A study carried out by the Rand Corporation finds that individuals in the United States pay significantly more for insulin than residents of 32 other high income countries.

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Insulin, a hormone that regulates the movement of glucose into cells, is a vitally important hormone for several reasons. It allows the human body to absorb glucose and helps balance the body’s glucose levels.

People with type 1 diabetes cannot produce insulin. People with type 2 diabetes either have developed resistance to the insulin their body produces or do not produce enough insulin to maintain normal glucose levels.

People with diabetes keep the condition under control with daily insulin injections.

A comprehensive study of insulin prices in nations similar to the U.S. finds that people in the U.S. pay significantly more for their insulin than people living in 32 other high income countries.

Basing their conclusions on manufacturers’ prices for insulin, the new “analysis provides the best available evidence about how much more expensive insulin is in the U.S. than in other nations around the world,” according to lead author Andrew Mulcahy, a senior policy researcher of the non-profit RAND Corporation.

Funded by the U.S. Department of Health and Human Services Office of the Assistant Secretary for Planning and Evaluation, the research, titled “Comparing insulin prices in the United States to other countries: Results from a price index analysis,” appears on Rand’s website.

There are various types of insulin, including:

  • rapid-acting insulin
  • short-acting insulin
  • intermediate-acting insulin
  • long-acting insulin

Laboratory-produced insulins are also available. Scientists make them by growing insulin proteins within Escherichia coli (E.coli bacteria). Human insulin and analog insulin are the two types of synthetic insulin available. Analog insulin is fast-acting and allows the body to use it more uniformly than human insulin.

Averaging all insulin types, the price per insulin unit in the U.S. is $98.70.

For their comparison of insulin prices, the study authors used sales and volume data for 2018 from the industry-standard IQVIA MIDAS database. The other 32 countries that the researchers considered in the study are members of the Organization for Economic Co-operation and Development (OECD).

The insulin prices in the United States are about eight times higher than in non-U.S. OECD countries combined.

The U.S. price for insulin is 6.3 times higher than in Canada and 8.9 times higher than in the United Kingdom. U.S. insulin is also 5.9 times more expensive than in Japan and 27.7 times more expensive than in Turkey.

While discounts and rebates for insulin mean that individuals in the U.S. typically pay significantly less than manufacturers’ prices, they still pay more than others pay elsewhere.

Even if the U.S. manufacturers cut their price in half, people in the U.S. will still pay four times more than people in other countries.

However, the difference between U.S. prices and elsewhere varies according to the type of insulin. The most significant differences between prices in the U.S. and elsewhere were for analog and short-acting insulin.

The study also found that U.S. doctors prescribe a more expensive combination of insulin types.

Regardless of the prescribed insulin mix, RAND’s analysis found that U.S. expenditures for individuals were always higher than in other countries, and often five to ten times higher.

The study found the U.S. was unusual in that it allowed individuals to purchase several insulin types over-the-counter, without a prescription. Even with these variants, manufacturer prices in the U.S. remained higher than in other countries.

Over the past decade, there has been a significant increase in the price of insulin in the U.S.

According to one federal analysis, the average wholesale prices of three insulin types — rapid-acting, long-acting, and short-acting — have risen by 15% to 17% annually between 2012 and 2016.

During the same period, the average annual outlay for individual adults receiving 50% rebates on their insulin went up from $1,432 to $2,853, according to an analysis of employer-sponsored health insurance.