A worrying new study has uncovered an unfortunate trend for those who struggle with diabetes.

The cost of hormone insulin has risen nearly 200 percent between 2002 and 2013, with total spending on insulin in 2013 greater than all other drugs, according to a University of Michigan Health System statement. The findings were published in the Journal of the American Medical Association.

The increase may have a lot to do with the introduction of analog insulins, a newer type of insulin which are better for some patients but are more costly.

The data was based on medical spending in the United States on insulin for 27,878 people with diabetes between 2002 and 2013.

The price increased from $4.34 to $12.92 per mL over that span. The total amount of insulin being used by patients also rose, jumping from 171 to 206 mL.

The average spending on insulin per patient jumped from $231.48 to $736.09 over that period, meaning that the cost of insulin for those with diabetes eventually outstripped per-patient spending combined on other diabetes drugs, which was $502.57 in 2013.

And the price of insulin isn’t likely to decline due to how much it costs to bring products to market.

“In the United States, the more than 3-fold increase in the cost of insulin over the past decade is alarming. It is a burden to both patients and payers and may deny some people access to a lifesaving therapy,” William Herman, M.D., MPH, the Michigan co-author and a longtime diabetes care researcher, said in the statement. “Although the newer, more expensive insulin analogs appear to have incremental benefits compared to older, less expensive insulin preparations, their premium price requires us to ask whether they are really necessary, and if so, for whom?”

Added Philip Clarke, Ph.D., the study’s senior author and a professor in Melbourne’s School of Population and Global Health and Centre for Health Policy: “What our study shows is how quickly things can change and why there is a need to focus on the costs as well as the benefits when deciding treatment options for people with diabetes.”