How to Manage the Rising Costs of Insulin

Modern medicine has made a big difference in many lives. Some drugs can actually cure or treat the disease. But most drugs relieve the symptoms of illness and don’t fix the problem, Moreover, most have side-effects that limit their usefulness. Case in point: antibiotics and antidepressants.

• Antibiotics work well for acute and chronic infections, but are often used improperly, causing problems with mitochondria, and gut bacteria.
• Antidepressants help people feel better, when used appropriately – before they were available, people just suffered – but they also deplete the normal neurotransmitters.

We also have great pain medications, but every one of them has terrible side-effects and should not be used long-term. However, one drug stands out among all the others as a real benefit, not just relieving a symptom, but actually restoring function to the metabolism: INSULIN.

Insulin is not a drug; it’s a hormone. It is the metabolic hormone that allows nourishment to your cells. Cells in the body need amino acids to make proteins, and glucose (sugar) to make energy. Insulin is the hormone that lets them in. It is the key that unlocks the door, allowing the cell to take up both amino acids (protein) and glucose (sugar). This is very important because if you don’t have insulin, then you cannot get significant amounts of these nutrients into your cells and they will shrivel-up and die of starvation. You could eat all the food you want, but you would still die of starvation. That’s what happened to people with diabetes (what we now call type 1 diabetes mellitus – or T1DM) before the discovery of insulin.

Over the last 100 years since the discovery of insulin and its connection to diabetes, millions of lives have been affected by this one substance. There are now multiple patented insulin-like drugs that mimic the action of insulin but have different effects. Some bind very strongly to the insulin receptor, and stay around all day; others work very quickly and disappear. All of them require injection into the body because they are broken down in the intestine if ingested as a pill. The exception is for one inhaled version of insulin that can be taken-up in the respiratory system and used in the body.

The Trump-Biden Football Game

However, there is a dark side. Because it is one of the few “drugs” necessary for life, insulin has become a political football.

In July 2020 President Trump signed four executive orders that affects drugs, and specifically insulin. In essence They demanded:[1]

1. Federally Qualified Health Clinics would provide insulin at cost.
2. Medicare programs would pay the lowest price on the international market.
3. People would not be prevented from buying their insulin (and other drugs) from other countries.
4. Rebates (kickbacks) to Pharmacy Benefits Managers would be eliminated.

The first Executive Order regarding insulin was published by the Federal Register on December 23rd. The stated purpose was to help those who are low-income, without insurance or have a high share-of-cost for their health care.  The EO states:

“The list price for a single vial of insulin today is often more than $250 and most patients use at least two vials per month…”

“This final rule establishes that health centers receiving funding under section 330(e) of the PHS Act are expected to offer insulin… at or below the price the health center paid through the 340B Program, plus a minimal administration fee,”[2]

Thus, the actual executive order does not regulate the cost of insulin, only that these clinics offer it at or below their cost of acquisition with a minimal administration fee. This doesn’t apply to pharmacies or private clinics, unless they receive federal funding as an FQHC.

When a new president takes office, the Executive Orders that have not been implemented are often suspended. Thus, when President Biden took office, he suspended all that President Trump had done, including this executive order.

I suppose it would be good to briefly discuss what an executive order is. The president of the United States has the tremendous job of executing all the laws made by congress. One of the “checks and balances” of the system, is that the president can choose not to enforce or execute certain laws. Also, because there are so many laws a huge bureaucracy has been created to administer them. The president writes executive orders to tell them what to do. The executive orders do not apply to individual citizens, only to those who work for the President of the United States. He is like the CEO of a very large corporation. He cannot dictate what the general population does, except as the laws enacted by congress are administered.

In this case, the president told clinics under federal controls to give insulin at or below their cost, which only affects those who use these clinics.

The Actual Cost of Insulin 

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