Insulin Crisis: Skyrocketing Costs, Inequitable Access, and Pharma Manipulation in Massachusetts Universities

The soaring cost of insulin continues to impose an overwhelming financial strain on millions of Americans, including those covered by university healthcare across Massachusetts. Although the state has made strides by capping insulin copays at $25, several individuals remain unprotected, especially since this policy only applies to those with state-regulated insurance plans. Students, faculty, and staff with self-funded university insurance are notably left exposed to unjust pharmaceutical pricing. 

A 2022 study by Yale University found that one in four people with diabetes had to ration their medication due to its prohibitive cost. Other research also revealed that 14% of insulin patients spend more than 40% of their income on this essential drug—an unsustainable financial burden that seriously impacts the most vulnerable. For many in the university setting, this translates to harrowing choices between life-saving insulin and other necessities.

This crisis is particularly evident in Massachusetts, where about half a million residents have diabetes, and 1.8 million are considered pre-diabetic. Many of them depend on insulin for their survival but face exorbitant monthly costs because of artificially inflated list prices. Such a dire situation has prompted the state to lodge a lawsuit under the insulin multidistrict litigation (MDL) against pharmaceutical companies and pharmacy benefit managers (PBMs) for engaging in anti-competitive practices that drive up insulin prices. This ongoing legal battle sheds light on how these entities control the pricing system for profit. Universities—many of which serve as plaintiffs—have a vested interest in this issue as this has affected their healthcare systems and their constituents in general.

Even though Massachusetts has earned recognition for its healthcare reform efforts, university healthcare statewide continues to face challenges due to a system prioritizing profit over patient well-being. Despite insulin’s low manufacturing cost—just $2 to $4 per vial—consumers are often charged hundreds of dollars. This price disparity prompts universities to reallocate intended funds to cope with the increasing healthcare costs. As a result, premiums rise while budgets for critical resources are cut. Those struggling with these costs are also forced to ration their medication. Yet such a practice poses serious health risks—ultimately affecting student academic performance and faculty productivity.

Massachusetts universities play a critical role in advocating for systemic change. They should use their influence to help the government push for greater price transparency and direct negotiations with pharmaceutical companies. In addition, they should support legislative reforms expanding insulin price caps to include self-funded healthcare plans. If institutions genuinely stand for equity and progress, they should demonstrate their commitment where it matters most—ensuring that no one in their community is priced out of the care they need.


About the Author

Yahn Olson is an attorney at the Environmental Litigation Group P.C., a Birmingham, AL firm dedicated to assisting victims pursue toxic exposure lawsuits.