Out-of-Pocket Expenses and Rationing Survey

People with diabetes are paying too much for the insulin and supplies that keep them alive. Many are forced to ration medicine they cannot afford, putting their health and lives at risk. T1International has been running this survey since 2016 to see hwo big this problem is, using real numbers from real people.

Our 2024 survey found that people with diabetes spend an average of almost 12% of their income on insulin and glucose monitoring supplies alone. More than a third of people surveyed said they had rationed supplies in the past year because of cost.

This data gives advocates, governments, and journalists the proof they need to push for change. Numbers from our own community make it impossible to ignore the scale of this crisis.

Background

2016: The First Survey

T1International ran the first global out-of-pocket cost survey for people with diabetes, asking about insulin use, delivery methods, and the real costs of insulin, test strips, and other supplies. This survey set the foundation for everything that came after.

2018: A Growing Picture

Nearly 1,500 people from 90 countries responded to our second survey. The results showed that 18% of respondents had rationed insulin in the past year, and people in the USA paid more for insulin than almost anywhere else in the world.

2020: Insulin Rationing During COVID-19

Our third survey reached 1,066 people from 64 countries and added new questions about the impact of COVID-19. The story stayed the same: 25% of respondents had rationed insulin in the past year, and people in the USA reported the highest costs in the world, averaging $490 a month.

2022: Published in a Peer-Reviewed Journal

Our fourth survey was published in the Journal of Diabetes Research and Clinical Practice (opens in a new tab) in 2024, giving this community data the same credibility as clinical research. The results confirmed that out-of-pocket costs remained highest in the United States, and that COVID-19 continued to disrupt access to insulin and supplies worldwide.

2024: The Crisis Continues

Our most recent survey found that people with diabetes spend an average of 12% of their income on insulin and supplies, climbing to 64% of income in low- and lower-middle-income countries. More than a third of respondents had rationed supplies in the past year. Read the findings, or download the 2024 report in English (opens in a new tab), French (opens in a new tab), or Spanish (opens in a new tab).