The price of the most effective drug used to treat diabetes is skyrocketing — even as the potentially life-threatening disease is becoming increasingly common among impoverished people.
Between 2002 and 2013, the average price of insulin in the United States tripled from $231 to $736 a year per patient, according to a new study published this week in the Journal of the American Medical Association. Insulin isn’t necessary for all diabetics — some living with type 2 diabetes only need medication to stimulate their body’s production of insulin. But those with type 1 diabetes truly can’t live without it.
“There are people with type 1 diabetes who will die without insulin,” said William Herman, a coauthor of the study, in an interview with STAT. Herman is also a professor of medicine and epidemiology at the University of Michigan School of Public Health. “It’s a real problem.”
“Problem” is an understatement.
This study came out just one day before the World Health Organization (WHO) unveiled new data on diabetes’ global reach. According to WHO, the number of people living with diabetes has nearly quadrupled since 1980, and the majority of the world’s 422 million diabetic adults live in developing countries. WHO previously estimated the world would reach this number by around 2040, if that. If this trend continues, more than 700 million will be living with diabetes by 2025 — less than a decade from now.
While the insulin study only looked at U.S. drug prices, WHO found that insulin prices were universally overpriced across the globe.
“Essential diabetes medicines and technologies, including insulin, needed for treatment are generally available in only 1 in 3 of the world’s poorest countries,” said Etienne Krug, the director of WHO’s noncommunicable disease, disability, violence and injury prevention department, in a press release. “Access to insulin is a matter of life or death for many people with diabetes.”
A 2008 WHO study found that in some developing countries, people living with type 1 diabetes — who require insulin to survive — were able to access insulin less than 25 percent of the time they needed it. For the majority of people surveyed, this was simply due to the high price of insulin.
In the U.S. those living in poverty are already far more likely to become diabetic, and when they can’t afford the high price of insulin, the cycle of health inequity only continues.
This recent spike in U.S. insulin prices can be attributed to the creation of a synthetic insulin, which has proven to be far more costly than the natural human insulin it replaced. However, this new breed of insulin is also faster-acting and considered more convenient to use, according to study coauthor Herman.
But is it necessary?
Herman said that while synthetic insulin may be preferable for those with type 1 diabetes, people with type 2 — the most prevalent form of the disease — really don’t need the type of “analog” insulin most doctors recommend.
“I think providers should have a frank discussion with their patients about using the older, less expensive human insulin, if it’s going to make the difference between being able to afford and take insulin,” Herman told KPCC. “The evidence that the advantages of analog insulin are worth the price for everyone with Type 2 diabetes is just not there, at least not in my mind.”