ROCHESTER, Minn. — The most commonly used forms of insulin cost 10 times more in the U.S. than in any other developed country, according to a commentary in Mayo Clinic Proceedings. This prohibitive cost is causing some U.S. patients with Type 1 diabetes to ration the amount of insulin they use, with life-threatening implications.

The commentary by S. Vincent Rajkumar, M.D., a Mayo Clinic physician, describes
the cost of insulin as an urgent public health issue. “There are 30
million patients with diabetes in the United States, and about 25%, or 7.4
million Americans, need insulin. For the 1.3 million patients with Type 1
diabetes, insulin is as vital as air and water. Some patients are rationing
insulin or switching to cheaper forms without proper supervision. We cannot
wait to act.”

The commentary
appears in the January issue of Mayo Clinic Proceedings, which focuses on
diabetes and the discovery of insulin in 1921. The use of insulin to treat
diabetes has transformed the lives of millions of people, but the sharp cost increase
in recent years has threatened patient care.

Insulin is a
naturally occurring hormone that helps regulate blood sugar levels. Insulin therapy is vital for people with Type 1 diabetes and for many patients with Type 2 diabetes. Type 1 diabetes is a chronic
condition where the pancreas produces little or no insulin. With Type 2 diabetes,
the body resists the effects of insulin or doesn’t produce enough to maintain
normal glucose levels. Long-term complications can be debilitating and

“There have
been many recent reports of deaths in patients with Type 1 diabetes because of
the lack of affordable insulin,” Dr. Rajkumar says. “The high
prevalence of diabetes, the chronic lifelong nature of the disease, and the
fact that patients with Type 1 diabetes will die without access to insulin make
this an urgent problem that must be solved expeditiously.”

“The No. 1
reason for the high cost of insulin is the presence of a vulnerable population
that needs insulin to survive,” he says. “This population is willing
to pay almost anything to have access to a lifesaving drug, and manufacturers
know it.”

Dr. Rajkumar, the
Edward W. and Betty Knight Scripps Professor of Medicine at Mayo Clinic College
of Medicine and Science, proposes several solutions that would help make
insulin and other prescription drugs more affordable. They include:

  • Patent
    reform to protect against monopolies in the pharmaceutical industry
  • Creating
    an easier regulatory path for generic and biosimilar drugs to enter the market
  • Legislation
    to prevent unjustifiable price increases
  • Promotion
    of nonprofit generic drug manufacturing
  • Laws
    to provide access to affordable and safe insulin in emergency circumstances

“We cannot afford to lose a
single additional life because of the high cost of insulin,” says Dr.
Rajkumar. “The price of insulin is a stark and troubling example of what’s
happening with other prescription drugs, and it highlights a systemic problem
with how drugs are priced, compared with just about every other


About Mayo Clinic Proceedings
Mayo Clinic Proceedings is a monthly peer-reviewed journal that publishes original articles and reviews dealing with clinical and laboratory medicine, clinical research, basic science research, and clinical epidemiology. Mayo Clinic Proceedings is sponsored by the Mayo Foundation for Medical Education and Research as part of its commitment to physician education. It publishes submissions from authors worldwide. The journal has been published for more than 90 years and has a circulation of 127,000.

About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news and An Inside Look at Mayo Clinic for more information about Mayo.

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