T1International Releases Report on Rationing and Cost Survey Data

T1International Releases Report on Rationing and Cost Survey Data

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LONDON – On June 18, T1International released the findings of its 2018 Out-of-Pocket Costs Survey. The survey included questions focusing on the price of insulin, test strips, and other diabetes management tools, as well as rationing, assistance with costs received, and healthcare coverage, the survey reflects the broad range of out-of-pocket costs that people with type 1 diabetes face worldwide. The 2018 survey had a total of 1,478 respondents from 90 countries.

Results found that dangerous and potentially fatal insulin rationing is widespread globally, with 18.0% of all country respondents having rationed insulin at least once in the previous year. It also found that respondents from the USA paid more by the dollar for insulin than almost any other country and that 25.9% of U.S. respondents reported having rationed insulin in the previous year. This confirms similar findings from previous smaller-scale surveys that one of every four people in the United States have had to ration insulin.

Elizabeth Pfiester, T1International Founder and Executive Director, shared her thoughts about the survey results: ‘‘Our survey confirms that globally, rationing insulin is all too common. It also confirms what many already know: respondents from the USA, one of the wealthiest countries in the world, had the highest degree of rationing of insulin and supplies compared to other high-income countries.”

Blood glucose strip rationing was also found to be common, according to the survey, with 33.5% of all respondents reporting having done so, and 38.6% having rationed in the USA. A staggering total of 66.6% reported that they had no financial coverage whatsoever for their out of pocket diabetes costs. Government assistance was reportedly more common in high-income countries (30.8%) compared to low-income countries (7.8%) while in the USA, only 5.5% of respondents noted that they benefited from government assistance.

One USA respondent framed the situation that many face, saying, ‘‘I can't afford a home. Most of my salary goes toward diabetic supplies. I have to ration everything.’’

Another said, ‘‘I’ve met my deductibles, only to later fall into the ‘donut hole.’ I feel like I’m speeding through life at 90mph, and I’m just trying to find the next opportunity to breathe. I don’t feel like I even know what’s going on half the time, which I think is what the intent of our healthcare system is. I just take as little insulin as possible to stretch my supply.’’

“We are glad to be able to put more concrete numbers on a crisis that we know is taking too much from people living with diabetes - not just lives, but piece-of-mind, financial security, and so much more. It is a disgrace that more is not being done about this global crisis, but T1International will keep advocating to ensure it ends,’’ said Pfiester.

More data, information and comments from the 2018 survey can be found at:

Questions about T1International or the survey can be directed to Elizabeth Pfiester by email at

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