Some know Serena Williams as a contender for the title of greatest women’s tennis player of all time, others as a four-time Olympic gold medalist and now some as the face of Ro, a GLP-1 weight-loss medication.
The original purpose of GLP-1 medications like Ro and Ozempic was to treat Type 2 diabetes. Once their weight-loss properties were popularized, though, it was game, set, match: celebrities and regular people alike flocked to pharmacies, leaving diabetics behind in the three-year-long shortage and consequential price hikes. This is part of a greater American failure to regulate and negotiate pharmaceutical pricing, especially for diabetics.
In 2022, America’s average insulin prices were nearly 10 times those of 33 other countries in the Organization for Economic Co-operation and Development. When 11.6% of Americans and 13.1% of those below the poverty line are diabetics as of 2021, this is a problem.
It is also not uncommon to see “diabetic supplies for cash” signs hung on utility poles across Atlanta or across other major cities. It makes sense: some diabetics have extra medication or equipment, and others are in need. Some resellers even sell test strips back to pharmacies and doctors. Thanks to this, there is a “thriving underground trade” with blurred legal and safety lines that need to be redrawn. After all, selling equipment like glucose test strips is legal, but selling actual medication is not, even though both can be dangerous.
People also don’t typically end up with extra supplies coincidentally. Of course, resellers sometimes have extras from federal health insurance, but other times, they’re intentionally not testing themselves enough to save medication and money. This falls in line with the pattern of 36% of adults with prescriptions delaying or rationing their medication and 1 in 5 diabetics rationing their supplies for financial reasons.
The World Health Organization also issued a warning in 2024 about increased rates of falsified semaglutides, a chemical found in GLP-1 products, caused by shortages. President Donald J. Trump, however, initiated withdrawal from the WHO on his inauguration day. This, combined with funding cuts to the Centers for Disease Control, raises concerns over similar corners being cut that may now go unnoticed.
Still, when so many Americans need these supplies to survive, their options are limited. Policies like former President Joe Biden’s $35 insulin price cap for Medicare recipients are imperfect, but a step forward. Greater leaps need to be made to help diabetics rationing insulin, 71% of whom are ineligible for the price cap. Taking a page from Europe’s playbook and negotiating directly with pharmaceutical companies could save lives.
Unfortunately, even Biden’s Medicare price-capping and drug-cost-reduction policies are at risk. Trump reversed initiatives to reduce drug costs for Medicare and Medicaid recipients on his inauguration day, further damaging America’s ability to negotiate prices. Just three days earlier, Medicare had announced the next set of drugs to be negotiated, including GLP-1 medications like Ozempic and Wegovy.
Trump has since shifted from his position on limited government intervention with pharmaceutical pricing and aims to match the prices other countries receive. His first victory was a September negotiation with Pfizer to lower prescription drug costs, and he has made it a goal to launch a “TrumpRx” website where Americans can buy cheaper medication. While this appears to be good news, it does raise the question of why Trump removed Biden’s policies in the first place. If reinstated, wouldn’t Biden’s policies further advance Trump’s goals?
California governor Gavin Newsom took similar action in October by launching the “CalRx” program, in which the state of California will sell price-capped insulin. Like the efforts of Trump and Biden, it’s significant progress, but doesn’t offer equity across the nation.
To guarantee help for all American diabetics, it is vital that Trump and other politicians take consistent action. In his first term, Trump emphasized lowering drug prices, but his actual progress was limited. His stripping of Biden’s policies just to create his own months later makes his efforts look all the more unstable. For real change, action must be widespread and consistent.
Some may say the main issue with Type 2 diabetics is the lifestyle that led them to the disease in the first place, not the prices they’re now faced with. Although those choices and circumstances are certainly worth studying, they’re often systematic and don’t change the facts. Diabetics are here now and they need help. Price negotiations and programs can provide that, and the federal government needs to deliver better healthcare equality.
