Virginia Film Festival

In a nation of plenty, the ultimate price is paid by those who cannot afford it. Pay or Die unveils the heart-wrenching stories of families caught in a life-or-death struggle, held captive by ransom demands for insulin. Directors Scott Ruderman and Rachel Dyer enlighten and unsettle audiences with a real-life horror movie, exposing the terrible truth of living with diabetes in the world’s wealthiest land. Every day, people’s lives are disrupted by pharmaceutical companies that mercilessly hike up the price of insulin. Less than a month after aging out of his mom’s insurance, 26-year-old Alec died from complications due to rationing his supply of insulin.

Alec’s story is told by his mother, activist Nicole Smith-Holt, whose advocacy for affordable insulin access is pushing lawmakers to make significant healthcare policy changes. As the clock ticks, audiences follow poignant journeys of loss and resilience, and the tragic consequences of America’s insulin crisis.

Discussion with director and producer Rachael Dyer and director, producer, and cinematographer Scott Ruderman. Moderated by Joe Fab (VAFF).