In 1921, a group of doctors developed the life-saving drug insulin and gave it to patients for free. So now, why is it impossible for some to afford this medication? Why are those who can’t afford insulin dying in tragic and avoidable circumstances? In less than one hundred years, the price for a nearly identical drug has skyrocketed upwards of 300 dollars for a single vial–but only in America. You would be hard pressed to meet someone that has never had a family member or friend who uses insulin; in fact, I have had Type One Diabetes since I was three years old. Yet, the American pharmaceutical system has made insulin nearly inaccessible for a large majority of these people. With constantly and drastically rising prices, insulin companies have done what few others have before: colluded to raise the cost of a life-saving drug in lock-step, resulting in no safe and or sustainable choice other than for diabetics to pay their inflated price.

A problem that they forgot to consider was that in America the right to life, liberty and the pursuit of happiness was first stated in the Declaration of Independence. Shouldn’t I then be allowed access to the medicine that keeps me alive? It’s a large burden to carry, knowing that for the rest of your life a portion of your pay is going to have to go to medicine; it’s even larger when this medicine is inexplicably and unjustifiably expensive. And it just keeps increasing. 

Insulin is not just something your grandma gives herself when she’s eating a sweet. In Type One Diabetes, the immune system attacks insulin producing cells in the pancreas, rendering the patient unable to produce insulin. Without multiple injections of insulin a day, a Type One diabetic will die. That’s what happened before insulin was discovered. A large majority of Type Two diabetics are also insulin-dependent, which means that both types need external insulin input. But many diabetics are now rationing insulin due to its high cost. Rationing insulin is not just dangerous in the short term, and extremely unpleasant causing symptoms similar to the flu, but also causes long-term effects. If not given enough insulin, people living with diabetes run the risk of amputation, seizure, brain damage, vision loss, organ failure, and even death. Despite these dire consequences, the high costs of insulin is driving diabetics to ration their insulin. In fact, it is no longer an uncommon occurrence for a diabetic to die due to hyperglycemia: high blood sugar. I vividly remember being six years old and seeing the news discuss a sixteen year old who had passed away due to her family not being in the financial place to afford her insulin. No sixteen year old should lose their life when it is one hundred percent avoidable but for the economic greed of companies, and no six year old should already be worried about how they are going to make a good enough living to survive.

Insulin has not advanced in years, but for the sake of argument, let’s just focus on the past twelve years. With the exception of one fast acting insulin in the past year, there have been no scientific developments that have been brought to market or even packaging differences in the production of insulin, yet the cost for all three of the main insulin brands has doubled in the past twelve years. The last actual change in the drug was when a synthetic way of producing insulin, rather than purifying from pigs, became available in 1982. 

The reason that these companies are getting away with raising costs is simple: no one is checking them, no one cares, and no one feels a need to change it. Unless they are directly affected by the disease, it is hard to understand why it matters so much. So what if your medicine costs a lot? You have insurance; they cover a lot of the cost, right? Technically, they’re not wrong. My family isn’t paying 300 dollars biweekly for me to survive, simply because my father has a job with good health insurance. However, millions of families in America do not have this luxury. Millions more won’t if the Trump administrations and his Supreme Court justices get their way in abolishing the Affordable Care Act. More than 130 million Americans will lose their protections for preexisting conditions, and of those Americans 1.9 million are diabetics. All of this in the middle of a pandemic where we are significantly more vulnerable. 

No one should be punished for a disease they have zero control over, to be forced to make the decision between using their medicine correctly, or making it last longer by suffering through the consequences. Corporate greed and games of hot potato with the blame has pushed people so far as to need to purchase their medicine through an honest to God black market so commonly that, when you go into your endocrinologist, it is not uncommon for them to ask you if that is how you are acquiring your medicine. This is both highly illegal and dangerous as no one is quality-checking the vials and anything could be in them. The poorer the person, the less likely they are to have health insurance, the more likely it is that they are going to need to pay the whole cost, resulting in either self imposed medical negligence or participation in unsafe practices. The system is set up in a way that is killing our lower income citizens because no one has stepped up and dealt with the issue.

Maybe by now you’ve forgotten a key point of this issue. It’s only happening in America. No other first world country is having this problem. A vial of humalog, one of the main brands of insulin, costs 327 dollars in America, 55 dollars in Germany, and 32 dollars in Canada. For reference, I use humalog and go through about 7 vials a month. Without insurance that would be 2,289 dollars a month and 27,468 dollars a year just to survive. This is without factoring in the cost of needles, alcohol swabs, test strips, continuous glucose monitors, glucagon, insulin pumps, and so much more. I really doubt that anyone can honestly look at these costs and not come to the conclusion that American companies are robbing diabetics because they know that diabetics will pay. But people are increasingly not able to afford it. Moreover, insurance co-pays for insulin are increasing as insurance companies pass the ridiculous costs on to their customers rather than fight companies producing insulin to lower the prices. So some diabetics are driving outside of the United States into Canada and stockpiling insulin for the next couple of months in their fridge. Just think about that for three minutes and tell me that that doesn’t scream of injustice. American citizens have to leave their country in order to buy the medicine that they are dependent upon because they can’t or won’t pay the sky-high prices. Maybe you’re still having problems trying to rationalize this, so here’s a scenario to put it into perspective. You’ve been feeling tired and worn down so you go to the doctor and they tell you that you have a vitamin D deficiency, prescribing you with vitamin supplements. When you go to CVS they ask you for 300 dollars. A week. For the rest of your life. Kinda seems unfair, right? Now imagine that you’re going to die if you go a day without it. That is the position that diabetics have been forced into within the United States.

Not only has this issue been repeatedly and systematically swept under the rug, but in recent days it has been used to further people in their political conquests. How many times have you heard that insulin prices have been lowered? Few things are as demoralizing as hearing your president stating that insulin is “so cheap, it’s like water” while you are actively seeing friends struggle to get by. Last time I checked 10mL of water isn’t 300 dollars. Despite wildly fabricated claims, no real plan or progress has been made. Large name insulin companies have been called to testify for their actions, but no change has been seen. There simply isn’t time though. People are worrying, suffering, and dying right now and yet outside of the diabetic community the sense of urgency is nonexistent. The mentality that healthcare, and therefore insulin, is a privilege rather than being a part of the basic human right to live, is severely detrimental to those that are reliant upon it for their survival. Imagine your loved one dying because their country made a long existing drug unaffordable for them. Imagine going to a sixteen year old’s funeral, taken from this world way too soon because some company saw an area of vulnerability and capitalized upon it. With no reason other than economic greed, America has decided to prey on it’s sick, and it simply cannot be allowed to continue. It’s nearly impossible to go about your day knowing that your country doesn’t care enough to address an epidemic of people with your disease dying and is actively making it worse. That they don’t care. But hey, why care? The rich are getting richer, so what? It’s not affecting you, right?

Photo by Mykenzie Johnson on Unsplash