Increases in Insulin Prices Drove Spending Over 4 Years, Report Says

A new report out this week found that increases in healthcare spending by people with type 1 diabetes were primarily driven by increases in insulin prices and, to a lesser extent, a shift toward use of more expensive analog insulins.

According to the Health Care Cost Institute (HCCI), the average annual cost of managing type 1 diabetes among individuals with employer-sponsored insurance rose to nearly $18,500 in 2016. That was up $6000 since 2012; 47% of the increase was due to the rising cost of insulin.

Insulin spending per person was $5700 in 2016, nearly a third of total healthcare spending for people with type 1 diabetes and an increase from $2900 in 2012.

“We are frequently told that high drug prices are justifiable in order to promote innovative new cures, but the cost of insulin—a longstanding therapy that 1.25 million Americans with type 1 diabetes rely on to live—has nearly doubled in the last five years, despite very little change in the underlying product,” Niall Brennan, chief executive officer of HCCI, said in a statement.

The report is based on an analysis of health insurance claims from 13,800 to 16,200 people with type 1 diabetes who had health insurance through work.

HCCI researchers tracked prices for every insulin product on the market between 2012 and 2016 and found that prices increased in all cases. The median price increase from 2012 to 2015 was 92%. But use of insulin rose only slightly, up 3%.

Even considering the possible use of manufacturer rebates and coupons, insulin prices still would have doubled, the report said.

The report tracked average daily use for both human and analog insulin products. Among basal, or human, insulins, daily use of Lantus/Toujeo declined by 4 units. This was offset by an increase in use of Levemir and the adoption of Tresiba, which came to market in 2015.

For analog insulins, individuals used 7 more units of Humalog daily in 2016 than in 2012, while daily use of Novolog declined by 4 units.

Delivery methods changed during the study period. Vials administered with a syringe remained the most common delivery method, making up 53% of insulin used in 2016, but down from 61% in 2012.

Prefilled insulin pens increased in popularity, rising from 38% of use in 2012 to 46% in 2016.

HCCI is an independent, nonpartisan research organization that analyzes the causes of the rise in health spending. Its data set currently totals about 100 million lives, including data from both Medicare and employer-sponsored insurance.