July 18, 2019 -- Like many Americans, Lija Greenseid comes home with souvenirs when she visits other countries for work or vacation.

Greenseid brings home insulin.

Israel, Italy, Germany, Greece, Taiwan and Canada -- all countries where she's bought insulin for her 13-year-old daughter at a fraction of the price in the U.S., even with health insurance. She's part of a group of people with diabetes and their parents who regularly caravan 5 hours each way from St. Paul, MN, to buy the life-saving medicine in Canada.

On a trip across the border this spring, six of them spent $1,265 on insulin supplies that would have cost them $12,400 back home.

"We saved over $11,000 by going to Canada," says Greenseid.

It's just one example of how far Americans are going to buy insulin, the price of which, on average, tripled between 2002 and 2013. One popular drug, NovoLog, increased in list price by 353% from 2001 to 2016. Insulin cost is a big reason the average annual per-patient spending on treatment for type 1 diabetes increased from $12,467 in 2012 to $18,494 in 2016.

Some families raise the money however they can. Other people with diabetes take older forms of insulin like that available for $25 at Walmart, or ration what they have -- a particularly risky strategy. One survey revealed that 45% of diabetes patients had gone without insulin because of the price.

And many, though it's unclear how many, go to Canada, which insulin activists say is a sign of a broken system in the U.S.

Greenseid's daughter was diagnosed with type 1 diabetes at age 7. She is able to live a normal, happy life. But because the family has a high-deductible health plan that doesn't cover the long-acting insulin that is most effective for her, that life often costs as much as $700 a month for insulin, on top of other costs like blood sugar test strips.

"We're able to purchase it at a lower price in Canada and elsewhere because those countries have put laws into place to make sure the citizens of their countries can buy it at an affordable price," Greenseid says.

"Instead of a system in which you can buy it easily and affordably, we have a system in which increasingly, more people are having to pay close to list price, which is too much money."