Pay or Die is a feature documentary that provides an inside look at how the lives of many Type 1 diabetics are being threatened—and lost—due to the outrageous cost of insulin in America. Filmmaker and Type 1 diabetic Scott Ruderman travels across America to meet with diabetics and advocates in an effort to understand why no generic insulin exists in America and how insulin’s exorbitant and continually rising pricing is leaving many Americans fighting for their lives.



Director Scott Ruderman’s adult life has been defined by one inescapable question: How can I make enough money as a filmmaker to afford the insulin I need to live? Pay or Die follows Scott as he embarks on a deeply personal journey across the country to understand the harrowing human cost of America’s insulin affordability crisis.

From a mother-and-daughter struggling to rebuild their lives after being evicted for spending their rent money on insulin, to a Minnesota family thrust into the national spotlight following the death of their 26-year-old son, the documentary provides an intimate look at the lives of Americans most affected by the skyrocketing cost of insulin. Pay or Die is a human rights story, one that will resonate with anyone interested in the equities of America’s healthcare system and its social justice failures.

Pay or Die begins with Scott’s personal story and his fruitless attempts to find out directly from insulin manufacturers why the price of insulin in America is so outrageously high. The film then introduces the audience to several Type 1 diabetics and their families, who show us the very real impact that this pricing has had on their lives.

On his journey, Scott will talk to experts, drug company representatives, and advocates as he grapples with the complex process of pricing insulin in America. Why are Type 1 diabetic Americans resorting to the use of expired insulin, grey and black market insulin, and even rationing their insulin? But perhaps the most compelling parts of Pay or Die are the first-hand stories of Type 1 diabetics who are living on the edge, trying desperately to afford the insulin they need on a twenty-four-seven basis.