What is the true financial cost of living with diabetes? Unfortunately, that depends on where you live.
As part of the Happy Diabetic Challenge to raise awareness for diabetes, I included the cost of living with diabetes as a prompt. This can be taken multiple ways, the physical toll diabetes takes on someone with diabetes, the financial costs that diabetes incurs, etc.
For me, the financial cost of living with diabetes has always been of interest to me. It’s infuriating to see that so many type 1 diabetics do not have reasonable financial access to the drugs that keep us alive. And for that matter, the amount of diabetics who do not have access to insulin at all.
For the sake of brevity, I will focus on just a few financial points of what it’s like to live with diabetes in Germany. I will be as factual as I can possibly be. If you would like further documentation, just ask.
In Germany, health insurance is a right, not a privilege. It is mandatory and everyone is insured.
Each month, 300 Euros are deducted from my paycheck. My husband has 255 Euros deducted. As you can see, the costs are similar for each of us. My husband does not have any health issues. There is no such thing as being charged more or discriminated against for having a pre-existing condition. The only thing I pay out of pocket for is insulin and glucagon, all pump and CGM supplies are 100% covered.
There are SO many examples of how affordable health coverage is in Germany, so I will pick three examples: an ER visit, Glucagon, and Insulin.
ER Visit.
I had to visit the Emergency Room when my pump broke and I didn’t have back-up pens with me. Don’t lecture me, it’s a LONG story. What you need to know:
It was one in the morning and my pump broke. I went to the ER to get insulin pens so that I could bridge the time until Monday morning when doctors and pharmacies are available (it was a Sunday). The ER checked my blood sugar a few times, gave me Levemir and Novolog pens, as well as about 25-30 needles to last me through the weekend. The entire experience took about 45 minutes. One important note: I WAS NOT INSURED IN GERMANY FOR PRE-EXISTING CONDITIONS. (Au-Pair/travel insurance is not the same as every-day German resident insurance.) I was absolutely terrified of what the ER bill would be. As it turns out, I had nothing to worry about. The entire experience, without insurance, cost me 32.05 Euro. (See image below with ER bill.)
Glucagon.
It’s the only drug in the world that can save a diabetic’s life in case of a severe low blood sugar. Thankfully, most of us will not have to use one. However, we should all have a Glucagon kit with us at all times. The issue: the price.
In Germany, without insurance, one Glucagon kit costs 32.70 Euro. A prescription is necessary, but it can be purchased without insurance. With insurance, I paid 5 Euros for one Glucagon kit. In the United States, the average selling price is $363. Let that sink in.
Insulin.
In this case, I will reference the newest insulin on the market, Fiasp. As referenced below, five (5) vials of Fiasp, without insurance, cost 199.28 Euro. With insurance in Germany, the cost is 10 Euro. This is compared to the rough average price of $291 for ONE (1) vial in the United States.
Let’s break that down.
Five vials in Germany cost less than ONE vial in the US. One vial in Germany, when broken down, costs 39.86 Euro. In this case, insulin in the US costs more than 7x as much as it does in Germany.
As much as I hate that insulin costs an outrageous and completely unaffordable price in the US, there are places in the rest of the world where there is NO access to insulin.
By standing up and fighting for our rights, we can make a difference. By advocating and educating, we can make a difference.
What is the financial cost of living with diabetes like in your country?
P.S. If you would be willing to share your country’s financial costs related to diabetic supplies, please reach out and send an e-mail to me: the.insulin.type@gmail.com
Factual and evidence based only.
theinsulintype.com 
Hi, I am a student at the Technical University of Berlin, and I will be migrating to Germany in a few months; and I have had type 1 diabetes for about 18 years. I’m taking insulin NovoRapid and Lantus, and I also need a blood sugar test strip. I wanted to know what kind of insurance coverage I should use to cover my insulin cost and what should I pay according to your insurance? I visited your insurance site but unfortunately did not give any explanation about the prices as well as the coverage of diabetes. Please guide me. I need this information as soon as possible
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Hi, I am a student at the Technical University of Berlin and I will be migrating to Germany in a few months and I have had type 1 diabetes for about 18 years. I’m taking insulin NovoRapid and Lantus and I also need a blood sugar test strip. I wanted to know what kind of insurance coverage should I use to cover the cost of my insulin and what should I pay according to your insurance? I visited your insurance site but unfortunately did not give any explanation about the costs as well as the coverage of diabetes. please guide me.
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Hi thanks so much for your information. My daughter is going to live in Germany next year from Australia. Can you please tell me what is a good private health provider in Germany to join her up ?
I would hate her not to have private health insurance and end up in a hospital and cost her a fortune – also for her supplies
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Hi Tracey, not a single private health insurance company would cover me while I was in Germany. I didn’t find a single one that would cover me specifically because of diabetes. When I first moved there, I was an Au-Pair, so I had health insurance through that, but it didn’t cover pre-existing issues. What will she be there for? Perhaps she can organize insurance that way…
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Thank you so much for your post!
