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Individuals most impacted by the rising cost of insulin are the uninsured and the under-insured. These patients are forced to pay the ever-increasing retail sale price (which is increasing due to a variety of factors, including increased wholesale price) or a percentage of this price when buying insulin.
Another way drug costs rise is when an insurer, working with its pharmacy benefit manager (PBM)âa middleman company that manages drug benefits for insurersâchanges the way it covers drugs. A PBM may stop covering some specific medications from its list and move others to higher, more expensive âtiers.â