Study: Patients skimping on insulin due to rising prices

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A recent study in JAMA Internal Medicine shows one in four patients say they've skimped on insulin because of high cost.

This includes patients with both type 1 and 2 diabetes. However, for type 1 diabetics, that don't make their own insulin, the consequences are even more dire. 

Some of the ways people are trying to stretch their insulin are by using less insulin than prescribed, not filling prescriptions, or just stopping it all together. 

43% of the patients that said they'd cut back on insulin to save money said their sugar levels were not under good control, compared to 28% of those that were taking the drug as prescribed. Lower income patients were most affected.  

Experts believe one of the contributing factors for the rising costs is lack of competition since only 3 manufacturers supply 100% of the insulin in the U.S., and 90% of the world's supply. 

Others point to newer, more expensive versions of the drug with no generics.

An interesting note is that when doctors discovered the drug, they sold the patent for a dollar to the University of Toronto reportedly because they didn't want to capitalize on a drug that would save lives.  

Of course, there have been modifications to that original insulin derived from animal sources, but some experts believe some patients might be able to avoid the expensive analogs.

The price hikes aren't just affecting patients, they're affecting taxpayers.  

Between 1991 and 2014, Medicaid reimbursement per unit of insulin was 20 fold higher than the national average.

Total Medicaid expenditures for insulin doubled from 200 million in 2010, to more than 400 million by 2014.    

A patient on 40 units a day, saw their annual cost go up from $370 in 1991 to more than $2800 in 2014. 

Pharmacies were paid $2 to $4 dollars per unit of insulin for Medicaid patients in the 1990's and by 2014, the cost ranged from $9 to $14 dollars per unit. 

The Health Care Cost Institute found consumer prices roughly doubled between 2012 and 2016.

Nurse practitioner Karen Aitken is part of a campaign from the American Diabetes Association to make insulin more affordable.

Aitken says prices for her personally have increased from $25 to as much as $350 dollars per vial, costing her $1500 for a three month supply.

Along with the monetary drain, Aitken says the stress associated with struggling to afford her insulin, is also taking a toll. "Managing type one diabetes is already extremely time intensive, you’re making decisions about your health 25, 30 times per day. Dosing, counting what you’re eating, it’s very, very complex.  It takes an extraordinary amount of emotional and physical energy. And then to have this added on I think to a lot of people it just feels really unfair," Aitkin says. 

In some cases, people without insurance can get assistance from the drug companies.  

If you're a government employee or contractor and can't afford your insulin, Eli Lilly is asking that you call the Lilly Diabetes Solution Center for help.