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Insulin Price and Unaffordability

Executive Summary

These days, high prices for insulin and its unaffordability present a pressing concern. A significant number of people do not take the prescribed dose due to financial hardships. Moreover, from year to year, the number of people diagnosed with diabetes is increasing. Insulin is a vital drug for them in order to maintain decent living conditions, and for this reason, reduced dozes affect their health state significantly. In this context, there is a necessity to address this problem. The most effective approach is elaborating legislation on price restrictions. It will limit the influence of marker leaders and prompt them to find cheaper ways of producing insulin. In addition, appropriate laws will contribute to making the insulin marker transparent, preventing additional expenditures. However, there is a likelihood of threats while implementing the chosen option. In order to minimize or avoid them, the active participation of the government is vital.

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Introduction

From year to year, the number of patients diagnosed with diabetes is increasing. According to American Diabetes Association (n. d.), “in 2018, 34.2 million Americans, or 10.5% of the population, had diabetes” (para. 1). Predominantly, people aged over 45 are considered to be at high risk. However, during the past years, the statistics show that cases of children and adolescents diagnosed with this disease are becoming more frequent. American Diabetes Association (n. d.) provides the following data: “About 210,000 Americans under age 20 are estimated to have diagnosed diabetes, approximately 0.25% of that population” (para. 6). Diabetic patients are required to take medications, namely insulin, on a constant basis for their whole life in order to adhere to decent living standards.

In case they abandon this recommendation, the consequences for their health can be dramatic. In addition, there is a high likelihood of a lethal outcome. However, occasionally, diabetic patients may encounter some hardships while following the requirement to take insulin regularly, and its high price is among the most pressing ones. Therefore, the purpose of this paper is to explore the problem of prices for insulin and present relevant recommendations in this regard.

Background of the Problem

Diabetic patients are required to take insulin on a constant basis, as this hormone maintains the appropriate level of sugar in the blood, helping to avoid achieving deadly levels of blood sugar. Organisms of people with such a diagnosis cannot make a sufficient amount of this hormone naturally. For this reason, they need to take this hormone additionally for daily blood sugar maintenance and managing occasional spikes.

However, analyzing the statistics of price changes for insulin, it may be noted that it approximately doubled in the period of four years. Hargrqves & Frost (2017) report that the annual cost of insulin was $2864 in 2012, while it raised to $5706 in 2016. This can be explained by the necessity to compensate the discounts, which are supplied to buyers under their health plans. In contrast, daily insulin consumption increased from 2012 to 2016 by only 3% (Hargraves & Frost, 2017). Assuming that an average patient needs 60 units per day, the daily cost raised from $ 7.8 $15 during four years (Hargraves & Frost, 2017). In this context, high prices for insulin may be a considerable burden for diabetic people, as they are required to take it on a daily basis.

Impact of the Problem

As a result of significant price increase, many patients tend to reduce the amount of insulin they take, which can lead to damaging health condition. Herkert et al. (2019) have conducted an experiment, which involved 199 diabetic patients. Fifty-one of the participants, which comprise approximately a quarter of the total number, admitted that they use less insulin than it is prescribed due to high prices (Herkert et al., 2019). Moreover, such patients were reported with blood sugar level deterioration, which may result in a lethal outcome. Basu et al. (2019) use the current data and make a prediction on the future development of this disease on their basis, assuming that the number of people, who need insulin-based drugs, will reach 79 million by 2030. Consequently, the inability to purchase the appropriate amount of this hormone will probably result in the health state deterioration of vast categories of the population. In this context, the necessity to take sufficient actions urgently is evident.

Approaches

There are several approaches, which may be helpful in solving this pressing concern. In general, insurance coverage has a direct impact on the price of insulin. Another key factor in forming the cost regards the manufacturers, who are responsible for regulating the price. Currently, there are three leaders in the U.S. pharmacy market, which produce insulin: Sanofi, Novo Nordisk, and Eli Lilly. According to Conner et al. (2019), they “control 99% of the global insulin market by value” (para. 1). The last circumstance, which affects the price is using intermediaries for the distribution of drugs. All these factors together result in the lack of transparency in mutual settlements, which appears to be a hot-button problem in the insulin market.

