How would you feel if you were deprived of the one thing keeping you alive? Many diabetics around the globe are facing this problem. Insulin, a hormone usually produced in the pancreas, is becoming too expensive for some patients living with the disease. The effects of the higher insulin prices are taking a toll on diabetics. Great lengths are being taken by diabetics to increase the amount of insulin they own. As a diabetic, this change greatly affects me and my community. If the price of insulin continues to rise in the next ten years, more people’s lives will be in danger. 

    In American, about 1.25 million people have type 1 diabetes and this number is predicted to continuously grow as more people are predicted to be diagnosed with type 1 diabetes ("Type 1 Diabetes Statistics"). Type 1 diabetes is an autoimmune disease where your pancreas cannot produce enough insulin to control your blood glucose level. Insulin is a hormone produced in your pancreas. There is no clear explanation of how someone gets type 1 diabetes. You have a higher chance of getting the disease if both of your parents, or even just one of them, have diabetes, but it is not always the case ("Learn the Genetics of Diabetes"). Some scientists also believe that diabetes could be connected to some environmental effects. Type 1 diabetes tends to be diagnosed more often in the winter months than in the summer months. Some scientists also say that certain viruses could cause type 1 diabetes depending on the strength of your immune system. If you are diagnosed with type 1 diabetes, you will have to do the work that your pancreas cannot do. You need to give yourself daily insulin injections after every meal you eat. In addition to insulin injections, you also need to monitor your blood sugar using a glucose monitor. You check your sugar levels multiple times a day to make sure you are in the desired range. Too much or too little insulin can cause your sugar levels to become dangerously low or high.

Insulin is a vital hormone produced in your pancreas. Specifically, insulin is produced in the beta cells which are in the islet cells. The islet cells, which make up about 2% of the pancreas, produce all of the necessary hormones to help maintain sugar levels ("Pancreas and insulin."). In your body, insulin is released as a reaction to the sugar levels rising in your blood. The insulin then takes some glucose out of your blood and places it into other cells in your body. The glucose is stored as energy to fuel your cells or it is stored in the liver cells as glycogen. Once the sugar levels start to drop, the pancreas stops releasing insulin and the sugar levels are back to normal. When you have diabetes, your pancreas is unable to do this type of work. That is why you have to inject insulin into your body. With insulin injections come insulin reactions. In the novel Needles by Andie Dominick, you learn about the hardships diabetics have to go through and how drastically your life can be changed because of type 1 diabetes. At the beginning of the novel, Dominick shows readers what happens when a diabetic has an insulin reaction. She describes insulin reactions as:

The skin on my stomach crawls, and I push myself up onto my butt and cross my legs. I

look down at the pieces and spot the one I’ve been looking for. My hand shakes as I pick 

it up. I’m getting scared. My breathing is uneven and my heart is racing, but I keep 

staring at the puzzle...Once I’ve closed my eyes, I can’t open them. I think about Denise 

describes her insulin reactions. She says she gets weak and shaky when there’s too

much insulin in her body. (Dominick, 42-43)

Insulin reactions are common among diabetics. It is usually a result of having hypoglycemia (low blood sugar), but can also occur during hyperglycemia (high blood sugar). Common types of insulin reactions are shakiness and dizziness. Other reactions include sweating, irritability, and fatigue. You usually get these reactions if you have taken too much insulin or after you have just done some high-intensity exercise which causes your blood sugar to decline. To reverse this effect, you have to eat food that has carbohydrates in it. On the other hand, if your blood sugar is high, you would have to inject more insulin into your body. 

In the U.S., the cost of insulin has almost doubled in the past four years (Respaut). Separately, each vial of insulin, depending on the brand, used to cost around $250 in 2013. Now, those same brands cost between $450 and $550 per vial (Alltucker). Generally, a single vial of insulin should take no longer than one month to use, depending on the person. The price of insulin quickly adds up and can become a struggle to buy. The price of the insulin depends a lot on the type of insulin, the brand of insulin, and your insurance plan. For example, in my case, we pay for a family health insurance plan with Harvard Pilgrim. Harvard Pilgrim has “deals” with certain companies that produce insulin where they can negotiate cheaper insulin prices for their customers. For Harvard Pilgrim, they are able to get a reduced price for insulin from the brands Humalog and Lantus. This is why my family only has to pay about $500 a year for the price of insulin. Unfortunately, not everyone is able to afford health insurance. It is very difficult for people who struggle to pay for health insurance, or can’t afford it at all, to find affordable insulin. 

