Meanwhile, in the U.S., the climbing price of insulin has lit up both Capitol Hill and the 2020 presidential campaign trail, especially as voters call high-out-pocket costs their biggest health care concern, according to a June 2019 Kaiser Family Foundation poll. In fact, German diabetes patients have some of the lowest out-of-pocket costs in the world for insulin, according to T1 International, an advocacy group for people with type 1 diabetes. After you hit the limit, the plan pays the rest that’s why West’s insulin costs are so low.
For those without such a condition, out-of-pocket costs are capped at 2%. For people with chronic conditions-like West-the out-of-pocket limit is set at 1% of household income. German law requires public plans to cap out-of-pocket health care costs, and to cover all medically necessary treatment, including insulin. One option they do have, however, is to negotiate lower prices on prescription meds with drug manufacturers. The panel sets a maximum price that insurers will pay for these medications―a practice known as “reference pricing.” Since most German residents are on public health insurance plans, and these plans are tightly regulated, there aren’t many ways for insurance providers to compete with one another. Drugs serving a similar purpose or delivering the same benefit get grouped together. When a new drug comes to the German market, an independent panel assesses its effectiveness and whether its treatment value is commensurate with the manufacturer’s proposed price. Germany has an easier time financing prescription coverage because these drugs cost less there. But in exchange, the coverage-including that of prescription drugs-is generous. She pays for that benefit: maybe a third of her paycheck is withheld each month for taxes, health care and other social services. West, like 90% of German residents, is on one of the country’s many public insurance plans, which are administered through non-profit insurance companies. has no such system in place, and last year some 13.2% of the 2.9 million people who took insulin in the country did not take it as prescribed, and 24.4% asked their doctor for a lower-cost medication, according to the Centers for Disease Control and Prevention. Germany is one of many Western nations, including England and Canada, which empower their governments to actively negotiate prescription drug prices, in turn holding consumer costs in check. The price of insulin has increased globally in recent years, but no wealthy country has felt the impact as acutely as the U.S., where the cost has more than doubled since 2012, going from on average $344 per prescription that year to $666 in 2016, according to the Health Care Cost Institute, and continually climbing since. “There is not a day I ever have to worry about if I can pay for something, or manage something.” In Germany, she pays about €10, roughly $11.
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