The United States is known for paying the highest costs of prescription drugs in the world, especially when compared to nations such as Japan and Canada.

The issue of increasing prescription drug prices has gained much attention over the last few years both from the general public as well as government officials who desire to change this pattern. This topic has been brought to the forefront of conversation thanks to recent examples like Daraparim and EpiPen, which observed dramatic price increases from their respective manufacturers.

Now, two members of Congress — Sen. Bernie Sanders (D-Vt.) and Sen. Elijah Cummings (D-Md.) — are asking the Department of Justice and Federal Trade Commission to investigate three manufacturers of insulin for price collusion.

The companies have increased the cost of insulin — typically at the same time — between 380 and 400 percent since 2004. The cost of insulin has more than tripled from $231 to $736 per year per patient between 2002 to 2013 — an astronomical cost given the 25.6 million people who are 20 years of older that are diagnosed with diabetes and require insulin therapy. This can prove to be a challenge for those who are unable to afford this life-sustaining drug.

The three manufacturers — Novo Nordisk, Eli Lilly and Sanofi — deny the accusations of collusion. They insist prices are set separately, with negotiations being performed with payers and/or pharmacy benefits managers to allow patients to have access to this drug.

Manufacturers can have the power to set these high prices as a result of exclusivity and monopoly rights that can be the result of FDA approval. It can also be the result of the complex nature of drug development or restrictions on price negotiations which can be a contributing factor to the increased price of insulin.

Yet the price of insulin continues to increase, rather than experience the decrease in cost that would be the result of competition coming into the market.

During the early part of 2015, it was noted that the increasingly high price of prescription drugs in the United State has existed for some time. In addition, it was reported that prescription prices in the American consumer market have inflated about 10 percent or more for three years in a row.

The surging drug prices can result from battles over profits between large pharma and insurance companies, but consumers are the ones who get caught in the middle. Regardless of what is currently being done, the American consumer is being significantly impacted, and consumers can take a stand in collaboration with their physicians to promote more value based-decision making when it comes to the prescription drugs that they are taking to manage their conditions.

The spike in insulin price appears to be another in a line of medications that are becoming increasingly challenging for consumers to acquire.