Alec Raeshawn Smith was shocked to be diagnosed with type 1 diabetes at age 23. The incurable autoimmune disease, which often strikes in childhood, is far less common than type 2 diabetes, which does not always require patients to take insulin. Type 1 diabetics must take it; before the hormone was isolated in a lab in 1921, the disease—which causes the pancreas to stop producing insulin—was always fatal. Smith learned a new routine of insulin injections and checking his blood glucose levels, and was able to get his blood sugar under control and move into an apartment of his own. But when he turned 26, Smith was no longer covered under his mother's insurance, and opted to go without insurance rather than pay $450 per month for a plan with a deductible of over $7,000. "It can't be that bad," he told his mom of his plan to avoid insurance. Within a month, he was dead. Now the Washington Post takes a long look at the tragic consequences of "intolerably expensive" insulin.
Smith thought it would be better to pay out of pocket for the insulin and other supplies required to manage his disease. But then he found out the insulin alone would cost him more than $1,000 a month, with hundreds more for other necessary supplies. Three companies dominate the global insulin market, and prices have skyrocketed at all of them: Eli Lilly's Humalog brand of insulin cost $21 for a 10-milliliter vial in 1996; it now costs $275. Sanofi's Lantus was $35 per vial in 2001 and is now $270. Novo Nordisk's Novolog was $40 in 2001 and is now $289. Because of this, some with T1D have taken to "insulin rationing," skimping on insulin intake to make their stash last longer. It's a dangerous practice, and one Smith's family and friends fear he was practicing in the days before his death. The full article, which delves into Smith's last days and what lawmakers are doing about insulin costs, is worth a read. (One study shows that we've been thinking "all wrong" about diabetes.)