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Despite any attempts to improve the situation, greater work is needed to be done. Conner et al. (2019) report: “Eli Lilly has launched an authorized generic insulin in the USA—identical to branded Humalog but at 50% of the US$275 per vial list price” (para. 2). However, these measures appear not to be effective in addressing the problem. The reason for it implies the fact that Sanofi, Novo Nordisk, and Eli Lilly occupied the whole insulin market, which prevents a competitive environment (Gotham et al., 2018). Consequently, they are capable of acting under their company’s interests and establishing high prices (Gotham et al., 2018). Moreover, the United States government has not implemented any restrictions on drug cost, and pharmacy organizations are free of forming the prices they need.

Proposed Solution to the Problem

After reviewing the current situation on the global insulting market and the possible approaches, it becomes evident that the government should actively participate in solving this pressing concern. Therefore, there is a need to publish appropriate legislation, which will limit the possible prices for drugs and insulin particularly. These regulations should involve calculations on the average salary and pension for understanding the possible sum, which people may spend on constant treatment. In addition, it should regard the average number of units, which patients are prescribed to take. This approach will be helpful to limit the freedom of Sanofi, Novo Nordisk, and Eli Lilly for form price on the global insulin market. As a result, the population will be able to purchase the required amount of the drug and avoiding significant health risks. Moreover, this option also prompts the mentioned companies to reorganize their production process and make it more transparent and expensive, which will be beneficial for them as well.

SWOT Analysis

In order to analyze the perceptiveness of the chosen solution and take into consideration possible threats, a SWOT analysis has been conducted. The objective of the analysis was to find a sufficient solution for making insulin more available for patients with diabetes. Pursuing this aim, it has been decided that the most effective approach would be implementing appropriate legislation on insulin price regulations. It is expected to limit the influence of market leaders, which are responsible for forming high prices for the drug.

SWOT analysis revealed considerable advantages of the chosen approach for addressing the problem. The definite strength of the chosen approach implies making insulin more available for vast categories of the population. Moreover, price restrictions will prompt organizations to make the production process cheaper. Apart from this, appropriate legislation will contribute to making the global insulin market more transparent. Using these strengths, it is possible to find opportunities to make the current method even more effective in the long run. First of all, by making the prices accessible for patients, the government will contribute to avoiding health risks among patients diagnosed with diabetes. Secondly, the chosen measure will stimulate pharmacy companies to improve their business by reconsidering the production process. Thirdly, unnecessary expenditures on production and distribution will be avoided.

Nevertheless, there are some weaknesses of the preferred strategy, which should be reviewed as well. The process of discussion and implementing legislation may take significant time periods, as it should regard a range of details. Furthermore, companies may suffer from unexpected and considerable expenditures on reorganizing the production process. In general, pharmacy companies will be incapable of finding cheap ways of making insulin-based drugs without additional scientific experiments. In addition, there is a likelihood that the outlined weaknesses will pose threats for people, dependent on insulin purchases and selling. For instance, the government may need additional time to elaborate laws due to a lack of explorations on cheap insulin production. Moreover, there is a risk that companies will struggle to recover from price restrictions, which may lead to bankruptcy or crises within a company. Additional scientific explorations will also require time and considerable funding.

In order to increase the benefit from the solution, it is essential to provide options for capitalizing on strengths and opportunities. First of all, it is possible to introduce special insurance coverages with a discount on insulin for patients diagnosed with 2 type diabetes. Secondly, the government may regulate the influence of pharmacy marker leaders in order to adhere to a competitive environment. Thirdly, the government may introduce additional regulation on drug production transparency in order to limit the money losses. As for the opportunities, the government will contribute to the health state improvement of the population in general. Moreover, companies will be more motivated to present a high-quality product due to activating the competitiveness between producers. Apart from this, as the production and distribution process will become transparent, companies will have more money for further development.

