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Every diabetic should have easy and affordable access to life-saving insulin. There shouldn’t even be a debate about it. However, many diabetics living in the United States find themselves paying an arm and a leg each month just to buy life-saving insulin. Prices in the US are sky-high compared to the rest of the developed world and Americans are fed up with what amounts to pretty much financial extortion, led by pharmaceutical, and insurance companies.

Even before you look at the immense human suffering high insulin prices cause—for instance, with people choosing to endanger their health by rationing what little insulin they have or even going without any—all it takes a casual glance at the stats to see that there’s something fishy going on. Forbes explains that while the US represents only 15 percent of the global insulin market, it actually generates a whopping 50 percent of the industry’s insulin revenue.

Bored Panda reached out to Dr. Andrew Carroll from Arizona to better understand the high insulin costs in the US and what Americans who can barely afford it can do. There are cheaper alternatives and they’re better than rationing your insulin which could lead to very serious health problems. “All medications in the US are more expensive than in the rest of the world. Part of the reason is that many drugs are developed in the US and pharmaceutical companies claim that they need to recover the costs of their research and development,” Dr. Carroll said.

“Because pricing tends to be controlled in other countries, the only way they can make a large profit is to increase the pricing in the US, where the only pricing control tends to come from competitive pricing between PBM’s (Pharmacy Benefit Managers), such as OptumRx, Express Scripts, etc.”

The price of insulin in the US is sky-high and is wrecking countless lives as a result

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According to Dr. Carroll, the US government has been asked to intervene to get all pharmaceutical pricing in the country under control. “I have a brother who is a pharmaceutical researcher. I know the development of medications takes a lot of work and money. So there is some need to recover those costs. But the pricing of drugs, over time, tends to go up, not down. If that was the excuse, then the pricing of a drug should go down over time, not up, since ideally, they will have recovered their R&D costs and initial production costs at the beginning,” he explained to Bored Panda.

Bored Panda wanted to know what diabetics who find themselves stuck financially can do. Dr. Carroll warned that rationing insulin is not a viable strategy.

“People who depend on insulin as the only means of diabetes control (Type I Diabetes) run a huge short and long term risk if they ration their medication. The costs, including Emergency Room visits as well as health effects, such as renal failure, blindness, heart attacks, and strokes, could cause long-term disability,” he said. However, there are ways around this, financially. At least in part.

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“There are some insulins which are much cheaper, and a diabetic’s physician can help guide them to find a solution which works and doesn’t force poverty. This could include Humulin-N, Humulin-R, and Humulin 70/30. But as you can see, even these are fairly expensive, despite having been generic for a long time.”

Dr. Carroll also pointed out that there is another way: “There are other programs such as the Medicine Assistance Tool, that if you qualify due to low income, may help you obtain medications for free through pharmaceutical manufacturer programs.”

Some stories are very tragic. People are bursting into tears listening to how some parents have to struggle to provide insulin for their kids

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“Newer versions of insulin retail for between $175 and $300 a vial. Most patients with diabetes need two to three vials per month, and some can require more,” writes Joshua Cohen for Forbes.

These are mind-boggling prices to pay for a vital product. Insulin therapy has been around since 1922 and developed over the years in a showcase of scientific strength. However, the financial side of things isn’t something to marvel over.

While the rest of the world has embraced the necessity to give diabetics free or at least cheap access to what they need, around a third of the 35 million Americans who have diabetes and require insulin to manage the disease find themselves facing very real, very practical financial dilemmas each month.

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The price of insulin in the US is incredibly high. Far, far higher than in nations all over the world

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Whether they’re insured, underinsured, or uninsured, Americans still pay a hefty price for something so basic that some other nations are giving away free of charge.

As to why the prices are so high, the short answer is that market isn’t as regulated as tightly as it could be and so drugmakers can pretty much do what they want. To put it bluntly, they keep the prices high because they can.

Meanwhile, the excuse that pharmaceutical companies tend to give is that they constantly innovate, creating more effective products.

Here’s how some more social media users have been reacting to the ridiculous fact that insulin still costs an arm and a leg in the US