The average price of insulin has skyrocketed in recent years, but the reasons for that increase aren’t clear. Numerous parties play a role in the production and delivery of insulin to patients – including manufacturers, wholesalers, insurers, pharmacy benefit managers and pharmacies – and the pricing negotiations that occur between them are often confidential. There is a need for transparency in the insulin supply chain to identify changes that will lead to long-term improvement in insulin affordability.

Solutions are only as good as the information used to create them, which is why we strongly encourage transparency by all parties involved in establishing the process that determines how much individuals pay for insulin. This is the first step in creating public policies that will reduce skyrocketing costs and keep a steady supply of insulin within reach of all people who need it.



This infographic depicts the numerous entities that play a role in getting insulin to the people who need it and the complex flow of money between them. Negotiations between them determine the final cost to people with diabetes.

The chart highlights the need for transparency to better understand the impact each of these transactions has on insulin affordability, an important first step in finding viable solutions.

Source: Insulin Access and Affordability Working Group: Conclusions and Recommendations



  • More than 34 million Americans have diabetes and about 7 million depend on insulin.
  • Diagnosed diabetes in the U.S. cost $327 billion in 2017, a 26 percent increase in five years.
  • Between 2002-2013, the average price of insulin nearly tripled, creating financial hardships for people who rely on it to survive.
  • In much of Europe, insulin costs about a sixth of what it does in the United States.
  • Some people with diabetes are cutting back on or skipping doses of insulin – or foregoing other necessities to pay for insulin – which puts their lives and health at risk.
  • People with diabetes are at significant risk for serious complications including kidney failure, heart disease, stroke, blindness and lower-limb amputations.



Our goal is to ensure that insulin is affordable and accessible for all people who need this lifesaving medication.

The American Diabetes Association recommends an array of short-term and long-term recommendations to help shed additional light on the issue, to combat increasing insulin costs, and to improve affordable access to medications, including:

  • Increasing pricing transparency throughout the insulin supply chain;
  • Increasing competition;
  • Lowering or removing patient cost-sharing for insulin;
  • Increasing access to health care coverage for all people with diabetes.

Copyright © American Diabetes Association 2018. All rights reserved.