Monday , October 23 2017
Home / Resources / Articles / What is the Actual Cost of Insulin for Your Patients?

What is the Actual Cost of Insulin for Your Patients?

For patients in the U.S., the price of this lifesaving treatment has risen dramatically.

Insulin can help control abnormal blood sugar, which makes it crucial for people managing diabetes.

Now, a new study reports that the cost of insulin has tripled over the last 10 years.

By looking at what people and their insurers paid for diabetes medications from 2002 through 2013, the researchers found that the average price of insulin has nearly tripled, from $4.34 per milliliter in 2002 to $12.92 in 2013. Since 2010, the cost of spending on insulin per person is higher than spending on all other diabetes drugs.

The study is published in the journal JAMA. Study author Dr. William H. Herman of the University of Michigan, added that, “The dramatic increase in the cost of insulin in the United States may deny some people access to a life-saving therapy….The price increases have had the greatest impact on individual patients without pharmacy benefits who pay out-of-pocket for their insulin, not on pharmacy benefit managers for large insurance companies who receive discounts.”

Over the study period, the cost of insulin per person more than tripled, from $231 a year to $736 a year and that is mostly with insurance.  And in 2016, with the new introduced insulins, the cost can go well over $6,000-$7,000 a year. Simultaneously, insulin use and dosing also went up, which the researchers say may be due to the rise of overweight and obesity nationwide. Obesity can contribute to diabetes, and weight gain interferes with how much insulin a person needs to maintain blood glucose control.

“Although the newer, more expensive insulins have some advantages over the older, less expensive insulins, physicians and patients must ask themselves if those advantages justify their use, especially for patients with type 2 diabetes,” says Herman. So now physicians are looking at going back to the simple human insulins of regular and NPH insulins which cost far less.

The sample consisted of 27,878 people treated for diabetes. During the study period, the prevalence of treated diabetes increased from 5.2 percent in 2002-2004 to 7.7 percent in 2011-2013. For those with recorded insulin use, the quantity per year increased from 171 mL in 2002-2004 to 206 mL in 2011-2013; over the same period, estimated spending for insulin per patient increased from $231 in 2002 to $736 in 2013. In 2013, estimated expenditure per patient amounted to $508 for analog insulin and $228 for human insulin.

The total expenditure on insulin in 2013 was significantly greater than the combined expenditure on all other anti-hyperglycemic medications of $503. The average price per milliliter of insulin increased by 197 percent from $4.34 per milliliter in 2002 to $12.92 per milliliter in 2013, whereas the average price of dipeptidyl peptidase-4 (DPP-4) inhibitors increased by 34 percent from $6.67 per tablet in 2006 to $8.92 in 2013. The average price of metformin decreased by 93 percent from $1.24 per tablet in 2002 to $0.31 per tablet in 2013.

“Significant changes in mean price of insulin, relative to comparator therapies, suggest a need to reassess the effectiveness and cost-effectiveness of alternative anti-hyperglycemic therapies,” the authors write.

Practice Pearls:

  • Insulin is a necessity for those with type 1 diabetes and many with type 2 diabetes.
  • Most other countries provide insulin at no cost.
  • For most people with diabetes, insulin is only one of their medications.

Researched and prepared by Steve Freed, BPHarm, Diabetes Educator, Publisher and reviewed by Dave Joffe, BSPharm, CDE

 

JAMA April 5, 2016, Vol 315, No. 13