Table of Contents
What is Insulin?
Insulin is a vital hormone that regulates blood sugar levels in the body. It helps turn food into energy and sends signals the liver to store blood sugar for future use. If the body can’t make enough insulin on it’s own, it can’t use the food that was consumed effectively. Because of this, it is an essential management tool for those living with diabetes.
In this article, we will explore the types of analog insulin, when insulin was developed, their manufacturers, the average cost of insulin (with and without health insurance), when prices began to increase, how long pharmaceutical manufacturers have profited, and what happens when a patient can’t fill their prescriptions because of the cost. We will also discuss what is being done to address this pricing issue.
Different Types of Insulin
There are two types of insulin: human insulin and analog insulin, both of which have different times of effectiveness and durations. Human insulin is a laboratory-made version of the hormone produced by the pancreas, while analog insulin is a synthetic version.
Insulins are classified by how fast they take affect in the body, how long it takes to reach the maximal effect and the duration of that effect. For example, analog insulin normally has a peak effect time of 1 to 2 hours and typically lasts for 4 to 6 hours. Insulin regulation is vital for many dealing with diabetes. Unfortunately, the cost of analog insulin has increased dramatically in recent years, and many patients are now struggling to afford the medication they need to stay healthy.
Insulin Development
Insulin was first discovered in 1921 and was initially derived from the pancreases of cows and pigs. The first human insulin was developed in the 1980s using genetic engineering. Analog insulin was developed in the 1990s and has since become the standard of care for diabetes treatment.
Types of Analog Insulin and Their Manufacturers
The manufacturers of analog insulin include Novo Nordisk; Eli Lilly, and Sanofi. Novo Nordisk produces rapid-acting insulin such as NovoLog and Fiasp. Novo Nordisk also produces long-acting products Levemir and Tresiba.
Eli Lilly produces short-acting insulin such as Humalog, and long-acting insulins Basaglar and Lantus. Sanofi produces a rapid-acting insulin Apidra, and a long-acting insulin Toujeo.
Average Cost of Insulin with and Without Health Insurance
The average cost of analog insulin with health insurance varies depending on the patient’s insurance plan, the type and brand of insulin used, and location. However, on average, patients with insurance pay around $600 to $900 per month for their insulin. Patients without insurance can pay up to $1,200 a month for their insulin. Typically, people with diabetes may use one to two vials of insulin per month, which means they could be spending anywhere from $1,440 to $12,000 per year. Without insurance, the cost of insulin can be prohibitively expensive, which is why some patients must ration their medication or skip doses altogether.
When Did Insulin Prices Increase?
The cost of insulin began to increase in the early 2000’s. According to a report from the House of Representatives Energy and Commerce Committee, the price of insulin increased by over 500% between 2001 and 2015. The report also found that the three manufacturers of insulin, Eli Lilly, Sanofi, and Novo Nordisk, have raised the price of insulin aggressively to meet revenue targets. During an investigation into the three insulin manufacturers, it was found they have engaged in strategies to maintain monopoly pricing and defend against competition from biosimilars. They manipulated the patent system granted by the FDA, marketed their products as being the only option available, and pursued tactics to switch patients to new formulations of their products before losing exclusivity. As the price of insulin continued to rise, many patients were struggling to afford their medication.
How long Have Insulin Manufacturers Profited?
Insulin manufacturers have been profiting from the sale of their medications for decades. According to a report from the Senate Finance Committee, the three major insulin manufacturers – Novo Nordisk, Eli Lilly, and Sanofi have collectively earned billions of dollars in profits from the sale of insulin. In 2018, these three companies made a combined $22 billion in profits from insulin sales.
Congressional Action to Address High Insulin Costs
In recent years, there has been growing concern about the high cost of insulin, and like what we saw with Camp Lejeune, several bills have been introduced in Congress to address the issue. In 2020, Congress passed H.R. 3 Elijah E. Cummings Lower Drug Costs Now Act, a bold reform to lower prescription drug prices. In 2022, Congress capped insulin out-of-pocket costs for Medicare Part D enrollees at $35 per month. This policy didn’t help uninsured people. Pressure to reduce insulin prices has been building for years, but Lilly decided to act now and announced price cuts for selected insulins because of congressional hearings, current lawsuits, and the threat of future lawsuits.
