Insulin Prices: What Inflation Reduction Act Does

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Many people with diabetes must monitor their blood sugar levels. Andriy Onufriyenko/Getty Images
  • The United States has one of the highest insulin prices in the world.
  • The Inflation Reduction Act caps the cost of insulin at $35 per vial for people on Medicare, but a provision to place the same cap on people with private insurance wasn’t included in the legislation.
  • Experts believe that more must be done to lower the cost of this life-saving drug, which is needed by many people living with diabetes.

Diabetes is the leading cause of death in the United States. seventh-leading cause of deathThe United States.

Access to insulin, a life-saving drug that regulates blood sugar in diabetics, remains a financial burden for many Americans.

The Inflation Reduction Act was signedToday’s President Joe Biden proposed that a provision be made to cap insulin copays at $35 per vial for insured Americans. But, this measure was rejected by the majority of Senate RepublicansIt was blocked.

The new law caps out of pocket costs for Medicare beneficiaries at $35. This provision goes into effect January 1.

The average insulin price in the United States is $98.70 per vial, across all forms of the drug. That’s nearly seven times higher than the country with the next most expensive insulin, Japan, which averages $14.40 for the drug, according to a recent RAND Corporation report.

“More than 7 million people in the U.S. use insulin and for the vast majority, having consistent access to insulin is nothing short of a life-or-death issue both in the short-term and long-term,” Keri Hurley-Kim, PharmD, MPH, an associate clinical professor at the University of California at Irvine’s College of Health Sciences, told Healthline.

“Patients with type 1 or advanced type 2 diabetes can experience very severe complications that require hospitalization and, in some cases, can be fatal,” she added. “In the long term, insufficient insulin use can cause diabetes to be more difficult to control and lead to complications such as amputations, kidney disease, heart attack, stroke, and loss of vision.”

People with diabetes have begun to travel to Canada in caravans in order to buy insulin at a lower price, as the government struggles with insulin costs. Some researchers are also trying to “open source” complex insulin formulations for public consumption.

However, neither effort is a quick solution.

According to research by GoodRx, the average retail price of insulin has increased 54 percent between 2014-2019.

Prices declined slightly – by 5 percent – in 2020 and 2021, but not enough to make up the difference.

As prices have risen so have the deaths.

In 2019, 87 647 Americans died of diabetes. According to data from the, that number had risen by 102,188 in 2020. Centers for Disease Control and Prevention.

2021: Deaths where diabetes was the underlying cause topped 100,000 again.

But how did a drug whose creator gave away the patent to the University of Toronto nearly for free 100 years ago in the hopes it wouldn’t be exploited for profit end being the subject of decades of price-gouging and patient desperation?

One reason is that insulins are not all created equal. There are many options, and the most effective ones often have the highest prices.

“Without insurance, most patients in the U.S. have to pay hundreds if not thousands of dollars per month for standard-of-care insulins,” Dr. Arti ThanguduHealthline was told by a private San Antonio endocrinologist, Dr. Judith.

“Insulin pens are safer and more convenient but often 10 times the cost of vials,” Thangudu explained. “Some insurance companies have pharmacy deductibles, forcing patients to pay high amounts before their insulin is covered despite paying monthly premiums. This forces patients to ration insulin leading to unnecessary hospitalizations, complications, and even death.”

Another reason is that there is no genuinely generic insulin in part because manufacturers often tweak their formulas in a process called “evergreening” to prevent their patents from expiring.

Experts agree that the Inflation Reduction Act is a positive step in the right direction. However, more work is needed to control insulin prices.

“The people most impacted by the price of insulin are those who do not have coverage and so must pay in cash for medications, as well as those with certain commercial plans that may have low premiums in exchange for very high deductibles,” Hurley-Kim explained. “These patients can pay hundreds of dollars per month for insulin alone, particularly if they require high doses. Many people with diabetes use two different types of insulin, which can double the cost.”

Even capping co-pays doesn’t do much for millions of uninsured Americans and critics of co-pay capping say that insurers will simply pass the costs on to consumers through increased premiums.

“The most salient argument against price capping revolves around the idea that the cost of insulin is simply one symptom of our broken healthcare system,” Hurley-Kim said. “It does not ensure access to comprehensive diabetes care, address the myriad other medications that are unaffordable, or acknowledge the ways the U.S. ignores the importance of effective preventative medicine and chronic disease management.”

Generic insulin should be available in the United States in 2024, she said, but even that will “not offer a complete solution.”

“It will still cost more than insulin in other countries. Even $30 or $100 a month can force a decision between enough medicine and enough food for some families,” Hurley-Kim said.

Source: Health Line

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