Insulin is a symbol of life for people with type 1 diabetes, and its costliness continues to be a major issue.
Insulin is a symbol of life for people with type 1 diabetes, and its costliness continues to be a major issue.
The reality for several UCF students is that they have to pay hundreds of dollars a month for something they need to survive.
Obtaining insulin is often a struggle for people with type 1 diabetes, especially for young adults given the medicine’s expensive cost.
In the United States alone, the price of insulin is substantial. Very Well Health shows that as of March, the price for a vial of insulin ranges from $50 to $1,000. It also said that a pack of insulin pens ranges from $45 to $600. Mayo Clinic Proceedings shows that in 1999, the cost of a single vial of Humalog insulin was only $21. However, 2019 represented a large price increase of 1000%, raising the price of that same single vial to $332.
And the price increase continues to be an issue, leaving insurance as the only affordable way to get by.
Rachelle Stone, a physician assistant in primary care at the UCF Student Health Services, works with diabetic students to help them transition from pediatrics to adult care once they get to college. Stone said that she has seen firsthand the effects that insulin prices have on students.
“I’ve definitely had many students that can’t afford their insulin or maybe they don’t have insurance. And, if you don’t have insurance, insulin is ridiculously expensive. Pretty much not affordable for most people,” Stone said.
Having insulin is a dire necessity for people with diabetes. Insulin helps prevent a person’s blood sugar from getting too high or too low. People with diabetes either don’t make enough insulin or don’t make any at all, according to Cleveland Clinic.
Insulin is the most expensive chronic illness in the U.S. to date. The condition costs the U.S. an estimated total of $327 billion in medical costs and lost work and wages, according to the CDC.
As a type 1 diabetic herself, Stone said that her experience with the illness helps her relate to the students that she works with.
UCF junior Aniya Scarlett is one of those students. Scarlett has had diabetes for three years now, and she said that the price of insulin is ridiculous.
“It’s very hard to be a college student, and then go from not really having too many responsibilities to having your health as one of the biggest responsibilities,” Scarlett said.
Scarlett remembered when her insulin was $500 every three months, and she said it wasn’t easy to keep up with.
“My family is very close, but we are not rich,” Scarlett said. “So, $500 every three months is like rent payment every three months. And so, that’s something we had to find; it’s not something that I just had.”
Scarlett said that now, with insurance, she went from $500 every three months, to paying only $30 for six vials of insulin.
The prices of insulin vary by each type. Dr. A. Laurel Gorman, an associate professor of medical education and pharmacology at the UCF College of Medicine, explained that there are less expensive types of insulins, such as NPH, but these don’t particularly work very well.
NPH insulin has a higher risk of hypoglycemia, a condition in which the blood sugar level is lower than the standard range, according to the National Library of Medicine.
As such, the newer ones tend to be more effective, but that effectiveness comes with a higher price.
“With something called ‘recombinant technology,’ drug companies have been able to develop these newer and better insulins, and it really improved the management of diabetes. And those are the ones that are really where they have very high pricing,” Gorman said.
Gorman also said that the cheapest way to obtain insulin is old-fashioned insulin shots. However, this way is also less effective.
According to St. Elizabeth Healthcare, these injections may cause low blood sugar levels due to the use of differing insulins. In addition, the injection areas may become resistant, due to frequent injections in the same place.
Between the insulin injections and the insulin pumps, Gorman said that most patients manage their diabetes most effectively with the pump, which tends to be highly expensive.
“Even with insurance, they could pay five, six, 7,000 a year, even with good insurance to afford the insulin for the pumps. And then the pumps themselves are very expensive,” Gorman said.
Gorman said that sometimes, rationing out insulin is a path that many take when they don’t have access to the amount of insulin that they need.
“They ration their insulin, so they’re not taking it properly to get their supply to stretch to the end of the month,” Gorman said.
That notion is true for UCF graduate student Liam Werner, who once traveled all the way to Maine and accidentally left his insulin in a hotel refrigerator.
“We didn’t have any insulin, so I had to start rationing the insulin that I had to draw it out the best I could, which a lot of people do,” Werner said.
Werner added that he later ended up buying the insulin out of pocket because he didn’t have enough. He said this cost his parents at least a couple hundred dollars just to get him through the 10-day trip.
Having good insurance remains the main way to get insulin for a decent price. However, for young adults, having insurance isn’t always a sure thing.
Young adults have the highest rate of uninsured of any age group, with about 30% of young adults being uninsured, according to the Centers for Medicare and Medicaid Services.
Dr. Ali Rizvi, an endocrinologist at UCF Health and a professor of medicine at UCF COM, said that one of the main reasons young people are uninsured is their employment status.
“The insurance system in the U.S. is tied to employment, mostly. So, it’s provided by the employer as a benefit. If you don’t have a job or not the right kind of job, or not the right kind of benefits, then there’s no safety net,” Rizvi said.
Sometimes not having insurance is the issue, but other times, the issue stems from the insurance just not being the best. Scarlett said that this was the case for her.
“My insurance wasn’t meant for people who were sick. And so, then when it rose, it worked for my 18 years. But, when diabetes came into my life, I had to switch everything around, and you can’t switch insurance halfway through,” Scarlett said.
Scarlett said that she had to wait a whole year until she could get better insurance.
UCF student Amanda Green remembered when her insurance stopped covering the brand of insulin that she had been using. She went to pick up her insulin from the pharmacy and was told that she would have to pay $220. Green said that her usual price was $30 a month.
“I was like, ‘I don’t have $220′. So, I had to wait. Luckily, I had some vials left,” Green said.
Green said this situation could have left her either out of $220 or out of insulin.
The issues regarding insurance may be beginning to change. In February, Congress introduced the Affordable Insulin Now Act, a bill that intends to cap the cost of insulin to only $35 a month.
But this is not for everyone. The bill only applies to patients who have private insurance and Medicare benefits, leaving those who are uninsured to continue paying drastic prices for the lifesaving drug. Rizvi said that the number of those uninsured is still a lot.
“Now with the Affordable Care Act, Obamacare, I think that helped bring the number of uninsured down from 50 million down to 31 million. But we still have 31 million people who have no coverage, and the rest also have just spotty coverage,” Rizvi said.
For diabetic students on campus, Stone said that the pharmacy does provide samples of insulin at no cost. However, they still require a prescription from a provider.
“Often the idea of samples is to get a patient started on the medicine to see if they like it or not, and then they could get it through their insurance. So, that’s ideally what samples are meant for, but we use them as providers to help patients out in certain situations too,” Stone said.
Stone said that how long those samples last depends on the amount of insulin that person uses, but she added that UCF does have enough samples to get a student by for one to two months.
“Sometimes a person only needs one vial a month. Sometimes a person needs four vials a month. So, it just depends on how much insulin you use,” Stone said.
For students living with diabetes, insulin is a symbol of life, and those who don’t have affordable access to it wish to be given the resources to treat their condition with no hindrances.
“Insulin is the key medication — the most powerful medication — we have for managing high blood sugar, and to have a patient being deprived of that because of cost or access is really not acceptable,” Rizvi said.
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