The 'catastrophic' high cost of insulin is financially straining diabetes patients
Nicole Smith-Holt’s son, Alec, died in 2017 from diabetic ketoacidosis, a condition that occurs when the body doesn’t have enough insulin.
Alec had Type 1 diabetes. The 26-year-old had been recently removed from his parents' health insurance plan and was about $300 short of the $1,300 he needed to pay for his insulin medication, his mother said.
In a bid to wait until his next payday to purchase the medication, he rationed the insulin he had left.
“Unfortunately, his body was found three days prior to payday,” said Smith-Holt, of Richfield, Minnesota.
In the five years since Alec’s death, not much has changed: The high cost of insulin remains a significant barrier to care for many Americans.
A study published this month in the journal Health Affairs found that 14% of people who use insulin in the United States face what is described as a “catastrophic” level of spending on the medication, meaning that after paying for other essentials, such as food and housing, they spend at least 40% of their remaining income on insulin.
The study’s estimate, which covered 2017 and 2018, didn’t include other costs related to diabetes care, such as glucose monitors, insulin pumps or other medications.
https://www.nbcnews.com/health/health-news/why-insulin-so-expensive-diabetes-united-states-rcna39295
Fcuk Big Pharma!
= new reply since forum marked as read
Diabetes is getting a lot of attention because it is common, and the preferred method of managing blood glucose is costly. But there are readily available, relatively inexpensive insulin available. They are more complex, harder to keep blood glucose on an even keel, but it does not cost $1300 to buy insulin which will keep you alive and regulated from Walmart. It now offers not only human insulin, but an analog version of insulin at relatively affordable rates.
It has, however, been at least a decade since my daughter with two chronic illnesses (IBD and PSC) has not spent her full, out-of-pocket maximum, in the first month of each new year on health insurance. In one bad year (bankruptcy of her employer, new employer who didn't offer health insurance immediately, and a gap-filling period on the ACA) she had to spend 3 full out-of-pocket maximums in a single year.
Her care costs (at the moment) $400,000 a year - most of that for biologics she must now take every 4 weeks. She has no Walmart alternative to keep her alive.
Focusing on a single medicine ignores the basic problem: People with chronic illnesses are not served well by out current system. Most of us who do not have chronic illnesses ignore the out-of-pocket maximum because we never come close to hitting it - or perhaps hit it once every decade. That is how they are designed. They are intended to be a fail-safe to prevent catastrophe if you happen to have a $100,000 health care year.
But those with chronic illnesses have to spend that much every single year. My daughter's health insurance is good - but she has to spend 25% of her income on her out-of-pocket medical care every single year - in the first month of the year.
Fixing the cost of the "sexy" problem - the donated to the public patent, for (not really the same) meds which now costing people thousands of dollars every year, does not solve the fact that people with chronic illness are paying a disproportionate amount of their income to stay alive.
The cost of insulin is a legitimate concern - but I'm getting fed up with pitting one illness against other illnesses for special treatment.
I can see happening with diabetes what has happened with other illnesses which were "sexy." Breast cancer patients are entitled to have reconstructive surgery on not only the breast with cancer - but also the other breast to make them balanced. A disease-specific fix was created for breast cancer (which I have) - while leaving all other cancer survivors (a group which also includes me) with much more disfiguring scars out in the cold - with our disfigurements treated as cosmetic.
Resolving this disfigurement (left by my limb-sparing sarcoma removal 19 months ago) is considered cosmetic.
If I want to add some fat padding (it's about a 1/2" crater) and a less visible scar by expanding the skin to cover the graft, I would have to pay for it out of pocket. Whereas my insurance company would have been obligated to pay for breast reconstruction for both breasts as medically necessary - even though I only had cancer in one breast. Because the breast cancer lobby is powerful - and the fix was tailored to respond to that single powerful voice, not to others similarly situated.
If a fix is created specifically for diabetes, the rest of us (like my daughter with two chronic illnesses) will have the identical problem to those of us whose cancers are equally or more disfiguring than breast cancer - but who aren't entitled to surgery to make us look "normal" again because our diseases aren't sexy enough to garner an individual fix.
Let's work on a fix for all similarly situated people, not just those who have one disease with a compelling story and enough "victims" to have a loud enough voice.
Simple rule changes that would help everyone, not just those with diabetes:
1. No one ever has to pay more than one out-of-pocket maximum in a single year. If you change from one ACA compliant plan to another, your year carries over - rather than starting fresh.
2. Either classify all chronic illnesses as eligible for reduced out-of-pocket maximums every year OR limit the number of years in which you are allowed to be charged an out-of-pocket max (E.g. 1 in 10, for example).
