INS and diabetes mellitus: The hardships imposed by high and escalating insulin prices have drawn particular attention; 7.6 million Americans use insulin to manage their diabetes.2 Medicare Part D plans alone spent $13.3 billion on insulin in 2017, up from $1.4 billion in 2007.3 Meanwhile, list prices for insulin—which are reflected in out-of-pocket (OOP) costs for the uninsured and for those with insurance before they meet their annual deductible—increased more than 250% between 2007 and 2018.4 High OOP costs contribute to medication non-adherence and insulin rationing, and even, reportedly, to several deaths.5–7