The U.S. consumes insulin in mass quantities. More than 7 million Americans rely on the hormone to manage diabetes, according to the American Diabetes Association. You might think that kind of bulk production would drive down prices, but no.

Over the past decade, out-of-pocket insulin costs jumped by more than 1,000%, according to a report last year from the Mayo Clinic. In 1999, one vial of Humalog®, a type of insulin, cost $21. Two decades later, it retails for $332. (Download a Humalog coupon.)

Plus, people with diabetes need delivery mechanisms to administer the medication. Prices for these can vary wildly. A package of 10 syringes can cost $7, while an insulin pump could run $6,000. And that doesn’t include maintenance supplies. (The Optum Store can help you save on your diabetes products. Shop now.)

All told, Americans with diabetes incur an average of $16,750 in annual health care costs. That’s more than twice as much as people without the disease, according to the Diabetes Leadership Council, an advocacy group. For people who are uninsured, diabetes costs can be catastrophic.

“We know economic circumstances really affect the ability to afford medications,” says Kasia Lipska, MD, an endocrinologist at the Yale School of Medicine. “People are forgoing other important necessities in order to afford insulin.”

According to a research study led by Dr. Lipska, 1 in 4 patients with diabetes report rationing insulin due to cost. They do this by not filling or delaying filling an insulin prescription or trying to stretch their dose by taking less than prescribed. This is dangerous: Underuse can cause serious health problems, including heart disease, nerve damage and vision loss. In extreme cases, it could lead to amputations.

The data is grim, especially given that medicinal insulin isn’t new. It’s been around for about 100 years. So what’s driving up prices?

A for-profit health system drives up insulin costs

The net cost of insulin paid to manufacturers has dropped in recent years, says George Huntley, CEO of the Diabetes Leadership Council. But those savings haven’t been passed on to patients. Even people with insurance often still pay the full list price. “You’ve got the sick subsidizing the healthy,” Huntley says. “That’s not how insurance is supposed to work. It’s a broken system.”

The explanation stems in part from the complexity of a system with too many middlemen, says Huntley. There’s little incentive to simplify things since people who use insulin rely on it for survival. They have no choice but to pay.

Plus, there isn’t much competition in the insulin market. Just 3 companies control almost all the supply, says the Mayo Clinic report. And unlike many other countries, the U.S. doesn’t regulate or control prices on medication. That leaves patients to fend for themselves with life-sustaining products. (These 4 diabetes-management tech solutions can make it easier.)

So what can you do about it?

For starters, be an advocate for long-term change, says Dr. Lipska. “The frustration I have is that a lot of the current solutions are piecemeal,” she says. “We need to bring the price down for everyone.”

Vote for lawmakers who promise to advocate for consumers and cap prices on medication. For the time being, here’s how to save money on insulin.

1. Talk to your doctor and your employer

Sometimes, an honest conversation about costs goes a long way. When your doctor writes a prescription, he or she probably isn’t considering the cost, says Dr. Lipska. Being specific about what you can afford can help your provider design a plan that fits your budget.

Alternately, if you have insurance through your job, try talking to your organization’s human resources department or plan administrator. Pharmaceutical benefit managers, companies that manage medication benefits on behalf of insurers, can pass rebates through at the point of sale to the consumer. But the employer has to ask for that feature, Huntley says.

2. Enroll in a patient-assistance program

For qualified low-income patients, insulin manufacturers run programs that generally sell insulin for less than $100 a month. To apply, call the manufacturer or fill out a form online at getinsulin.org.

3. Download an insulin coupon

If your insurance doesn’t cover insulin, third-party coupons such as those offered by Optum Perks can help offset the costs. Either download our discount card and present it at checkout, or download a coupon for insulin lispro, insulin aspart or another insulin product.

4. Pick up insulin at Walmart

Through a partnership with an insulin producer, Walmart offers its ReliOn® brand of insulin for just $25 per vial. In addition to being cheap, the insulin can be purchased without a prescription. But the product comes with some notable downsides.

Most people with diabetes today take analog insulin, a newer insulin that works in predictable ways. It’s extremely helpful to people who struggle to manage their blood sugar. ReliOn, on the other hand, is a synthetic human insulin, which is more difficult to manage. Unlike analogs, human insulin requires users to follow a strict diet with specific carbohydrate intakes at set times throughout the day.

Some people find it difficult to manage human insulin, especially children. And departure from the plan can be dangerous. In one instance, a man in Virginia died after switching to ReliOn. So consult with your doctor before making the switch.

5. Visit a community health center

If you don’t have insurance, community health centers are a great option. In addition to providing health care, they can help you get discounted insulin. To find a list of centers funded by the U.S. Department of Health and Human Services, visit findahealthcenter.hrsa.gov.

Whatever medication you need, Optum Perks can help. Download our app today and use it to find coupons for insulin and other prescriptions.

Additional source
How many Americans rely on insulin:
Diabetes Care (2018). “Insulin Access and Affordability Working Group: Conclusions and Recommendations.”