The road to affordable insulin is ride or die for some Americans suffering with diabetes who have to ration their medicine or rely on donated samples from people they meet in Facebook FB, +2.43% groups.

Presidential candidate Bernie Sanders, an Independent senator from Vermont, will be riding shotgun in a caravan to Canada on July 28 alongside Americans living with diabetes as they travel from Detroit to Windsor, Ontario in Canada to get cheaper insulin, his campaign announced Thursday.

“My hope is that because he’s a top-tier candidate, it will also force the other top-tier presidential candidates to take a stand on this issue of insulin affordability,” Quinn Nystrom, a Minnesota-based diabetic advocate and writer for OnTrack Diabetes told MarketWatch Friday.

Nystrom, 33, was diagnosed with Type 1 Diabetes when she was 13-years-old. She’ll be riding with Sanders and 15 others with diabetes on the third trip to Canada to buy insulin without insurance or a prescription at a tenth of the price in the U.S.

Quinn Nystrom, a nationally-recognized diabetes advocate and writer for OnTrack Diabetes, with fellow diabetics making a road trip to Canada to get affordable insulin. (Photo courtesy of Quinn Nystrom). Quinn Nystrom

More than 100 million Americans have diabetes or prediabetes, and one vial of insulin can cost hundreds of dollars with insurance. The average insulin price in the U.S. nearly tripled between 2002 and 2013, according to the American Diabetes Association.

Diabetes, including Type 1 and Type 2, was the most expensive chronic illness in the U.S. in 2017 costing more than $327 billion per year, including $15 billion for insulin, the ADA reported.

“ ‘Americans are having to play Russian roulette with their lives.’ ” — Quinn Nystrom, a Minnesota-based diabetic advocate

The cost is crippling for people like Nystrom, a single mom saddled with student loans who went into credit-card debt to afford her diabetes medication each month. She says two vials of insulin would have cost her $680 without insurance when she went to a pharmacy last month. She paid $233 out of pocket with her high deductible insurance plan for it. Earlier this year, she says she paid $597 out of pocket to cover the cost of an insulin pump and related supplies like a glucose monitor.

“Americans are having to play Russian roulette with their lives,” said Nystrom, who has led similar caravan trips to get cheaper insulin in Canada with other diabetics in need. She says a vial of insulin in Canada cost her $26, a nearly identical vial in the U.S. is $300.

Pharmaceutical companies profit from inflating the costs of prescription drugs. This year, drugmaker Sanofi SNY, +0.03% raised prices on some insulin products up to 5.2%. Others, like Novo Nordisk NVO, +1.20% have hiked prices on some of its insulin by 4.9%. (They were not immediately available for comment.)

Some Americans suffering with diabetes are rationing their insulin supply and donating to others who can’t afford it

Brian Kelly, 26, who works at a social-impact advertising agency in Brooklyn, was diagnosed with Type 1 diabetes when he was 13. He considers himself fortunate to have had insurance most of his life, but at times he’s had to rely on free insulin samples at the doctor’s office to get by.

Even with insurance now he’s paying upwards of $200 for a vial of insulin. He currently pays $450 with insurance per month for insulin and associated supplies.

“I’ve rationed my insulin before, which led to poor blood sugars and overall health,” Kelly said, adding that he has a budget in place to prioritize his medical costs but is still struggling. “I don’t know how I will be able to afford rent, student loans and general expenses.”

“ ‘We aren’t fighting for luxury vitamins, we are fighting for insulin, without which we will die.’ ”

When he was waiting on insurance coverage he turned to Facebook groups like Beyond Type 1, a support group with more than 1 million followers for people with Type 1 diabetes to discuss questions about health-care coverage.

U.S. officials have not approved of donating leftover insulin or diabetes-related supplies, but some diabetics are left with no other choice but to borrow to survive when they can’t afford medicine and have organized donation efforts with people they meet in Facebook groups, Kelly said.

Facebook groups like Beyond Type 1 let people post fundraisers to raise money for medication or promote diabetes-related scholarships. Others, like the group “You know you’re a Type 1 diabetic when” offer up emotional support for people living with Type 1 or Type 2 diabetes.

“We aren’t fighting for luxury vitamins, we are fighting for insulin, without which we will die,” Kelly said. “People are dying, and if they aren’t dying today they are damaging their bodies which leads to complications down the road like amputations, blindness, organ failure and death.”

Sanders has fought for lower prescription drug costs for decades and continues to advocate against privatized health care in America. The Vermont senator spearheaded similar trips to Canada 20 years ago with breast cancer patients to find affordable treatment.

“Canada has a nationalized, single-payer system that allows them to negotiate much better prices with the drug companies,” Sanders told CNN T, +0.19% about the price gap on prescription drugs between Canada’s publicly funded health-care system and the U.S. “In our country it is a much different story. The pharmaceutical companies brought in $69 billion in profit. That is insane and it is a real threat to the health of every American,” he added.

Nystrom has spent most of her life advocating for affordable health care for diabetics and says having Sanders on board the caravan will magnify the life-threatening crisis she’s battling with millions of Americans one day at a time.

“It means everything to us because we’ve never had someone of his notoriety say this is a crisis and, not only do they recognize it’s a crisis, they put their money where their mouth is and say, ‘I will come with you on that bus and ride to Canada with you.’”