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T1International Out-of-Pocket Expense Survey

Download T1International's 2024 Out-of-Pocket Expenses and Rationing Survey
Background

In 2016, T1International carried out our first global out of pocket cost survey for people with type 1 diabetes. We asked respondents to answer questions regarding insulin utilization, insulin delivery methods, and out-of-pocket costs for insulin, test strips and other diabetes management tools. 

In 2018, we improved the survey, learning more the situation for people with type 1 diabetes around the world, and growing our response rate. The majority of the data can be viewed in the visualizations and graphics at the above link.

In 2020, our third iteration of the survey, we added additional questions about the impact of COVID-19, and focused on US rationing and healthcare coverage results as they compare to those of other countries. Results were published as a research paper in the Journal of Diabetes Research and Clinical Practice. 

In 2022, we continued investigating out of pocket expenses, rationing of insulin and diabetes testing supplies, and more. Our results compared Canada, Germany, India, Panama, Sweden, the United Kingdom, and the United States. Results were published in Frontiers in Clinical Diabetes and Healthcare in 2024.

In 2024, we offered the survey in five languages (English, Arabic, French, Spanish, and Swahili) and compared self-reported data on insulin and glucose self-monitoring supply rationing against previous years' data, and compared our data to World Health Organization (WHO) affordability metrics, as well as percentage of income spent, budgeting adjustments made, and access challenges. 

The insulin crisis isn't over - but you can help with a gift that powers the fight for #insulin4all.
Why does this data matter?

It’s not over. Despite global attention and promises of action, the insulin price crisis continues—and for many, it’s getting worse. This report compares self-reported data on insulin and glucose self-monitoring supply rationing, percentage of income spent, and access challenges against previous years’ data, as well as World Health Organization (WHO) affordability metrics. Our findings make it clear: the crisis of access and affordability for people with type1 diabetes is far from over.

This study highlights the significant financial burden that people with type 1 diabetes face in the absence of full healthcare coverage and associated rationing of insulin and other diabetes supplies. Even in this sample of participants from mostly high-income countries, over a third rationed insulin and glucose self-monitoring supplies.

We know that patients are spending an unsustainable amount for the medicine and supplies they need to simply stay alive - on average, almost 12% of their income on insulin and glucose monitoring supplies alone. That's why we're Fighting for Five. Our community is advocating globally for a world where the cost of insulin and glucose testing supplies represents no more than 5% of a person’s income in any given country.