinic. https://my.clevelandclinic.org/health/articles/22601-insulin (accessed 2022-10-19).
  2. National Diabetes Statistics Report | Diabetes | CDC. https://www.cdc.gov/diabetes/data/statistics-report/index.html (accessed 2022-10-19).
  3. Type 1 diabetes symptoms and treatments. https://www.nhsinform.scot/illnesses-and-conditions/diabetes/type-1-diabetes (accessed 2022-10-19).
  4. Van Nuys, K.; Ribero, R.; Ryan, M.; Sood, N. Estimation of the Share of Net Expenditures on Insulin Captured by US Manufacturers, Wholesalers, Pharmacy Benefit Managers, Pharmacies, and Health Plans From 2014 to 2018. JAMA Health Forum 2021, 2 (11), e213409. https://doi.org/10.1001/jamahealthforum.2021.3409.
  5. Cefalu, W. T.; Dawes, D. E.; Gavlak, G.; Goldman, D.; Herman, W. H.; Van Nuys, K.; Powers, A. C.; Taylor, S. I.; Yatvin, A. L.; on behalf of the Insulin Access and Affordability Working Group. Insulin Access and Affordability Working Group: Conclusions and Recommendations. Diabetes Care 2018, 41 (6), 1299–1311. https://doi.org/10.2337/dci18-0019.
  6. Daily, Bel. The Real Silent Killer: Insulin Prices, Especially for Latino Communities. BELatina. https://belatina.com/the-real-silent-killer-insulin-prices-especially-for-latino-communities/ (accessed 2022-10-19).
  7. Latino Health Disparities. LULAC. https://lulac.org/programs/health/health_disparities/ (accessed 2022-10-19).
  8. Galván, M. E. F. (Noticias T. for A., Astrid. How the failure to cap insulin prices impacts Latinos. Axios. https://www.axios.com/2022/08/09/insulin-cap-reconciliation-latinos-diabetes (accessed 2022-10-19).
  9. Chemists. U.S. Bureau of Labor Statistics. https://www.bls.gov/oes/current/oes192031.htm (accessed 2022-10-20).
  10. Sprunt, B. House Passes Bill to Cap Insulin Prices. NPR. March 31, 2022.
  11. Senator Baldwin Cosponsors Legislation to Cap Insulin Prices at $35 Per Month | U.S. Senator Tammy Baldwin of Wisconsin. https://www.baldwin.senate.gov/news/press-releases/senator-baldwin-cosponsors-to-legislation-to-cap-insulin-prices-at-35-per-month (accessed 2022-11-01)