A study finds that 14% of people who use insulin in the US face “catastrophic” levels of spending on insulin.

That means they spent at least 40% of their post-subsistence income—or what is available after paying for food and housing—on insulin.

Over 30 million Americans have diabetes, and more than 7 million of them require daily insulin. But the cost of the drug has risen considerably in the last decade. Though US lawmakers are considering policies to address the challenge, not much is known about who is most burdened by insulin prices.

The study in Health Affairs provides much-needed data on Americans who use insulin, whether and how they’re insured, and who is most at risk of extreme financial burden.

In 1996, when the pharmaceutical company Eli Lilly debuted its Humalog brand of insulin, a fast-acting type of insulin, a vial cost $21. “Now it costs more than 10 times that,” says senior author Kasia Lipska, an associate professor at Yale School of Medicine.

And it’s not just Humalog. Insulin list prices, on average, have more than doubled in the last decade. “This is not inflation, there’s much more going on,” Lipska says.

Much of the rising costs can be attributed to supply chains that have become more complicated, the researchers say. Each step added to the chain means another entity is collecting profits, leading to higher costs for patients dependent on insulin.

“And we have no reason to believe that will change anytime soon,” says lead author Baylee Bakkila, a medical student at Yale School of Medicine.

Read the full article about insulin by Fred Mamoun at Futurity.