A self-described “caravan of Americans” with Type 1 diabetes travelled into Canada over the weekend to get dramatically cheaper, life-saving insulin. And they say this won’t be the last time they cross the border.

"We're on a #CaravanToCanada because the USA charges astronomical prices for insulin that most people can't afford," tweeted diabetes advocate Quinn Nystrom, who documented the group’s trip online.

On Saturday morning, a group of six Minnesotans -- including parents going on their children’s behalf -- drove 1,000 km to get to a Shoppers Drug Mart in Fort Frances, Ont.

Nystrom told CTVNews.ca that in Canada, she bought the “same, exact” medication -- used to regulate her blood glucose levels -- at essentially a tenth of what it would cost in the U.S.

“We got so much interest about this and so many people -- who haven't gone before -- now want to go because the insulin was 10 times cheaper in Canada,” Nystrom said in a phone interview. “So we want to go back.”

She ended up paying approximately US$300 in Ontario; the same amount of insulin in the U.S. would have cost her around US$3,300. “It was such huge discrepancy in cost with just a five-hour drive -- it was really quite crazy,” she said.

Among the caravan was Nicole Smith Holt, whose 26-year-old son, Alec Smith, died because the high price of insulin in the U.S. caused him to ration his supply.

“Alec would still be here today if I had known that I could come to Canada,” Smith Holt said.

Nystrom said everyone saved significant amounts of money -- despite what they paid for in lodging, gas and food.

“We are very grateful to Canada for the warm welcome that we’ve received … and the laws that have been enacted in Canada to keep the pharmaceutical companies in check, so they’re not price-gouging its citizens,” she said.

What helps keep Canadian pharmaceutical prices for insulin and other drugs low is primarily the federal Patented Medicine Prices Review Board that sets a price cap for patented drugs.


In Canada, although most insulin users obtain prescriptions from their doctors, the drug is obtainable at pharmacies for anyone who needs it.

“The shocking thing for us Americans is that we didn’t need a prescription,’” she said, mentioning that the pharmacist did ask them if they’d taken the drug before or had any adverse reactions.

“We answered those questions and then she just asked, ‘What kind of insulin do you want?’ and ‘How much do you want of it?’” she said. “It was so easy.”

Throughout the trip, she used the hashtag #insulin4all” as a call to action. She wants the American government to do more to enact stronger legislation and make medication affordable for patients.

The hashtag is widely associated with a campaign from the national advocacy group, T1 International.

On their website, they say the price of insulin in the U.S. has skyrocketed by more than 1,100 per cent -- based on figures from Truven Health Analytics, which provides data to health-care organizations.

Steve Morgan, a professor of Health Services and Policy with the University of British Columbia, called the caravan “really great political theatre.”

“Because it draws a lot of attention to this very real problem in the United States of exceedingly high list prices of medicines and very many Americans without insurance to help them with the cost at all,” he said.

“It certainly highlights the complexity of drug pricing not just in the United States but around the world. And that’s because the list prices of medicines in countries around the world often bear no resemblance whatsoever to what the public insurance systems or the private insurers actually negotiate in terms of secret prices with manufacturers.”

He added: “It also highlights the fact that millions of Americans -- and, frankly, millions of Canadians -- don’t have insurance, and therefore don’t even have access to those negotiated secret deals. And as a consequence, it puts them at a lot of risk.”

Upon hearing about the weekend’s caravan, Barry Power, director of therapeutic content with the Canadian Pharmacists Association said he “wasn’t surprised because there’s a fairly wide price discrepancy.”

He said people just go to where their dollar will go further. While Canadian insulin prices aren’t expected to spike due to some copycat trips from Americans, there are other issues that could arise.

The United States has roughly 10 times the population of Canada, so diabetes patients crossing the border en masse wouldn’t be sustainable.

“If even a small proportion of Americans start coming to Canada to access their insulin, it could cause shortages in the Canadian supply,” he told CTVNews.ca.

He explained an unexpected “busload of Americans” going to one particular pharmacy could create a shortage there lasting a day or two, Power said.


Nystrom and the others who piled into their cars over the weekend are all part of an online Facebook support group for those with diabetes.

Several years ago, member Lija Greenseid, mother of a 13-year-old daughter with diabetes, first noticed the staggering price difference when her child had needed an emergency supply of insulin during a family trip to Canada.

More recently, Greenseid asked people on Facebook if they wanted to refill their insulin prescriptions in Canada.

“And a bunch of us responded back to her saying, ‘yeah, we’re in,’” Nystrom laughed. The group was only there for a day and the caravan returned home by Sunday afternoon.

While she acknowledged the trips to Canada weren’t a long-term solution for all Americans, Nystrom said she and a larger group are planning on going again during the summer.

U.S. advocates have urged the government to enact basic steps to help reduce high drug prices which include forcing medical insurers and drug providers to show how much each of them are charging for the same drug.

Another step would be allowing the import of drugs from places like Canada or Mexico.

Power said “it’s a very sad situation that Americans are forced to go to other countries to be able to get affordable medications.”

He adds this type of medical tourism in the United States has been an issue for decades. He stressed American legislators “absolutely need to take steps to address it.”