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Alec Smith
Insulin Rationing Victim
Type 1 diabetic who died at age 26 from rationing insulin he could not afford after aging off his parents health insurance, becoming a symbol of the American pharmaceutical pricing crisis
Overview
Alec Raeshawn Smith (1991-2017) was a 26-year-old restaurant manager from Minneapolis, Minnesota, who died on June 27, 2017, of diabetic ketoacidosis after rationing his insulin because he could not afford the cost. Smith had aged off his mother health insurance at age 26 under ACA provisions and discovered that his insulin, which cost approximately $1,300 per month without insurance, was unaffordable on his restaurant manager salary of approximately $35,000 per year. He was found dead in his apartment three days before his next payday, surrounded by empty insulin pens. Manufacturers of insulin, including Eli Lilly, Novo Nordisk, and Sanofi, had raised insulin prices by over 1,000% in the two decades preceding his death, despite the drug having been discovered in 1921 and the patent sold by its discoverers for $1 each. Smith death became a galvanizing event in the national movement for insulin affordability, leading his mother Nicole Smith-Holt to become one of the most prominent advocates for prescription drug price reform. His story was cited in multiple congressional hearings and contributed to the passage of insulin price caps in the Inflation Reduction Act of 2022.
Key Affiliations
Controversies & Concerns
Died at 26 from rationing insulin that costs less than $10 to manufacture but was priced at over $1,300/month by pharmaceutical companies
Was found dead in his apartment three days before payday, surrounded by empty insulin pens
His death exposed the life-or-death consequences of pharmaceutical pricing practices for millions of Americans who ration medications
Insulin manufacturers Eli Lilly, Novo Nordisk, and Sanofi had raised insulin prices over 1,000% while the drug cost under $10 per vial to produce
His case became evidence in congressional hearings on pharmaceutical price gouging and contributed to insulin price cap legislation
Related Investigations (1)
Known Associates & Connections
Nicole Smith-Holt
Mother who became a leading national advocate for insulin affordability after Alec death
Sources & Documentation
3 documented sources from official records, investigations, and reports
Washington Post: The Human Toll of Rising Insulin Prices(2019)
Senate HELP Committee: Testimony of Nicole Smith-Holt on the Death of Alec Smith(2019)
Minnesota Legislature: Alec Smith Insulin Affordability Act(2020)
Personal Information
- Born
- 1991
- Birthplace
- Minnesota
Education
- •Local schools in the Minneapolis area
Key Timeline
2017-05
Ages off mother health insurance at age 26; discovers insulin costs approximately $1,300/month without coverage
2017-06-27
Found dead in his apartment from diabetic ketoacidosis; had been rationing insulin to stretch supply until payday
2019
Minnesota passes the Alec Smith Insulin Affordability Act, establishing an emergency insulin program
2022-08
Inflation Reduction Act caps insulin costs at $35/month for Medicare patients, legislation influenced by advocacy sparked by his death