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Diabetics Are Feeling the Squeeze

More than a third of U.S. adults have diabetes or prediabetes, and the price of insulin has more than doubled in the past 5 years.

Per-person spending on insulin doubled in a recent five-year period, according to a report released Tuesday by the Health Care Cost Institute.

Individuals with type 1 diabetes spent an average of $5,705 on insulin in 2016, compared with $2,864 in 2012, according to the study. Yes, insulin prices DOUBLED in 5 years, due almost entirely to price increases at the point of sale. Inflation, for the record, is about 2% annually.

This is of special import for payers, as one third of U.S. adults are now living with diabetes or prediabetes, according to a separate report from the Centers for Disease Control and Prevention (CDC). Their report finds that as of 2015, 30.3 million Americans – 9.4 percent of the U.S. population – have diabetes.

Dramatic price increases like this have the biggest impact on the uninsured and those with the high-deductible health plans currently in fashion with self-funded employers seeking shelter from skyrocketing healthcare costs. And we have seen that as out-of-pocket costs increase, especially for patients with chronic conditions, diseases often go untreated and other health issues are almost certain to follow.

Rx spending diabetics

According to the Health Care Cost Institute study, for a type I diabetic using an average amount of insulin, the price increased from $7.80 a day in 2012 to $15 a day in 2016. This after the cost of insulin tripled between 2002 and 2013.

Here, it is worth noting that Frederick Banting, who discovered insulin in 1923, surrendered the patent for nothing – for free – because he thought it should be available to and affordable for everyone.

Policymakers are taking notice. In May 2018 the American Diabetes Association testified before Congress on the issue. The state of Minnesota is taking action by suing three of the world’s largest insulin manufacturers. And now, Colorado Gov. Jared Polis has signed a bill into law that places a $100 per month cap on insulin co-pays, regardless of how much insulin a patient uses.

Payers like you (or your clients) will be expected to foot any costs over and above.


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