Why Is Insulin So Expensive? (And 4 Tips to Afford Yours)
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Why Is Insulin So Expensive? (And What to Do if You Can't Afford It)

Why Is Insulin So Expensive? (And What to Do if You Can't Afford It)
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Updated on January 21, 2025
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Insulin is a lifesaving treatment for people with type 1 diabetes and some people with type 2 diabetes, but in the United States it can be extraordinarily expensive. Insulin prices have risen steeply in recent years — nearly tripling since 2010.

 Some patients have been forced to ration their insulin, a practice that is dangerous and sometimes even deadly. If you’re having trouble affording your insulin, you have options, including lower-cost formulations, emergency medical help, and patient assistance programs.

Why Insulin Is So Expensive

There are only three significant insulin manufacturers in the United States, so there isn’t much competition to lower drug prices. Eli Lilly, Novo Nordisk, and Sanofi control more than 90 percent of the global insulin market and almost all of it in the United States.

Pharmacy benefit managers (PBMs) also contribute to the high cost of insulin. PBMs are third-party administrators who negotiate with pharmacies, as well as with device and drug manufacturers, on behalf of health insurers to control spending. This system gives multiple involved groups the power to determine what covered medications and devices patients can access through insurance.

 
PBMs also get rebates from drug companies, meaning that they get money back post-purchase when patients and insurers buy certain drugs and devices. Rebates work similarly to sales commissions, with more expensive covered drugs generating higher rebates for PBMs. Some groups have raised concerns that PBMs can favor more expensive products over more affordable ones to maximize profit.

Prices are even higher for those without insurance. In 2019, uninsured people paid an average of $123 per insulin fill, compared to $63 for those with insurance.

 And in 2022, the standard cost of insulin was nearly 10 times as expensive in the U.S. as in 33 other countries.

To address this disparity, half of U.S. states, along with the District of Columbia, have put a cap on insulin copayments for state-regulated commercial health insurance plans.

 Some states have also capped copays for other diabetes medications and supplies.
In addition, since March 2023, the “Big Three” manufacturers have all announced voluntary price drops for their non-branded insulins, offering a cheaper alternative to their branded products.

They have also reduced the list price of their branded products by up to 70 percent. For example, Eli Lilly announced in 2023 that it would cap monthly out-of-pocket costs for insulin at $35 for those without Medicare coverage. However, due to factors including high pharmacy prices, geography, poor pharmacy stock availability, and pharmacies not advertising low-cost options, many patients still struggle to access Lispro, Eli Lilly’s affordable insulin.

The U.S. government has also made strides to lower the cost of insulin. In September 2024, the Federal Trade Commission sued the top three PBMs for artificially inflating insulin prices.

 If the suit is successful, it will further drive down the cost for people who need the drug. Additionally, in 2023, the State of California entered into a contract with drugmaker Civica Rx to create its own line of insulin that will cost $30 for people in the state.

Do People With Type 2 Diabetes Have to Be on Insulin?

Do People With Type 2 Diabetes Have to Be on Insulin?

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How to Find Lower-Cost Insulin

If you’re unable to afford insulin, consider following one of these strategies.

For Insulin Emergencies, Seek Medical Help

Some people with diabetes who can’t afford to take as much insulin as their doctors prescribe take dangerous measures, such as using expired insulin or rationing their supply by taking less than they need. Up to 30 percent of Americans with diabetes report rationing or skipping their insulin due to its high cost.

Rationing or skipping insulin can be life-threatening. If you’re in severe or immediate need of insulin, don’t wait to seek help. Go to the nearest hospital emergency department (ED) for immediate treatment. If you aren’t near a hospital, you can call 911.

Use Less Expensive Over-the-Counter Insulin

If you can’t afford prescription insulin brands, many pharmacies sell over-the-counter insulin, including Regular (R) insulin, a short-acting insulin for use before meals, and NPH (neutral protamine Hagedorn) insulin, an intermediate-acting basal insulin that is taken at least twice per day.

These over-the-counter insulins are older formulations that are no longer preferred for diabetes treatment. While available without a prescription for a relatively low price, these options are considerably more difficult to use than modern insulins, and may be more likely to cause hypoglycemia.


Use a Coupon or Patient Assistance Program

The “Big Three” manufacturers each offer patient assistance programs for people who cannot afford their insulin:

You can also look online for manufacturers’ coupons and savings cards:

If you’re unsure what kind of help you qualify for, check out GetInsulin.org, a resource cultivated by a nonprofit diabetes advocacy group that can direct you to assistance programs for which you’re eligible.

Other organizations that can help you find information on, and access to, insulin include:

Other Resources

Ask your doctor to review your course of treatment to see if there are any lower-cost insulins or delivery systems they can prescribe that will allow you to maintain the same level of health and quality of life you find acceptable. Be sure that the conversation is thorough and covers any hidden costs, such as extra testing strips.

Other potential resources could include:

  • Local community health centers, which are federally supported clinics that provide primary care services, including diabetes care for patients who are uninsured or underinsured, or have a very low income.

  • Traveling to Mexico or Canada to buy insulin, as it costs less in these countries.

The Takeaway

  • Up to 30 percent of Americans diagnosed with diabetes have reported rationing or skipping their insulin entirely due to lack of affordability. Not receiving proper insulin can cause life-threatening complications.
  • You should never have to skip or ration insulin because you can’t afford it. If you’re having trouble paying for insulin, let your doctor know as soon as possible.
  • There are many resources available for Americans who need insulin but lack the means to pay for it. Your doctor may be able to prescribe you a lower-cost insulin, or you may qualify for an assistance program from an insulin manufacturer.
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Elise M. Brett, MD

Medical Reviewer
Castle Connolly Top Doctor
Elise M Brett, MD, is a board-certified adult endocrinologist. She received a bachelor's degree from the University of Michigan and her MD degree from the Icahn School of Medicine at Mount Sinai. She completed her residency training in internal medicine and fellowship in endocrinology and metabolism at The Mount Sinai Hospital. She has been in private practice in Manhattan since 1999.

Dr. Brett practices general endocrinology and diabetes and has additional certification in neck ultrasound and fine-needle aspiration biopsy, which she performs regularly in the office. She is voluntary faculty and associate clinical professor at the Icahn School of Medicine at Mount Sinai. She is a former member of the board of directors of the American Association of Clinical Endocrinology. She has lectured nationally and published book chapters and peer reviewed articles on various topics, including thyroid cancer, neck ultrasound, parathyroid disease, obesity, diabetes, and nutrition support.
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Erica Patino

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Erica Patino is a freelance writer and editor, content strategist, and usability specialist who has worked for a variety of online health outlets, including Healthline, Sharecare, and Twill Care. She was previously a senior editor at Everyday Health. She is also the founder and editor-in-chief of Hear 2 Tell, a website that covers advances in hearing loss treatment. Patino lives in Portland, Oregon, with her husband and twin sons.
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Resources
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