Treatment Cost: High cost of insulin associated with poor glycaemic control

Costs for some insulin preparations have increased threefold or more, with concomitant increases in out-of-pocket costs, according to a study published in The Journal of the American Medical Association (JAMA).

Investigators asked 199 diabetic patients for whom insulin had been prescribed whether they practiced any cost-saving behaviours (e.g., using less insulin than prescribed, not filling insulin prescriptions, not starting insulin because of cost). Glycaemic control within 3 months was assessed, with "poor control" defined as HBA1C level of ≥9.0%.

One quarter of patients reported cost-related insulin underuse. Those patients were more likely to report low incomes, but only 60% of low-income patients had discussed concerns about costs with their clinicians. Poor glycaemic control was significantly more prevalent among patients who reported cost-related underuse than among other patients (43% vs. 28%).

Insulin is lifesaving for people with diabetes and is included on the Model List of Essential Medicines formulated by the World Health Organization. This means it should be available at all times at a price the individual and the community can afford.