In addition, it is vital to present options for minimizing the outlined weaknesses and avoiding possible threats. In order to accelerate the process of legislation elaboration, it is advisable to attract more people to the process of discussion and creation of regulations. In addition, in case of significant unexpected expenditures for companies, they may be provided with cost-efficient loans or funding. The government should also stimulate the process of conducting scientific experiments to attract more people and organizing a contest with a prize for the best project. Moreover, it is possible to take necessary actions, which will be highly likely to prevent the probable threats. For instance, the government should prompt scientific explorations before starting to implement regulations on price restrictions. Moreover, the government should discuss the possibility of funding pharmacy companies on innovations or propose state credit programs with low percentages. Lastly, scientific explorations on cheaper production of insulin should be funded on a state level.

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Results of the Analysis

The SWOT analyses revealed that the chosen method would be beneficial for pursuing the aim of making insulin more accessible. It will also activate competitiveness in the market and result in transparency in the process of insulin production. However, in order to minimize the weaknesses of the proposed solution and avoiding probable threats, governmental participation is required. It should provide funding for scientific experiments and companies in case it is needed. Therefore, it will be possible to achieve the maximum positive result.

Recommendations

Summarizing the information presented above, the most effective method of regulating the high prices for insulin implies elaborating appropriate legislation on cost restrictions. The government should actively participate in the solution of this hot-button problem. They should stimulate scientific experiments on the ways of producing insulin cheaper without any dangers to the health state. Moreover, it should provide additional funding for the exploration and realization of the program. It is also advisable to monitor the professional activity of Sanofi, Novo Nordisk, and Eli Lilly and providing conditions for a competitive market. There is a need to regulate the transparency on this marker via appropriate laws. In addition, it is crucial to check the quality of new products in order not to admit health state deterioration of patients diagnosed with diabetes. This way, it will be possible to limit the increasing prices for insulin and supply the population with decent conditions for caring for their health in the long run.

Conclusion

In conclusion, it should be highlighted that the problem of high prices for insulin and its unaffordability appears to be a pressing concern. The statistics depict a drastic increase in the price for insulin, though the amount of compensation for insulation for patients with diabetes was not raised significantly. Moreover, the consequences of this problem may be dangerous for the health of the vast categories of the population, as diabetes is becoming more widespread from year to year. Therefore, the need to address this problem in the near future is apparent.

The most effective solution for the problem could be elaborating legislation on restrictions for prices on insulin. This measure would allow to limit the influence of global market leaders and prompt them to find cheaper ways of production. In addition, the appropriate policy would stimulate the companies to make the production process more transparent, allowing to save money on avoiding additional expenditures. Despite evident benefits, there is a risk of probable threats, and in order not to admit or avoid them, active governmental participation is essential.

References

Basu, S., Yudkin, J. S., Kehlenbrink, S., Davies, J. I., Wild, S. H., Lipska, K. J.,… & Beran, D. (2019). Estimation of global insulin use for type 2 diabetes, 2018–30: a microsimulation analysis. The Lancet Diabetes & Endocrinology, 7(1), 25-33. Web.

Conner, F., Pfiester, E., Elliott, J., & Slama-Chaudhry, A. (2019). Unaffordable insulin: patients pay the price. The Lancet Diabetes & Endocrinology, 7(10), 748. Web.

Gotham, D., Barber, M.J., & Hill, A. (2018). Production costs and potential prices for biosimilars of human insulin and insulin analogues. BMJ Global Health, 3(5). Web.

Hargraves, J., & Frost, A. (2017). Price of insulin prescription doubled between 2012 and 2016. Healthcare Cost Institute. Web.

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Herkert, D., Vijayakumar, P., Luo, J., Schwartz, J. I., Rabin, T. L., DeFilippo, E., & Lipska, K. J. (2019). Cost-related insulin underuse among patients with diabetes. JAMA internal medicine, 179(1), 112-114. Web.

Statistics about diabetes. (n. d.). American Diabetes Association. Web.

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