A woman hands an insulin pen to Sen. Bill Cassidy (R-LA) during a town hall meeting on February 23, 2017 in Thibodaux, Louisiana. The woman who says the pen costs $500 is worried if it will still be covered by Cassidy's new healthcare legislation.

A woman hands an insulin pen to Sen. Bill Cassidy (R-LA) during a town hall meeting on February 23, 2017 in Thibodaux, Louisiana. The woman who says the pen costs $500 is worried if it will still be covered by Cassidy's new healthcare legislation.

You’ve probably heard about the migrant caravans traveling through Mexico to the U.S. border.

Well, there’s another kind of caravan crossing borders in search of survival: diabetic Americans traveling to Canada to get cheaper insulin.

In the U.S., 7.5 million people need to take insulin. And while the production cost of insulin is relatively low, its retail price has skyrocketed in recent years — making it unaffordable and sometimes dangerous to obtain.

From The Washington Post:

Some pharmaceutical companies, under pressure from U.S. lawmakers, have tried to reduce the cost for some patients. But many who rely on insulin still struggle. Large numbers resort to rationing — a dangerous and sometimes deadly practice.

Some diabetics and their families are taking matters into their own hands. They meet in coffee shops and strip mall parking lots to exchange emergency supplies. An unknown number travel outside the country to buy the lifesaving drug for less.

None of this is recommended by U.S. officials, and some of it might be illegal under Food and Drug Administration guidelines. But the organizers of the caravan — their word, a nod to the migrants traveling in groups through Mexico to the U.S. border — are speaking out about their trip because they want Americans to see how drug prices push ordinary people to extremes.

We reached out to several pharmaceutical companies that sell insulin for comment. They offered several statements, which you can read at the bottom of the page.

Why does the U.S. treat insulin like a luxury, when it’s so widely and gravely needed? And how can policymakers and pharmaceutical companies reform healthcare costs?

Show produced by Paige Osburn. Text by Kathryn Fink.


  • Lija Greenseid Consultant, Minnesota. Her 13-year-old daughter has type-1 diabetes; she has gone to Canada to purchase insulin.
  • Sarah Owermohle Drug policy reporter, POLITICO
  • Dr. LaShawn McIver Senior vice president of government affairs and advocacy, American Diabetes Association.

Statements From Pharmaceutical Companies That Sell Insulin

We reached out to three companies that control 75-80 percent of the global insulin market about the cost of the drug. Here is what they told us.

From Lilly:

The U.S. health care system has evolved – and today, it places an unfair burden on people who use insulin. Too many people with diabetes and other chronic conditions have high deductible insurance plans that force them to pay thousands of dollars before their coverage kicks in. Because insurers, including many employers, value lower premiums over low deductibles, some people with diabetes effectively subsidize premiums for the healthy. That’s not how it should work. We’ve been advocating for important policy changes that can directly benefit patients, including the Rebate Rule proposed by HHS and exempting insulin from the deductibles of insurance coverage. In the meantime, Lilly is committed to ensuring everyone who needs our insulins is able to get them (see list below)

The system is complex, and it’s not intuitive. That’s why last year we opened The Lilly Diabetes Solution Center. People can call (833) 808-1234 to talk to a live representative who will provide individualized service based upon each person’s circumstance. Our Solution Center, along with other options, are helping more than 20,000 people each month significantly lower what they pay at the pharmacy. We want to help anyone who needs it until permanent policy solutions are implemented.

From Novo Nordisk:

While many can access and afford their medication through insurance coverage, we know that as the healthcare system has changed and a growing number of Americans with diabetes struggle to pay for their healthcare, and this can include paying for the medicines we make. As a company focused on improving the lives of people with diabetes, we don’t believe this is acceptable.

It’s a systemic issue and yes, we’re a part of the system

Access does not always translate to affordability. While we are accountable for the list price, we ultimately do not dictate what most patients pay for their medicines. That’s based on how one’s insurance benefits are structured. But as benefits have evolved, there have been unintended consequences causing patients to pay more at the pharmacy counter.

Some ideas about what can be done

Structural reforms are urgently needed to expand access to affordable drugs and ensure patient choice as innovative treatments come to market. A good first step would include passing laws that enable insurance companies to classify insulins as a preventive medicine.

We have options for people

We are still taking steps to increase access to our life-saving medicines.

  • We sponsor a patient support program called NovoCare, in existence since 2003, where people can find applications for co-pay cards and our patient assistance program.
  • We participate in the Medicaid program, where many of our analog insulins are essentially free to states, while under the 340B program covered entities purchase these drugs at “penny pricing,” ensuring affordable access to insulin for these underserved populations.
  • And finally, people can get affordable human insulin over-the-counter at about $25 a vial at national pharmacies like CVS, Walgreens and Walmart. We have done this for over 15 years, and, just as when one uses any insulin, consult your healthcare provider.

Are we done? No. Is this enough? No. We want to work alongside our stakeholders in the healthcare system to find solutions that ensure access to affordable insulin

Anyone wanting to find out more about how we can help can call us at 1.800.727.6500 or go to NovoCare.com.

From Sanofi:

Sanofi believes that no one should struggle to pay for their insulin, regardless of their insurance status or income level. We encourage anyone prescribed a Sanofi medicine that is having financial challenges or trouble navigating insurance to call Sanofi Patient Connection at (888) 847-4877 where eligible patients can be connected to the medicines and resources they need.

All uninsured patients – regardless of income level – can benefit from the Insulins Valyou Savings Program which offers one set price of $99 to access Sanofi insulins with a valid prescription, for up to 10 boxes of pens and/or 10 mL vials per month. Qualified low-income, uninsured patients could receive medications at no charge through the patient assistance component of the Sanofi Patient Connection program. In addition, all commercially insured patients can participate in our co-pay programs which limits out-of-pocket expenses sometimes to $0 regardless of income level or insurance design.

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