THE PRICE OF LIFE: Unraveling the Causes and Consequences of Diabetes Healthcare Costs in the United States and Beyond

Abstract

This thesis provides an in-depth analysis of the escalating global diabetes crisis, with a particular focus on the comparative cost of diabetes care in the United States versus Canada, France, the United Kingdom, and Germany. The initial research question was as follows: How does the cost of diabetes care in high-income countries differ on a country-by-country basis and how does this variation affect the livelihoods of diabetic populations from such countries? This project aims to uncover how disparities in healthcare systems and the pricing of essential diabetes care – especially insulin – affect patient outcomes and quality of life. Through a mix of quantitative data on diabetes prevalence and healthcare expenditure, alongside qualitative insights from interviews with diabetic patients and healthcare providers, this thesis explores the complex interplay between healthcare infrastructure, insurance coverage, and the accessibility of diabetes treatment. The research highlights the stark contrast between the United States’ fragmented and high-cost care and the more equitable and lower-cost care found in the comparison countries. For example, in 2018, insulin cost an average of $98.70 per vial in the United States, $7.52 in the United Kingdom, $9.08 in France, $11 in Germany, and $12 in Canada. This thesis argues that these disparities are largely due to the unique structure of the US healthcare system, which is characterized by a reliance on private insurance and a lack of price regulation for pharmaceuticals. This situation has led to significant out-of-pocket expenses for diabetic US patients, impacting their adherence to treatment and overall health. This paper culminates in proposing targeted policy recommendations for both states and the federal government that aim to reform the US healthcare system and reduce the financial burden on diabetic patients. These include the expansion of insulin price caps, partnerships for affordable diabetes supplies, and comprehensive legislation to ensure that a wider range of diabetes care is covered at a manageable cost. By drawing on successful strategies from the comparison countries, the thesis presents a path forward that could lead to more equitable and effective diabetes care in the United States.