Today is World Diabetes Day. For my #diabetic fiends, I see you and I am here with you. We deal with so much in the margins of “typical” living. I love and fight for you all.

I want to share a project I completed for @powersoffour and @KateNarrative's data storytelling course...

...at @iSchoolUI: a tale of two rents (an #NDAM thread)

If you’re reading this, there’s a non-zero chance you don’t think about where to get your insulin. But for me and the ~7.4 million insulin-dependent diabetics (of multiple types), we get ours at a pharmacy counter.
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People w/ #t1d go through about 3 vials of insulin a month. Insulin costs $175, $250, $300, $392, $450, $500–– it depends on type, delivery mechanism, etc. The overall rule: cheaper = more difficult to use, so older insulin’s less than newer ones, vials more than pens.
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Insulin costs $6 to produce.

Which means Eli Lilly, Novo Nordisk, and Sanofi–– the big 3, producing 90% of the world’s insulin–– make at least a 2816% profit for the hormone your body produces naturally.

We #PWD pay way too much on insulin. It wasn’t always this expensive.
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Being diabetic didn’t always cost this much.
It doesn’t have to be this hard.

Below, you’ll see the first of a series of pie charts depicting a monthly budget. I created those charts, and they’re based on the following details and data:
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–at $7.25/hour, it’s currently impossible for people with diabetes to support themselves on a full-time minimum wage job.
–at $7.25/hour, it’s currently IMPOSSIBLE for people with diabetes to support themselves on a full-time minimum wage job.
–at $7.25/hour, it’s currently
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...IMPOSSIBLE FOR PEOPLE WITH DIABETES TO SUPPORT THEMSELVES ON A FULL-TIME MINIMUM WAGE JOB.
–bc it’s IMPOSSIBLE, monthly income is assumed to be double full-time minimum wage salary; for character count reasons, I use (2xFMW) in the following tweets
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–the percentage spent on insulin assumes 3 vials/month, given that’s the average for people w/ #t1d
–the cost of rent used is based on national (US) averages
–the specific insulin I reference is insulin lispro (Humalog), but suffice to say it isn’t an outlier in cost
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–Finally, –I used insulin data from @lollydaggle, rent data from the US Census, and FMW data from the US Dept. of Labor.

In 2000, I was 8 and eagerly awaiting @ChaoticVagrant’s arrival in the world.
I wasn’t yet diabetic.
Insulin was affordable for most, at $29.72/vial.
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In 2001, when Lantus premiered on the market, insulin cost $37/vial. Still affordable at 6% monthly budget, but would you be okay paying $37 for a gallon of milk?
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In fact, during the early 2000s, it wasn’t insulin but rent that spiked in cost. By 2005, it would be 1/2 a monthly budget; yes, that means the avg. rent = an entire month’s minimum wage salary. But in 2002, it was still close to the recommended percentage (⅓ salary).
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In 2003, I was dx'ed with type 1. I was 11, and I took the diagnosis like a champ. I was lucky, too, because I was insured before my diagnosis–– it would be over a decade before #diabetics like me would be guaranteed protection against medical history-based discrimination.
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In 2004, insulin cost $55/vial. Still affordable, but with rent at a whopping 46% monthly budget, I’m sure many looked askance at their insulin and wondered how to cut back.
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By 2005, people with diabetes spent 60% paying two rents: the first for their body, the second for their home. Both were rising in cost, while the minimum wage remained stagnant–– and thus, the opening throes of the insulin crisis.
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Many, including those in the #DOC would believe the insulin crisis is only about insulin, but it’s not. The insulin crisis evolved out of a collection of difficult situations and their worst-case outcomes. It is therefore not JUST about insulin, but also about minimum wage...
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...and about rent, and about healthcare. We only call it the insulin crisis because that’s what differs between you and I.
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In 2006, the situation worsened. #Diabetics paid 62% in rent, leaving a measly 38% of their budget for
–heating and cooling
–water
–garbage removal
–a landline
–groceries
–clothing
–syringes
–glucometer test strips
–other medical supplies
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There was a brief reprieve in 2007. My family had moved, and I was eating again. I wasn’t cutting anymore. Insulin was still rising in cost, but the minimum wage rose, too–– for the first of three changes over the coming years.
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But the reprieve wouldn’t last. The housing bubble burst in 2007, and people lost their homes, their jobs. While this played out in the US, @LillyPad laid plans to increase their revenue off insulin.
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(To put that in 2020 terms: that would be like toilet paper suppliers charging $50/roll while people were laid off and furloughed due to #COVID19)

