Where are you getting that "well-insured patients owe nothing or a co-pay of $20 to $35 a month for insulin"? I have top tier private insurance (university job), and I have consistently paid between $50 and $60 for my insulin since 2012. That was the year most US insurance companies made insulin a "Tier 2" drug subject to coinsurance, where the patient pays a percentage (typically 20%) of the medication's list price as opposed to a flat copay. In my experience, this pattern is remarkably consistent across insurance companies.

Where are you getting that "well-insured patients owe nothing or a co-pay of $20 to $35 a month for insulin"? I have top tier private insurance (university job), and I have consistently paid between $50 and $60 for my insulin since 2012. That was the year most US insurance companies made insulin a "Tier 2" drug subject to coinsurance, where the patient pays a percentage (typically 20%) of the medication's list price as opposed to a flat copay. In my experience, this pattern is remarkably consistent across insurance companies.

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