"You may not be able to prove who's behind the price rigging, but remember these prices are not an issue in Canada or in Europe or other countries where the governments keep the drug makers from going wild. It's only in America."

Nevertheless, some diabetes experts say the pharmacy industry should not be tarred with the same critical brush.

"Think of all the good things they actually do," said Cox in Missoula, and ticked off programs for many low-income, uninsured people as well as the industry's support of children at diabetes camps and professional conferences.

DRUG MAKERS BLAMED

Three major pharmacy benefit companies were asked to comment on the insulin price increase. Only one, Express Scripts, the largest benefit manager in the U.S., replied.

The cost of insulin is high for patients because "drug makers continue to increase prices significantly each year, and there is no generic insulin available on the market," said Jennifer Leone Luddy, Express Scripts spokesperson, who added that her company's mission is "to keep prescription medication affordable and accessible."

She described a major effort "to ensure patients get the right medication, are using, and achieve the best results from their medication."