I started looking for colleges in 2008. I was 16. Insulin cost $87/vial–– $261/month. Imagine buying an iPod every month.
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In 2009, I started my first #library job. I made $175/paycheck IF I could make it to every shift–– which with a chronic illness, wasn't the case. Insulin was $93/vial. I couldn’t buy two vials with a paycheck.
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In 2010, I graduated high school and started college. My dad went down to working like, 8 hours a week–– rocket scientists weren’t in high demand when the economy was in crisis.
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Many think the insulin hikes started as a result of the ACA, but I’m not convinced. These spikes (atypical, even considering inflation) started before the ACA was passed. They weren’t the decisions of a company floundering in the wake of new demand.
They were deliberate.
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In 2011, I drove to Birmingham for one last visit with my pediatric endocrinologist. I was 19. I remember the kind Black woman who discovered I’d be paying out of pocket for the visit–– my family had lost our health insurance with dad’s job–– and made sure...
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... I left with enough insulin and supplies to last me the year. That gallon bag cost more than my car.

It was the same drive during which my friend asked if I needed him to investigate black market insulin.
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In 2012, @victorBradIey proposed and I said yes.
My monthly insulin––~$350–– cost more than the engagement ring he bought for me, with his first #library paycheck.
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In 2013, we began looking for grad programs. We knew we couldn’t support ourselves with our impending humanities degrees alone. Insulin cost $154/vial.

That was the year a doc told me I could “stop worrying” about the cost , and made a show of marking the noncompliant box.
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In 2014, we married in my parent’s backyard. My friends made the food, and our “DJ” was a kid with Spotify. We honeymooned in Chattanooga.

My insulin cost $558/month, $58 more than we spent on the entire wedding.
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In January 2015, I was still dependent on my parents for my medical costs. By June, I stopped using my pump to sever financial dependence on them–– they often used it to control me, to emotionally and mentally abuse me. *My* insulin cost

$5.
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It cost $5 through @Illinois_Alma's medication subsidization plan. I wept. The List price was $223.

The cost of insulin had risen so much by 2015 that Humalog earned Eli Lilly nearly 20% of the company’s ENTIRE YEARLY REVENUE.
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In 2016, the list price of insulin was $256. #PWD could expect to spend $770 OR MORE on insulin, because of extra companies involved in getting insulin into patient hands. The insulin had not changed. I’ve taken Humalog every day since May 5, 2003.
It
has
not
changed.
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The cost continues to spike, even as the medication remains the same. Yet, @LillyPad insists that their company “respects people” even while they extort us.
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The existential horror 2016 ushered in hurt our bodies. Every comorbidity I’ve developed has happened since November 2016. Our blood sugar rises with stress; what do we do when we can only afford a set number of dosages?
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How do we get ourselves out of poverty, if we can’t even afford to get ourselves out of bed?
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We did nothing to deserve this. No one–– #diabetic or not, ethical/moral or not, no ONE–– deserves to spend $807 to wake up each morning.
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In 2019, the average entry-level salary for college grads was the EXACT SAME as double the federal minimum wage. It’s also pretty close to what my partner made as a rural #librarian WITH A MASTER’S DEGREE.
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To see a more in-depth monthly budget for recent grads, look at https://drive.google.com/file/d/1Wvb6gxJqxdcZH9qfFuSFerUyE9028z_j/view?usp=sharing
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To work 2 min. wage jobs and still only have 26% of your salary to pay for EVERYTHING other than insulin and rent is horrific.
To go to college for four years, to accrue that debt, and only have 26% of your salary to pay for EVERYTHING other than insulin and rent is horrific.
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When people shit on millenials and gen-z (zoomers), this is what I think of. It’s a miracle @victorBradIey and I can live independently of our families, for the costs levied at us because of my body.

We’ve not always been able to.
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1 in 4 people with diabetes report having rationed or currently rationing their insulin (have you ever thought about rationing your blood? your oxygen?) and I’m one of them. We had to make a GoFundMe to pay for my health insurance, and it still wasn’t enough.
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This is the insulin crisis.
This is why we need #insulin4all.
This is why we need #MedicareForAll, a $15 min wage, #UniversalBasicIncome, and student loan forgiveness.

If there's even ONE person in our community struggling to afford insulin, then we've got some work to do.
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