### Understanding the Rising Cost of Insulin and How to Afford It Many diabetics, especially those with type 1 diabetes, rely on insulin to manage their blood sugar levels. However, the cost of insulin has doubled in recent years, making it difficult for many to afford. This increase is due to several factors, including the role of pharmacy benefit managers (PBMs), drug rebates, and the complex history of insulin pricing. #### Why Has Insulin Become So Expensive? 1. **Pharmacy Benefit Managers (PBMs)**: PBMs negotiate drug prices on behalf of insurance companies. They often receive rebates from drug manufacturers, which can lead to higher list prices for medications, including insulin. 2. **Drug Rebates**: Manufacturers offer rebates to PBMs to ensure their drugs are included in insurance formularies. These rebates can drive up the list price of insulin. 3. **Limited Manufacturers**: Only a few companies produce insulin, reducing competition and allowing prices to remain high. 4. **Advancements in Insulin**: Newer insulin analogs are more expensive than older human insulins, contributing to higher costs. #### Tips for Affording Insulin 1. **Patient Assistance Programs**: Many drug manufacturers offer programs to help patients afford their medications. Check with the American Diabetes Association or the National Institute of Diabetes and Digestive and Kidney Diseases for resources. 2. **Switching Insulins**: Talk to your doctor about switching to a less expensive insulin. Older human insulins may be a cost-effective alternative. 3. **Different Delivery Methods**: Using a vial and syringe is often cheaper than prefilled pens or insulin pumps. Discuss the best option with your healthcare provider. 4. **Buying from Abroad**: If you live near Canada, consider purchasing insulin there, where it is often cheaper. The FDA has guidelines for importing prescription medications. 5. **Review Treatment Plans**: Regularly review your treatment plan with your doctor to ensure you are using the most cost-effective and clinically appropriate insulin. By understanding the factors behind rising insulin costs and exploring various strategies, patients can better manage their diabetes without breaking the bank.