Earlier this week, we shared the concerns of patients who are struggling with the rising cost of EpiPens, injection devices that can save lives in the case of a severe allergic reaction to foods or other substances. The important thing about EpiPens, though, is that patients hope to never actually need to use them. Another drug with significant recent price increases, insulin, has to be taken every day… when patients can afford it.

Insulin is another injectable drug based on a human hormone, but it’s one that patients take every day. Well, they’re supposed to take it every day, which is kind of the problem. Affording different forms of insulin has become so difficult that patients are stretching out containers, which can cost hundreds of dollars for customers without insurance or who have a high deductible.

The problem is a national one. In a great piece looking at the problem across the country, Lee Newspapers details the insulin crisis, where it may have come from, and how patients and health care providers are trying to deal with it.

Treating diabetes patients has become as much about helping patients afford their drugs and deal with the expense than dealing with the disease itself, and patients who use large amounts of insulin can be paying more for the drug than for their mortgages.

A medical professor who has tracked the cost of insulin over the years says that a one-month supply of a popular version that cost $45 wholesale in 2001 cost $1,447 14 years later, an increase of almost 3,000%. That’s the wholesale price, not the retail price that an uninsured patient would pay.

“These patients are desperate,” a pharmacist and diabetes educator in Texas explained. “They do without their insulin, skip doses, lower their prescribed dose to stretch out the insulin they have, and end up in the emergency room or ICU with long-term complications such as kidney failure, leg amputations or vision problems.”

Keeping blood glucose readings and insulin doses calibrated is an important part of not dealing with the serious potential side effects of diabetes, and when insurers switch around which forms they’ll cover, or patients simply can’t afford the version they’ve been prescribed, patients can be harmed.

Who’s to blame for the increase? Health care providers blame the negotiations between pharmacy benefit managers and drug companies.

Insulin extracted from animal pancreases has been on the market since 1920, and the first synthetic insulin came out in 1978. While the invention of longer-acting insulins has meant new patents and new revenue sources for drug companies, it hasn’t meant that the most popular and effective forms of the drug have become any cheaper.

Insulin price spike leaves diabetes patients in crisis [Lee Newspapers]