Endocrine Society: Policy and Practice Changes Necessary to Improve Access to Insulin

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In a position statement, the Endocrine Society suggests several changes to combat the rising costs of insulin.
In a position statement, the Endocrine Society suggests several changes to combat the rising costs of insulin.

According to a position statement published by the Endocrine Society, the rising cost of insulin makes it difficult for patients to manage diabetes. Changes to policy and medical practices can help combat the increasing expenses related to insulin and diabetes care.

The Endocrine Society's position statement sought to address barriers to accessing affordable insulin for diabetes management and determine whether policy solutions could address treatment affordability and improve medication adherence.

Lack of transparency in financial agreements between stakeholders and the drug supply chain, regional cost differences, and insurance coverage all cloud the true cost of insulin. Since 2001, the list price of commonly used insulins has increased dramatically — in some cases by as much as 353% (Novolog) or 585% (Humalog) per vial. 

More than a quarter of respondents in a survey conducted by the American Diabetes Association said that rising costs have affected their ability to purchase or use insulin. Additionally, patients affected by rising insulin costs were more likely to experience adverse health effects, including stress and anxiety.

The statement suggests that a combination of policy and practice changes could lower the costs associated with insulin and expand access to the necessary medication. Greater transparency is needed to understand increases in list prices and how they are established, and more favorable incentives that reduce cost and improve care, such as value-based purchasing agreements or providing rebates to the consumers, should be introduced. Lower-cost human insulins should be used as cost-effective alternatives to modern insulins, and healthcare providers should receive training on their use. 

Further, the accessibility of patient assistance programs should be improved and copay savings cards should be eliminated, as they incentivize the prescription of higher-cost medications. Finally, eliminating gag rules that prevent pharmacists from recommending less expensive ways to pay for medications could help patients understand their options.

Overall, the rising cost of insulin has made it increasingly difficult for patients with diabetes to receive affordable, life-saving medication, especially patients from low-income backgrounds, patients with high deductibles, and uninsured patients. The Endocrine Society suggests several changes for combating these challenges.

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Reference

Endocrine Society. Increasing insulin affordability. https://www.endocrine.org/advocacy/priorities-and-positions/increasing-insulin-affordability. Updated November 5, 2018. Accessed November 23, 2018.

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