Human insulin as effective as costlier insulin analogs in diabetes

"For decades, people initiating insulin treatment were prescribed human insulin," said Andrew J. Karter, senior research scientist with the Kaiser Permanente Division of Research. "Then in the 2000s, a new generation of long-acting insulin analogs emerged that were designed to mimic human insulin."

"The problem is that insulin analogs are much more expensive than human NPH insulin," said Lipska. A vial of insulin analog now costs about $200 to $300, while a vial of NPH insulin costs just $25. Dr. Karter's research has shown that high out-of-pocket cost of medications, especially at the time of initiation, are linked to poorer adherence, which directly affects outcomes for diabetes patients."

"The cost differential between analog and NPH insulins is huge, up to a 10-fold difference," Karter said. "Some people with type 2 diabetes may find the potential benefits of insulin analogs worth the additional cost. But we found no population-level evidence to suggest that the extra expenditure is warranted for most people with type 2 diabetes, particularly when the high cost could prevent some of them from getting the treatment they need or divert resources away from other, potentially beneficial clinical interventions."