The increase in prices have caused many diabetics to start rationing their insulin, which can be dangerous for your health. One of the people affected by this was Alec Smith. Once he was no longer able to use his mother's health insurance, he struggled to obtain the drug that was keeping him alive. He ended up rationing his insulin until he passed away. His mother states “‘We have people who are making life and death decision daily of,’ “Do I buy groceries and or do I buy my insulin?”’”(Picchi).  While the number of deaths from lack of insulin is relatively low compared to other diseases, the problem is rising quickly. Each year, the prices of insulin are continuing to rise, and there are many people to blame. Some blame the manufacturers of the insulin, like Novo Nordisk or Eli Lilly. Others blame pharmacy benefit managers (“PBMs”) (Bluth). There is a continuous debate between the two on whose fault it is for the rising insulin prices. Throughout all of this, there are actions being proposed to help lower the price or to help others pay for insulin. President Trump's Health and Human Services Secretary Alex Azar is planning to get rid of some rebates to lower to copays on insulin. Also, new bills have been introduced to Congress that would make it legal for people to buy insulin from Canada and eventually from other countries (Fleshler). This will help because the cost of insulin in other countries is dramatically lower than the prices in the United States. 

As a diabetic, I know how hard, time-consuming, and expensive type 1 diabetes is. It only makes it harder for us when the price of insulin is always on the rise. Since the number of type 1 diabetics continues to increase, so will the price of the valuable drug keeping them alive. Insulin is necessary for everyone's survival, but diabetics have a much harder way of obtaining it because of the increasing prices. If the price of insulin continues to rise, so will the deaths of type 1 diabetics.  People point fingers to blame others for the crisis, but we should instead support measures to help reduce the price of insulin or help diabetics obtain more affordable insulin. The way the price of insulin increases makes you wonder whether America really cares about all diabetics. If not everyone can afford this specific drug, then why don’t insulin manufacturers and PBM’s make it more affordable?

Works Cited

Alltucker, Ken. "Struggling to stay alive: Rising insulin prices cause diabetics to go to extremes." USA Today, 27 Mar. 2019, www.usatoday.com/in-depth/news/50-states/2019/03/21/diabetes-insulin-costs-diabetics-drug-prices-increase/3196757002/. Accessed 14 Oct. 2019.

Bluth, Rachel. "The Blame Game: Everyone And No One Is Raising Insulin Prices." Kaiser Health News, 10 Apr. 2019, khn.org/news/the-blame-game-everyone-and-no-one-is-raising-insulin-prices/. Accessed 14 Oct. 2019.

Dominick, Andie. Needles: A Memoir of Growing Up with Diabetes. Scribner, 1998.

Fleshler, Dan. "The Government's Big Ideas to Bring Insulin Prices Down." Healthline, 13 Feb. 2019, www.healthline.com/diabetesmine/government-big-ideas-insulin-prices#1. Accessed 14 Oct. 2019.

"Learn the Genetics of Diabetes." American Diabetes Association, www.diabetes.org/diabetes/genetics-diabetes. Accessed 14 Oct. 2019.

"Pancreas and insulin." MyDr.com.au, 25 Aug. 2018, www.mydr.com.au/gastrointestinal-health/pancreas-and-insulin. Accessed 14 Oct. 2019.

Picchi, Aimee. "Price of insulin more than doubled over five years." CBS News, 22 Jan. 2019, www.cbsnews.com/news/price-of-insulin-more-than-doubled-over-five-years/. Accessed 14 Oct. 2019.

Respaut, Robin, and Chad Terhune. "U.S. insulin costs per patient nearly doubled from 2012 to 2016: study." Reuters, 22 Jan. 2019, www.reuters.com/article/us-usa-healthcare-diabetes-cost/u-s-insulin-costs-per-patient-nearly-doubled-from-2012-to-2016-study-idUSKCN1PG136. Accessed 14 Oct. 2019.

"Type 1 Diabetes Statistics." Beyond Type 1, beyondtype1.org/type-1-diabetes-statistics/. Accessed 14 Oct. 2019.