Olivia Alvord, Staff Writer and Taryn Zard, Staff Writer
According to the Washington State Department of Health (DOH), “diabetes is the seventh leading cause of death in the state, causing 1,652 deaths in 2012.” That same year, the DOH estimated that nearly 425,000 Washington residents had been diagnosed with diabetes; 172,000 had undiagnosed diabetes, and 1.8 million had prediabetes.
Diabetes is a significant problem in the U.S. given the ever-rising costs associated with the life-saving drug required to treat the condition: insulin.
These concerns prompted Washington to put forth an effort to significantly reduce the cost of insulin. The 2020 legislative session sought suggestions as to how the current state of accessibility could be improved, which included discussion of equitable distribution and affordability of pharmaceuticals. Such conversations have thus far been centered around product price caps, and importing the drug from Canada to cut costs.
According to the American Medical Association, the cost of insulin has “increased in price by more than 500 percent from 2006 to 2015,” which often pushes Washington residents to travel across the Canadian border in search of much lower prices.
Sen. Karen Keiser – D., of the 33rd district, introduced four bills regarding pharmaceutical affordability.
For Senate Bill (SB) 6113, in particular, Keiser’s motivation is to control the cost of the drug, since those who need the medication now spend three times more on insulin than they have in the past 15 years. “Patrons testified in favor of Keiser’s proposals. Supporters ranged from diabetics to retired doctors and pharmacists. Amber Markland, a small business owner in Olympia, brought her diabetic 8-year-old son with her, along with a vial of insulin, which she said cost $300,” stated The Seattle Times regarding a recent meeting.
Someone without previous experience with diabetes might wonder why the availability of insulin is so important. Diabetes is a disorder in which a person’s pancreas, an organ located behind the stomach, produces insufficient amounts of a compound called insulin, or the insulin produced is attacked by a person’s body, resulting in the condition.
A person needs certain levels of sugar in their bloodstream, which serves as a source of energy. However, sugar levels that are too high or low are bad. To counter this, the pancreas produces both glycogen; a cell that breaks down molecules to produce glucose (sugar), and insulin; the glucose inhibitor in tandem. This process helps keep balance in the bloodstream.
Insulin is naturally produced in the body, but in some people with conditions, such as diabetes, the chemical cannot be manufactured properly. For people who cannot internally produce insulin, taking an artificial substitute is a must. The synthetic insulin which these people require to live can be made in a lab quite easily, and with a minimal cost to producers.
The discovery that the pancreas produces cells that could monitor the sugar levels in a person’s body was first made by a German medical student in 1869. After its official discovery in 1922, the patent for synthetic insulin was sold for $3. At that point, patients were able to purchase a vial for as low as $1.49, and were able to do so for the next 50 years.
Based on calculations that account for inflation, past trends would put the current cost of a vial of insulin at approximately $8.86. However, due to price changes effected by “Big Pharma,” the cost of insulin has risen astronomically in recent years, with the price resting somewhere between $200-$300 for the same amount.
SB 6087 was another piece of legislation aimed at easing the challenges associated with obtaining insulin. The bill had its first reading on Feb. 7, 2020. The specific piece of legislation is an attempt to make better coverage available for insulin products and would introduce a price cap of $100 for the drug in Washington.
Insulin can be the difference between life or death, because if not properly treated, diabetes and similar diseases will cause the body to release ketones into the bloodstream. This results in the break-down of fat and proteins for energy in a state known as ketoacidosis. Additionally, if a person has glucose levels that are too high or low, they can enter a diabetic coma.
Such complications prove the need for drugs such as insulin, but price can be a very large barrier for those who need treatment. The proposed laws are an attempt to maximize the availability of the drug, while mitigating the cost for consumers. This trend is not unique to Washington; all across the nation, states are considering the proposition– insulin needs to be less costly and more available to those who rely on its life-saving properties.