MTV Documentary Films Unveils Insulin Crisis Docu ‘Pay Or Die’ Trailer



MTV Documentary Films has released the trailer for “Pay Or Die,” a documentary about America’s soaring insulin costs that the platform acquired out of this year’s South by Southwest Film Festival.

The 90-minute film, which was executive produced by Sarah Silverman, will open theatrically at New York City’s IFC Center on November 1, the first day of National Diabetes Month. That screening will be followed by a nationwide rollout. The theatrical release of the doc will qualify it for Academy Award consideration. Paramount + will begin streaming “Pay Or Die” on World Diabetes Day – Nov. 14.

Directed by Scott Alexander Ruderman and Rachael Dyer, “Pay Or Die” follows three families struggling to afford their diabetes medications. In 2022 the American Diabetes Association reported that over 37 million Americans – about 11% of the nation – are living with diabetes and 8.4 million Americans rely on insulin to survive. According to “Pay Or Die” nearly two-million Americans living with diabetes cannot afford insulin.

Like Michael Moore’s “Sicko,” “Pay Or Die” spotlights America’s battle for affordable healthcare.

“We wanted to make sure that the film gets out ahead of the 2024 elections, because we’re hoping this will be a conversation that can be a part of those election stakes,” Dyer told Variety in June.

The film features Alec Smith, an uninsured 26-year-old Minneapolis man who died in 2017 of complications from rationing his insulin. After aging off of his mother’s insurance plan, Smith couldn’t afford the $1,300 per month he needed for the drug.

Ruderman and Dyer follow Smith’s parents as they battle Minnesota lawmakers over affordable insulin, the price of which is artificially hiked by the pharmaceutical industry and insurance companies. In 2022 The Alec Smith Insulin Affordability Act, which regulates insulin costs, was implemented.

The docu also follows a mother and daughter struggling to rebuild their lives after spending their rent money on insulin and a 19-year-old diagnosed with Type 1 diabetes during the COVID-19 pandemic.

“The power we have as filmmakers is to try to make the world a better place,” Ruderman said. “We want to save lives. We want to prevent this from happening and not only to insulin, but there’s a lot of other expensive medications: cancer medication, inhalers, blood pressure pills. It really shows what happens when healthcare is treated too much like a business and not as a public service.”

MTV Documentary Films, run by Sheila Nevins, currently has two feature docs vying for Oscar consideration: “Pay Or Die” and “The Eternal Memory,” a look at love and Alzheimer’s disease 

“Pay Or Die” was executive produced by Sheila Nevins, Trish Adlesic, Sarah Silverman, Amy Zvi, Regina K. Scully, Lauran Bromley, Douglas Choi, Dawn Bonder, Marci Wiseman, Russell Long, Sarah Lucas and Zak Kilberg. Rachael Dyer, Scott Alexander Ruderman, and Yael Melamede served as producers.
Ruderman was also the cinematographer; Will Rogers edited and Toby Shimin served as the supervising editor. Music is by T. Griffin.

Watch the trailer below:


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