This article was last updated on April 16, 2022
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In the United States today, the cost of insulin is cripplingly high. The average list price of Humalog, a popular fast-acting form of insulin made by Eli Lilly that was introduced in 1996 at $20 per vial, has now skyrocketed to $274.70. Other popular forms of insulin have also gone up significantly, but we will use Humalog as our example in this article. The price of insulin fluctuates so much that patients are not sure what they will be paying from month to month, making financial planning next to impossible.
Prescription Hope Inc. explores the problem of fluctuating insulin prices, giving some background on the price changes and how they hurt American patients with diabetes.
Insulin: A Hundred-Year-Old Drug
Many people are surprised by the continuing rise in the price of insulin because the drug was initially developed in the 1920s. Drugmakers continually cite the cost of research and development when explaining why prescription drugs are so expensive, but spending billions of dollars developing a drug that has worked for 100 years is less understandable. A complex web of industry and political factors causes insulin prices to fluctuate so much.
There is a complex relationship between health insurers, pharmacy benefit managers, drug companies, and doctors. Drug rebates given to insurance companies for covering a particular medication in its formulary are driving skyrocketing prescription prices for drugs like Humalog.
While the federal government has tried to rein in insulin prices, they have been largely unsuccessful. The government claims to be putting pressure on insulin makers, but the prices have not come down. In other countries like Canada, a vial of Humalog costs only $32. This huge difference underscores the weakness in the American healthcare system.
Dangers of Rationing Insulin
One-fourth of diabetes patients cannot afford their monthly prescribed medication. Some patients have been forced to try to stretch their medication by rationing it for more than a month at a time. While it is understandable that people may try desperate measures to survive, rationing insulin can cause severe complications and death.
One such patient, Alec Raeshawn Smith, died in 2017 because he could not afford his insulin after leaving his parents' insurance plan and was forced to ration the drug. He died of ketoacidosis, a condition that happens when the body produces a high level of blood acids called ketones. The condition can cause high blood sugar, low potassium, and swelling on the brain, along with more serious complications that lead to death.
How Much Insulin Do Patients Need?
The average diabetes patient with employer-sponsored insurance uses 62 units of insulin per day. This means that a single vial of Humalog would last for 16 days. As a result, most diabetes patients need to have at least two vials of the drug in their monthly prescription, and many have up to four vials. This can lead to out-of-pocket costs of up to $1,100 per month with no insurance.
Fluctuations in Insulin Prices
This is how the list price of Humalog has changed since it was developed in 1996:
June 1996: $21
August 2001: $39.75
Early 2005: $60
July 2005: $102
November 2015: $237
April 2021: $274.70
The doubling of the drug’s price from early 2005 to July 2005 and again between 2005 and 2015 shows the struggle that diabetes patients have endured when trying to afford their prescription medication.
Solutions on the Way
Fortunately, cost protection programs like that offered by Prescription Hope Inc. are available to manage the high, fluctuating cost of insulin. When a patient uses their services, they will be able to access the medication through the manufacturer’s patient assistance program at a low monthly cost of $50 with no insurance needed. These prices are only available to patients who qualify under income regulations.
Paying a simple $50 per month in a predictable fashion is far easier than bracing oneself for the monthly rise in insulin prices. Patients will be better able to deal with the effects of their disease if they are not constantly worried about paying too much for their life-saving medication.
Why the Company Was Founded
Prescription Hope Inc. was founded because founder Douglas Pierce’s mother was diagnosed with a life-threatening condition and could not afford her medication. Through extensive research, Pierce was able to find a program through the drugmaker that would help his mother access the medication, but the process of applying for this assistance was complicated. He decided to start a company that would take the hassle out of accessing these programs and pass the savings along to the American people.
If you have diabetes, think about how much you pay for insulin each month. If the price is high and constantly changing, you may be looking for a way to regulate your costs. Contact the company for help with setting up a plan to bring you your expensive prescriptions for an affordable monthly fee.
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