Insulin isn’t affordable for many Americans. That may be a human rights abuse, report says.

The cost of insulin has sparked hearings in Congress and they are calling for changes in diabetics and patient advocates. However, for many Americans who depend on medication, it remains out of reach, and this contributes to human rights abuses, according to a new report by Human Rights Watch, a better-known organization for investigating war crimes. and atrocities such as genocide.

The problem is specific to the United States, given the country’s lack of control over drug prices and the complex insurance system that can leave people uninsured or uninsured, according to the control group.

Other nations pay much less for life-saving medication, with a congressional report finding that Americans pay about three times the cost of a dose of insulin compared to 11 other developed countries.

The three major pharmaceutical companies that control the insulin market, Eli Lilly, Novo Nordisk and Sanofi, have significantly increased the prices of their analogue insulins since they introduced their products more than two decades ago. Analogs, which are synthetic versions of insulin, control blood sugar better than so-called human insulin, and now account for more than 90 percent of the market, according to the center-right American Forum of Action.

Eli Lilly’s list price for Humalog, his analog insulin product, has risen 680 percent to $ 275 a roadside in 2018 since its introduction in 1996, Human Rights Watch said.

The cost of Novo Nordisk Novolog has increased 400% to approximately $ 289 per road since it was introduced in 2000, while the list price of Sanofi has increased 420% to $ 276 per road since reached the market, also in the year 2000, according to the report. All numbers adjust to inflation.

“Almost every insulin-dependent person interviewed by Human Rights Watch said they had rationed analog insulin because of the cost of the pocket, taking it in ways not recommended by their doctor in order to expand their supply,” he said. the report.

The result can be illness and even death, as in the case of Alec Smith, who struggled to pay for his insulin after aging from his mother’s health insurance plan.

The 26-year-old could not afford the cost of his insulin pocket, produced by Eli Lilly, and died of diabetic ketoacidosis, a complication of diabetes that can be treated with insulin. He died a month after leaving his mother’s insurance plan.

Insulin manufacturers “know that people are dying, that people can’t afford it,” Sa’Ra Skipper, a diabetic, told Human Rights Watch. Her sister, also diabetic, was hospitalized for diabetic ketoacidosis after sharing her insulin with her because of the cost.

Eli Lilly, Novo Nordisk and Sanofi did not immediately return comments.

“A privilege that many cannot afford”

Of course, insulin is not the only drug that has experienced a sharp rise in prices, and Human Rights Watch noted that access to life-saving drugs is often a “privilege that many cannot afford.”

But people who are most affected by high drug prices are “socially and economically marginalized, reinforcing existing forms of structural discrimination.”

For example, lower limb amputations are a risk of diabetes, but black adults are more than twice as likely to have a diabetes-related amputation as white adults, the report notes. Hispanic and black diabetics are also more likely to ration insulin than white patients, he added.

The U.S. does not regulate drug prices, which has allowed pharmaceutical companies to “set very high prices,” the report notes. But he said there is some fault pharmacy benefit managers (PBM): Powerful intermediaries in the healthcare market who manage which drugs are covered by insurance companies.

Pharmaceutical companies compete to be included in PBM formulas, or in the list of covered drugs, by offering so-called “discounts” or cash payments provided by drug manufacturers to PBMs. But pharmaceutical companies are raising higher list prices to make sure they don’t sacrifice the end result, the report notes.

“Violation of domestic and international law”

So how does this contribute to human rights abuses? Human Rights Watch says insulin is so expensive in the United States that it undermines “equal and affordable access [to essential medicines]a cornerstone of the human right to health “.

The impact on disadvantaged groups is “in violation of national and international law prohibiting discrimination,” he added.

Several human rights agreements that have been signed or ratified by the U.S. are also being violated by the high cost of insulin, the group said. He praised the US government for its “continued failure” to implement policies that would limit the soaring cost of insulin. But it also has words for drug makers.

“Businesses also have a responsibility, under the United Nations Guiding Principles on Business and Human Rights, to respect human rights and to ensure that their practices do not cause or contribute to human rights abuses,” Human Rights Watch said. .

But the most important step could be taken by lawmakers, the group said: “Congress should consider legislation to provide insulin to all insulin-dependent people in the country for free.”

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