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Study finds that nearly one in five Americans with diabetes use insulin to save money

Research published Monday shows that insulin costs are still a major barrier for many Americans suffering from diabetes, according to research.

The Annals of Internal Medicine revealed that nearly one in five Americans with diabetes in the United States in 2021 either delayed, skipped, or used less insulin to save money. This is 16.5% of the insulin-dependent population.

These findings are based on data from the 2021 National Health Interview Survey. This survey is conducted annually by the Centers for Disease Control and Prevention and interviews tens of thousands of Americans about their experiences with health.

This was the first time the CDC asked questions about insulin use. However, concerns about high insulin prices have been raised for years.

“I have seen patients with life-threatening diabetes complications in the ICU,” Dr. Adam Gaffney, a Massachusetts critical care physician at The Cambridge Health Alliance, said.

He stated that universal access to insulin is essential, and there are no cost barriers.

The Inflation Reduction Act was signed into law in August by President Joe Biden. It will set a $35 monthly cap on insulin for seniors who are Medicare-eligible. However, the bill will not apply to millions of Americans who have private insurance or are uninsured.

According to the study, those two groups had the highest insulin rationing rates. The lowest rates of insulin rationing were found in those who have public health coverage such as Medicare and Medicaid.

According to research, Insulin rationing was more common among black Americans (23.2%) than it was among white and Hispanic Americans (16%).

It was also more common in type 1 diabetics (18%) than it was in type 2 (15.8%). This is particularly alarming because type 1 diabetics who fail to take their insulin as directed can experience multiple long-term health issues, including death or diabetic coma.

Insulin costs can be lowered

Gaffney stated that the problem is simply the insulin list price being too high.

He said, “We have let pharmaceutical companies set the agenda and that is going to the expense of our patients.”

Eric Tichy, division chair of pharmacy supplies solutions at the Mayo Clinic in Rochester

(Minnesota), tracks insulin costs and said that only a few drugmakers — Eli Lilly Novo Nordisk, Sanofi — control the insulin market in the U.S. He said that they can keep insulin prices high because there is no generic competition.

Tichy also stated that insulin products can’t always be interchangeable. For example, if a patient takes an Eli Lilly product, they may not be able to switch to Sanofi’s product.

Experts say that the government’s ability to control drug prices is limited at this point.

Juliette Cubanski (deputy director, of the program on Medicare policy at KFF), stated that the U.S. requires additional policies to “improve insulin affordability for those who may not have adequate insurance coverage or none at all.”

One option is for states or other entities to make their insulin themselves, as California has indicated.

Tichy is part of Civica Rx, a nonprofit drugmaker. In March, Tichy announced that it would make generic insulin for consumers for $30 per vial and $55 for five cartridges.

The American Diabetes Association states that type 1 diabetics require an average of two to three vials per month. Gaffney stated that a month’s supply of insulin for the uninsured or those with poor coverage can run to $1,000 on average.

Cubanski stated that lawmakers can make policies to target “evergreening,” which is a process where drug companies make incremental improvements that extend the patent life.

Gaffney advocated changes in policies to lower the insulin list price.

He stated that the most ambitious proposal he would like for the U.S. to have is universal health care with no copays. He also wants to see the U.S. pay for insulin at the same low prices as other countries.

He said, “I believe we can realize something similar in the United States.” “It’s a huge project, but we also need to lower the prices charged pharmaceutical companies.”

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