Why Americans look north for insulin
As drug costs soar in U.S., some diabetics crossing border for cheaper prices
As their minivan rolled north, they felt their nerves kick in — but they kept on driving.
At the wheel: Lija Greenseid, a rule-abiding Minnesota mom steering her Mazda5 on a crossborder drug run.
Her daughter, who is 13, has Type 1 diabetes and needs insulin. In the U.S., it can cost hundreds of dollars per vial. In Canada, you can buy it without a prescription for a tenth of that price.
So, Greenseid led a small caravan last month to Fort Frances, Ont., where she and five other Americans paid about $1,609 for drugs that would have cost them $16,089 in the United States.
“It felt like we were robbing the pharmacy,” said Quinn Nystrom, a Type 1 diabetic who joined the caravan that day. “It had been years since I had 10 vials in my hands.”
Like millions of Americans, Greenseid and Nystrom are stressed and outraged by the rising costs of prescription drugs in the U.S. — a problem Republicans and Democrats alike have promised to fix.
Insulin is a big part of the challenge. More than 30 million Americans have diabetes, according to the American Diabetes Association. About 7.5 million, including 1.5 million with Type 1 diabetes, rely on insulin.
Between 2012 and 2016, the cost of insulin for treating Type 1 diabetes nearly doubled, according to the non-profit Health Care Cost Institute.
Some pharmaceutical companies, under pressure from U.S. lawmakers, have tried to reduce the cost for some patients. But many who rely on insulin still struggle. Large numbers resort to rationing — a dangerous and sometimes deadly practice.
Some diabetics and their families are taking matters into their own hands. They meet in coffee shops and strip mall parking lots to exchange emergency supplies. An unknown number travel outside the country to buy the life-saving drug for less.
Republicans and Democrats have produced federal and state proposals to import drugs from Canada. Those ideas aren’t popular in Ottawa, where many worry that bulk buys from the United States could cause shortages or drive up prices.
Barry Power, director of therapeutic content with the Canadian Pharmacists Association, said they’re tracking U.S. drugbuying proposals and reports of cross-border trade closely, but has yet to see a disruption to Canadian insulin supplies.
He said insulin prices in Canada are controlled through policy, including price caps and negotiations with manufacturers.
“This is something the U.S. could do,” he said.
When the Canadian scientist Frederick Banting co-discovered insulin in the early 1920s, he balked at commercializing it because it seemed unethical to profit from a critical drug. He sold his share of the patent to the University of Toronto for $1, in the hope the drug would remain widely accessible.
In the nearly 100 years since, insulin has become a lifeline for millions. But the price in the U.S. has surged.
A spokesperson for the Pharmaceutical Research and Manufacturers of America noted that drug companies are increasingly offering rebates on insulin — but they aren’t always reaching consumers.
“Too often, these negotiated discounts and rebates are not shared with patients, resulting in the sickest patients paying higher out-of-pocket costs to subsidize the healthy,” PhRMA spokesperson Holly Campbell said in an email.
In the United States, you can buy some types of insulin without a prescription. But to get the newer analog insulin on which Type 1 diabetics rely, you need to visit or call your doctor.
If Nystrom forgets to pack enough for an extended trip, she said, she needs to get her endocrinologist on the phone. In Canada, she can get the analog insulin she needs.
“I don’t think that the solution is going outside the United States,” Greenseid said. “The reason they have lower prices is because they have put in regulations to make sure their citizens are not paying too much. We have not yet made that decision in the U.S.”