February 17, 2020
The surging cost of insulin is forcing many people with diabetes to consider purchasing the life-saving medication from alternatives sources – like Craigslist.
To be sure, the discounts are there.
Analog insulin, including Humalog, Lantus and Novolog, costs hundreds of dollars less on the online marketplace, according to a study published Monday in JAMA Internal Medicine. Human synthetic insulin also is considerably less expensive.
The illegal market's existence is evidence of a broken health care system that forces some diabetics to make risky purchases just to stay alive, researchers say.
"It calls for policy change," said Rosemarry Frasso, a qualitative research scientist at Thomas Jefferson University. "There are some states where they cap it at $100 per month. Illinois has just done that. Something has to be done.
"The unregulated resale of prescription drugs isn't legal – and in this case can be really dangerous. We're not sure who is buying it, but it's worrisome. It's a cry for policy change."
The retail cost of the four most-popular insulin medications more than tripled between 2007 and 2017. For instance, the monthly wholesale price of Humulin, a short-acting insulin, increased from $258 in 2010 to nearly $1,100 in 2015.
Others, as researchers found, are turning to secondary markets online. And that's a risky place to buy medications.
Secondhand purchases carry a considerable risk of contamination, said Dr. Jennifer Goldstein, program director for clinical research at ChristianaCare in Delaware. Additionally, insulin must be stored at an appropriate temperature – a particular concern when it is shipped – to maintain its potency.
"You have no idea what you're buying," said Goldstein, who has treated many patients hospitalized by a diabetic crisis that stemmed from an inability to afford their insulin. "You have no idea what you're getting. And that's the greatest danger."
Over a 12-day span last summer, researchers found 432 Craigslist advertisements selling insulin and albuterol, an asthma medication. The listings stemmed from 240 cities in 31 states. About 75% involved insulin.
The average price per vial of analog insulin was $372.30 cheaper than the retail price listed on Drugs.com. The average vial of human synthetic insulin was $123.19 less expensive.
"People need this life-saving medicine," Frasso said. "If they're resourceful, they're going to find a way to get it. But Craigslist is an unregulated marketplace for this. Folks are taking a risk by purchasing insulin in this way."
Researchers found that many sellers came with altruistic intentions. Some sold their remaining insulin when their prescription changed, knowing other diabetics are in need.
Such sales are against Craigslist policy – in addition to being illegal. And though the buyer assumes some risk, researchers fear that consequences could be worse if greater enforcement is taken.
That's why they're pushing for policy changes to ensure all diabetics have access to insulin.
"Patients should not have to go to Craiglist to find affordable insulin," Goldstein said. "We need to find a solution to the insulin cost crisis."