Recently, the American Diabetes Association issued a white paper on Insulin Access and Affordability by their Working Group.

While we continue to applaud the American Diabetes Association for speaking out about the high cost of insulin, we remain concerned with their approach and some of the recommendations in their paper.

T1International was alarmed to find multiple suggestions that American doctors should prescribe older, cheaper human insulins like R and NPH to help solve the price crisis. This type of rhetoric will likely encourage medical professionals and health insurers to justify prescribing and covering the insulins that are less effective for many.

We have recently seen an increase in the push for ‘Walmart insulin’ in the US as a solution for the insulin crisis. This has been at the same time as increased media coverage of the crisis and greater demands for legislative action by the public.

People should know that ReliOn R and ReliOn N (sometimes known as Regular and NPH) insulins cost $25 in many states and they are an option in emergency situations. This type of insulin is obviously better than no insulin at all, but we repeat that it is not a solution to the insulin affordability crisis.

People with diabetes must consult a doctor before attempting to change to this type of insulin which reacts very differently – and more unpredictably – than analog insulin. This unpredictability means that a person would need to afford additional blood glucose testing strips. Someone without insurance will not be able to afford the strips and other supplies needed, nor the doctor visits for the support that is essential when switching to this insulin.

Twenty-five dollars per vial is not an affordable price for everyone. The ADA’s suggestion that prescribing this insulin should become a common money-saving practice also exacerbates a two-tiered system where the rich get the ‘better insulin’ and the poor are forced to use the older, and often more problematic, insulin.

Finally, the paper mentions the need for more transparency, but offers no suggestions of how that should happen. This is incredibly frustrating for people living with diabetes because there has been legislative movement on the state-level towards transparency, but we have seen insufficient support from the ADA.

This deadly crisis needs action now. Solutions proposed must address the prices set by Eli Lilly, Novo Nordisk and Sanofi. Care for people living with diabetes in the USA cannot be compromised because of pharma's greed.

We continue to request that T1International have the opportunity to share our experience and expertise with the ADA so that we can put patients first and join efforts in the fight for #insulin4all.