Insulin is an essential medication for the more than seven million Americans with type 1 diabetes. Over the last two decades, its price has increase exponentially. Despite minimal advancements in formulation or efficacy since the 1990s, the cost for insulin has surged by as much as 1,000%. These steep price hikes, which are occurring even as the actual production costs remain relatively stable, have placed increasingly large financial burdens on self-funded payers who are forced to outlay millions of dollars annually to cover the costs of overpriced insulin and other diabetes medications for health care plan members.

In the last 10 years, spending on insulin in America has tripled, increasing from $8 billion in 2012 to $22.3 billion in 2022, prompting medical providers and patient support organizations, including the American Diabetes Association, to push for solutions to the insulin affordability crisis. Likewise, newer diabetes medications such as Ozempic and other Glucagon-like Peptide-1 Receptor Agonists (GLP-1 RAs) are stunningly expensive to the point that the Senate HELP Committee recently launched an investigation into these "outrageously high prices." 

The insulin market is highly concentrated, with three manufacturers — Eli Lilly, Novo Nordisk, and Sanofi — dominating nearly 96% of the global market. Additionally, three major pharmacy benefit managers (PBMs) — CVS Caremark, Express Scripts, and OptumRx — control more than 80% of all prescription drug sales in the U.S. This concentration of market power has raised serious questions about anti-competitive practices and lack of pricing transparency.