The Endocrine Society is calling for immediate action by policymakers to address the underlying factors responsible for the rising cost of insulin, a life-saving drug taken by 7.4 million people in the United States.

“Rising costs have made access to affordable insulin far more difficult for people with diabetes, especially low-income individuals, those on high deductible health plans, beneficiaries using Medicare Part B to cover insulin delivered via pump, Medicare beneficiaries

in the Part D donut hole, and those who turn 26 and must transition from their  parents’ insurance, to manage their diabetes and avoid unnecessary complications and hospitalizations,” the Society wrote in a position statement published in January in The Journal of Clinical Endocrinology and Metabolism.

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In recent decades, the cost of insulin has risen for patients. The price of Novolog’s product has increased 353% between 2001 and 2016 and Humalog’s by 1,200% between 2001 and 2019 in the United States. Increases like these are causing an unnecessary burden for uninsured and underinsured patients with diabetes.

The Endocrine Society states that stakeholders across the entire supply chain have been, in part, responsible for the increased cost of insulin, and each member in the chain could take preventative steps which may reduce inadvertent impacts to individuals with diabetes.

For manufacturers, the Society recommends for greater transparency across the supply chain to identify factors responsible for price increases. Manufacturers should eliminate rebates and instead passing the savings directly to the consumers, they said.

Other recommendations include:

· Patient assistance programs could be improved with the goal of increasing accessibility.

· Pharmacists should familiarize themselves with lower cost options and educate their customers on whether or not less expensive options are available. Pharmacy benefit managers should develop arrangements directly with manufacturers which ensure that large price increases do not occur annually.

· Lower-cost insulin, such as human insulins, which should be available at no cost to patients, should be prescribed by physicians and prioritized by hospital administrators.

· Employers should seek health care plans which limit copays and educate their employees about options before open enrollment.

Policy makers may also affect all areas of the supply chain by adopting legislation that benefits those living with diabetes. For example, price increases could be tied to inflation, thereby avoiding steep increases in price, a payment model could be incorporated into Medicare to reduce out-of-pocket expenses, the approval process for insulin biosimilars could be expedited, and the government could negotiate drug prices directly with manufacturers.

A survey of Americans living with diabetes found that 27% of adults and 34% of families with children on insulin indicated they were financially burdened by insulin costs, forgoing filling other medications, visiting the doctor, or rationing their insulin.


The Endocrine Society. Addressing Insulin Access and Affordability: An Endocrine Society Position Statement. J Clin Endocrinol Metab. 2021;dgaa817. doi:10.1210/clinem/dgaa817.