I soon will move to Germany and I did know there is a good healthcare system but didn’t really look up the cost of diabetes there. Glad to figure out it is completely affordable. Could you let me know how to get a pump prescripted? Did you have to go to a GP first and have the whole thing set? I come from France and already have a pump but will have to gradually change to the German system and give up my French system.. thanks for your help!
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The prices in Germany that were posted were post German government negotiated prices.
The source used for Insulin in the U S was pre-negotiated prices –
After negotiation, the price in U S is 1.30 for the poor, and in the 40’s U S for the rest of the 86% who bought insurance.
That is because the U S, which is compromised of states, negotiates prices at the state level, and uses insurers to negotiate prices at the state level.
For those who are not looking at a map and the size differanrce – Germany as a nation, fits inside of the state New Mexico, or Montana. Texas is as big as 2 Germanies put together.
Germany is far denser in population as well, which reduces transportation costs. As a nation, Germany has 1/4 the U S population. As anyone who deals with distribution knows – the distance something needs to be shipped adds costs.
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To qualify for insurance “for the poor,” you must make less than 23k a year—for a family of two. I am insured. I paid around $250 for 5 Novolog pens. My insulin pumps cost me $100/month, And if you have an insurance deductible or the insulin you prefer isn’t covered, it will cost thousands more. Monthly CGM supplies with insurance, around $90. Not to mention an emergency visit and paying for insulin out of pocket if there’s an emergency (good luck getting that reimbursed). Oh, and there’s the cost of insurance itself. To avoid that high deductible and to see specialists at an affordable copay, you MUST purchase a good plan. As a consultant, that costs me $600/month. It’s all still worth it considering the out-of-pocket costs I would be paying without insurance.
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Hi, Lots of love from India and Thank you so much for sharing this cost breakup of Type-1 Diabetes in Germany. I have been living with Type-1 for more than 2 years. I am thinking of pursuing Master’s in Germany, but I had my doubts about living with Type-1 in Germany. This article has given a bit of clarity what it might cost there.
Can you tell me which insurance a foreign student can take in Germany while studying for Post Graduation? Also, I know its mandatory for every student coming there, so it will be a great help if it can be understood that such pre-condition would be covered or not?
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Hi, I just wanted to say thank you for this – I’m living with T1 Diabetes in the U.S and currently looking into options for moving to Germany (for a few reasons, but one of them being that the cost of diabetes supplies here without insurance is insane!) I recently did a breakdown of what a month’s worth of supplies would cost for me if I lost the insurance I have through my work, and it’s terrifying – $1413 USD for insulin, test strips, lancets, pump supplies, and the two oral meds I’m on for my thyroid and cholesterol. Half of that is just for the insulin, two vials of Humalog per month. Given that my monthly income is around 1500 a month (if you add my insurance premium back in) it just wouldn’t be possible to survive here if I no longer had insurance through my employer. So it’s nice to see that the options in Germany are indeed much more reasonable, if I can find a way to move there.
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Hi, this is great news! I’ll move into Berlin soon, and I was slightly afraid of the costs (I’m from Latin America). Could you tell me what’s your insurance company? Also, what’s your pump model? I believe the ones by Roche aren’t covered, and while I’m not attached to any particular brand, I’d like to research a bit before switching, just for peace of mind.
Would you happen to know the costs, if any, of the test stripes and lancets for those with a pump but no CGM?
Thank you!!
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I have Salus BKK for insurance, but there are a lot of options and to be honest, I don’t know the differences between them. But coverage is fantastic here 👌 I have the Medtronic Minimed 640G. As mentioned, I’m not an expert, but I’ve never heard of German insurance companies denying certain brands. That happens often in the US that a company isn’t “preferred” but I don’t think that’s the case here. I think it’s more of a decision you make with your doctor. As for test strips and lancets, mine are 100% covered and I even have a CGM. Let me know if you want to chat further about it! I’d be happy to help as best I can.
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Hi there, how do you get a prescription for novorapid insulin Germany and how do you order supplies like canulars and reservoirs for the pump – like what’s the Germany company to order through as my daughter might be going to live there from Australia
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Hi Tracey, she can visit a “diabetologe” in Germany who will write a prescription (endocrinologist). Otherwise, I was informed by a pharmacy that they will take prescriptions from other countries as long as it is very specific on dosage, etc.
I ordered my pump supplies from https://www.diashop.de/ . No prescription is needed for pump supplies, but insulin requires a prescription.
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This is a really good post, thank you for sharing. I’m a T1D in the US, and right now I don’t have health insurance. I’m working on it, though! Luckily I have a stash of supplies, as I was anticipating this. If I was to go get my insulin without insurance (Humalog and Lantus) it would cost something like $700 for a months supply. Test strips would be over $200. Almost $1000/month just to keep from dying. I’ve never got glucagon before because it’s too expensive. Hope I never need it 😐
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Its so crazy how different it is in other countries. I am too from the US and it really is hard to pay for all of the supplies, plus Europe seems to come out with things faster (new tech/etc)
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That’s what is so frustrating for me. The US is the richest nation in the world, but has one of the worst healthcare insurance systems in the world. Puzzling and infuriating.
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