Early each year, Kristin Thompson-Lerberg sits down with her husband to plan how they’ll reach their family’s insurance policy’s $3,000 deductible. The conversation is always short: Thompson-Lerberg needs about 8 vials of insulin each month to treat her Type-1 diabetes, and at $275 per vial before insurance kicks in, it takes just two months to reach the deductible from insulin alone.
But their budget expanded after pharmaceutical giant Eli Lilly announced on Mar. 1 that the monthly out-of-pocket prices of their insulin brands will soon be capped at $35 regardless of a person’s insurance. For Humalog, the company’s best-selling insulin brand (and the one Thompson-Lerberg uses), that amounts to a 70% price cut in list price. “This news from Eli Lilly will be life-changing for our family,” Thompson-Lerberg says.
While some have criticized Lilly’s announcement as being too little, too late after decades of insulin price hikes, the change will have a huge financial impact for many of the 8.4 million Americans who rely on insulin to regulate their glucose levels. Diabetes care accounts for a quarter of all money spent on U.S. health care, according to the American Diabetes Association, and insulin is a large part of that price tag. A quarter of people in the U.S. with diabetes have reported rationing their insulin for financial reasons.
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“Diabetes is a very expensive illness,” says Serena Valentine, executive director of the health and wellness non-profit CORE Initiative in Houston, who has Type-1 diabetes. She remembers being evicted, as a student, from her apartment nearly 20 years ago because she had to funnel her rent toward insulin payments. “It wasn’t really a choice,” she says. “While I lost an apartment, some people lost their lives.”
The high cost of the drug has long kept diabetes patients and advocates focused on how to get or improve access to insulin. With the price cap comes a chance to redirect their efforts and energy toward other challenging—and pricey—aspects of the disease.
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Lowering the cost of insulin is only the first step in addressing obstacles to diabetes management, Valentine says. Other high costs of care include regular trips to the doctor and managing the right diet to keep glucose levels stable. “You should be able to readily access the guidance of the people that you need to talk to without finances being a barrier,” says Thompson-Lerberg.
For many patients, the money saved on insulin will go back into managing their diabetes in other ways. Thompson-Lerberg recently switched from a standard insulin pump to a continuous glucose monitor, a device that measures her glucose levels every five minutes and automatically delivers targeted amounts of insulin to keep her within a safe range—”almost like having an external pancreas,” she says. It’s the gold standard for diabetes management. But until the insulin price cut was announced, she hadn’t planned to use it around the clock. Continuous glucose monitors are expensive to use, even beyond the initial cost of the devices themselves; the wearable sensors that the machines require can cost more than $200 per month. Now, however, “not having to pay so much for insulin absolutely frees up a little more funding to be able to use it,” she says.
Thompson-Lerberg is hopeful that cheaper insulin prices will allow more people with diabetes access to disease-improving solutions like these—and that this, in turn, will help lower the stigma that she and others she knows have faced from specialists who don’t appreciate the everyday challenges of diabetes management. “I’ve had times where I was shamed for having high blood sugar,” she says. “When people have access to what they need and can more independently self manage, then I think people are more willing to ask for help.”
Jessyka McCaulley, a 29-year old entrepreneur who has Type-1 diabetes and sells diabetes-awareness merchandise online, says that the money she’ll soon be saving on insulin is going to go right back into her small business and platform, “just to help spread awareness that is still so much needed.”
“Diabetes is definitely a mental disease as well as a physical one,” she says. “This is one less stress that we have to worry about.”