28 May Reasons for the Drastic Price Increase of Insulin and What You Can Do About It

The price of insulin keeps on skyrocketing every year. According to the American Diabetes Association, spending on insulin tripled within a decade. By 2022, the cost had hit a staggering $22.3 billion. Between 2017 and 2022, the inflation-adjusted cost of insulin increased by 24%.

This is a significant problem since millions of people suffering from Type 1 and Type 2 diabetes can’t go without the drug. Over the years, people have initiated an insulin overpricing lawsuit. In 2023, Eli Lilly settled for $13.5 million and agreed to cap its price at $35 for four years. So why is insulin so expensive in the United States, and what can you do about it?

Why Have Insulin Prices Drastically Increased?

Here are some reasons why insulin is expensive in the US:

Lack of Competition

A major reason for high insulin prices is the lack of competition. In the United States, there are three major companies dominating the market. These are Eli Lilly, Novo Nordisk and Sanofi. These companies have safeguarded their patents for years.

What they do is make some slight changes, which gives them more market control. This makes it harder for cheaper and generic insulin brands to penetrate the market.

Supply Chain

There are many intermediaries involved in the supply of insulin in the country. These include:

• Wholesalers
• PBMs (pharmacy benefit managers)
• Pharmacies
• Health plans

Each group takes a cut, which raises the final price that patients have to pay. PBMs often negotiate deals that benefit the insurers and manufacturers but pinch the consumer.

Lack of Price Regulation

The US government doesn’t have a mandated price for most medications, including insulin. Therefore, there are very few rules that prevent drug companies from increasing their prices. Price control by the federal government is covered under Medicaid and Medicare.

Few Efforts to Reduce Prices

While there are some efforts which have been put in place to reduce prices, quite frankly, these are not enough. For example, the Inflation Reduction Act of 2022 capped insulin at $35 for Medicare Part D enrollees. From July 1, 2023, insulin covered under Medicare Part B was also capped at $35 per month.

These changes haven’t helped everyone. People without insurance still face high costs.

What Can You Do About High Insulin Prices?

If you or someone you know is struggling to afford insulin, you can look into patient assistance programs. Drug manufacturers and nonprofit organizations sometimes lower the cost of giving insulin for free to people who meet certain requirements.

You can also compare prices and use discounts. Through mobile apps like GoodRx, you can find the lowest prices in your area. Some pharmacies have insulin alternatives. However, talk to your doctor about suggesting other options that are affordable yet effective before switching your medication.

Lastly, speak up. People underestimate the difference they can make by contacting lawmakers and urging them to support policies that cap insulin prices and increase transparency in the drug system. Try joining advocacy groups to push for long-term change.

Conclusion

The rising cost of insulin is, without a doubt, a very serious issue. Even though larger reforms take time, there are a few steps you can take to find affordable options.

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More information:

• Mattingly TJ 2nd, Levy JF, Slejko JF, Onwudiwe NC, Perfetto EM. Estimating Drug Costs: How do Manufacturer Net Prices Compare with Other Common US Price References? Pharmacoeconomics. 2018 Sep;36(9):1093-1099. doi: 10.1007/s40273-018-0667-9. PMID: 29752675; PMCID: PMC6061401.
  https://pmc.ncbi.nlm.nih.gov/articles/PMC6061401/

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Last Updated on May 28, 2025 by Marie Benz MD FAAD