Insulin price spike leads to lawsuitInsulin is fast becoming a medication that only the well-insured or well-heeled diabetic can afford.

With the price of insulin more than tripling in a decade, some diabetics are having to make tough choices about how to pay for the medication. In some cases, diabetics are cutting back or even going without the drug. Many of the 26 million Americans with diabetes must use insulin daily to treat the disease, or else risk illnesses such as kidney failure and disabilities such as blindness.

While American diabetics may have faced monthly costs of $100 to $200 several years ago, some are now grappling with costs of $400 to $500 per month.

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Insulin prices for American patients are far higher than in other countries, a recent survey of patients from the advocacy group T1International discovered. American diabetics said they pay $13.47 per milliliter for Eli Lilly’s (LLY) Humalog insulin, the highest price among the countries surveyed and about four times more than what Canadian diabetics pay.

“People are suffering a lot,” said Allison Bailey, a college student in Iowa with Type 1 diabetes. “There are no generics. We have to go through these big companies, and they charge so much.”

Bailey said she paid about $130 for several vials of Eli Lilly’s Humalog in 2010. This year, her insulin prescription has a price tag of about $495. She noted that she switched from using pump therapy in 2010 and now injects insulin with a pen, and that while the prices aren’t apples-to-apples, costs have overall sharply increased.

She said she should go back to pump therapy, but she doesn’t believe she can afford it given the higher cost of insulin as well as the expense of a pump, which can cost more than $5,000.

Others are also caught in a bind. Bailey said one diabetic friend told her she was taking 80 percent of the insulin she should because of the cost. “She said it’s better than zero percent,” Bailey added.

Aside from insulin, diabetics face other medical costs for treating the disease, such as test strips and medical care.

One doctor who has tracked the cost of insulin told Lee Newspapers that concentrated insulin had a wholesale price of $45 in 2001. By 2015, that had jumped to $1,447, or an increase of about 3,000 percent, which he called “unbelievable.”

The rapid rise in the price of insulin comes when the pharmaceutical industry is increasingly under fire for boosting prices for medications that otherwise haven’t changed. Drug companies argue that they must raise prices to help fund development of new drugs, something that many lawmakers increasingly view with a skeptical eye.

Insulin, after all, isn’t a new medication. It was developed almost a century ago, but just three pharmaceutical companies -- Eli Lilly, Sanofi (SNY) and Novo Nordisk (NVO) -- own the patents to producing it. All three have hiked their prices from 2010 to 2015, and no generic has yet been developed because the companies have made small improvements to the medication, Yale School of Medicine endocrinologist Kasia Lipska wrote in The New York Times earlier this year.

Insulin treatments have become more efficient and are helping patients live longer, a spokeswoman for the Pharmaceutical Research and Manufacturers of America, said in an email. She added that list prices misrepresent what patients actually pay because insurers and pharmacy benefit managers negotiate discounts.

“In fact, an analysis by SSR Health found that net prices for insulins actually declined in 2015 due to robust competition and negotiation in the marketplace,” she noted. “With that said, we recognize too often patients struggle with access to their medicines at the pharmacy.”

The plight of diabetics who need insulin has come to the forefront with the discussion of the 480 percent jump in the cost of EpiPens, which has drawn scrutiny from lawmakers. Senators Susan Collins (R-Maine) and Claire McCaskill (D-Missouri) have called on EpiPen maker Mylan (MYL) to explain the price surge.

“There have been numerous accounts of individuals who are simply unable to afford this lifesaving medication and as a consequence have gone without, risked using an expired product, or resorted to uncertain (but less expensive) treatments,” the senators wrote in a letter to Mylan on Wednesday.

The focus on EpiPen pricing is prompting some diabetics to ask why similar attention isn’t being given to insulin costs. Reading about the reaction to the price-spike for EpiPens prompted Bailey to reach out to Senator Chuck Grassley (R-Iowa) to investigate, as well as two diabetes organizations.

“I’m just in shock that this is allowed to happen,” she said. “EpiPens are for emergencies, and I’m glad Congress is doing something. But I have to use insulin all day, every day. It’s not just for emergencies.”