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Why Are Diabetes Drugs So Expensive

Medications: What Your Pharmacist Won’t Tell You

Medications: What Your Pharmacist Won’t Tell You

If there’s any cost in health care that should be easy to understand, it’s the cost of prescription medications. Pharmacies buy prescription drugs in bulk from pharmaceutical corporations and suppliers the same way they buy aspirin, and then sell them for a profit. But somehow this simple transaction is wrapped in so many layers of confusion that almost no one understands what’s really happening. So let’s start by trying to figure this out. Any time you go to a store (say, a grocery store) you expect to see all of the products being sold with their prices plainly displayed. When you go to the checkout, that’s the price you expect to be charged. You also expect to be able to check the price of the same or a comparable product in competing stores so you can shop around. That’s how the free market works. Imagine what it would be like if a grocery store never displayed the price of anything. And the price you’re charged might be totally different from the price the next customer is charged for the same product. In fact, suppose you couldn’t even pick your own groceries. A grocery list would be handed to you by a food expert and you’d be billed based on your particular grocery plan. Eggs might cost you $5, the next person $10 and some poor guy who doesn’t have a grocery plan would have to pay $50 for the same carton. Don’t even think about shopping around. Your grocery plan follows you everywhere and determines the price you pay and, since you’re only allowed to buy what’s on the list, you can’t even price compare similar items (like brown eggs vs. white eggs). The only way to save money would be to go without groceries. Do you think this would make food cheaper or easier to get? Well, whats described above is pretty close to how prescription medi Continue reading >>

Diabetics Can Spend $1,000 A Month Taking Care Of Themselves — And It's Not Just Because Of Insulin

Diabetics Can Spend $1,000 A Month Taking Care Of Themselves — And It's Not Just Because Of Insulin

A paramedic checking the blood sugar levels of a diabetes patient. Beawiharta Beawiharta/Reuters Diabetes, in particular type 1 diabetes, can be an expensive chronic disease to manage. That's being felt as the cost of insulin increases, while at the same time high health insurance deductibles leave families on the hook to cover more of the cost than ever before. It means, in some cases, all the expenses can climb past $1,000 a month. There are two types of diabetes of which nearly 29.1 million Americans have one or the other. Type 1 is an autoimmune disease, in which the body mistakenly kills so-called beta cells that are supposed to make the body's insulin, a hormone that helps people absorb and process the sugar in food. This kind of diabetes can affect any age group, though it's most often diagnosed in children, teens, and young adults. The roughly 1.25 million people in the US who have Type 1 diabetes need to inject insulin to live. Type 2 diabetes, the more common form, is something that develops either based on genetic or lifestyle choices, and doesn't always require that you need to take insulin. But insulin isn't the only thing type 1 diabetics have to keep track of. There are a lot of supplies that come with the diagnosis: there are test strips, which help monitor blood sugar levels there are lancets that are used to draw the blood, not to mention alcohol swabs to clean the area where injections happen. There are also the needles/syringes you need to inject the insulin. There's also a device called glucagon, an emergency drug for diabetics that is kind of like the EpiPen. If a diabetic' blood sugar gets too low and he or she passes out, someone can administer the glucagon to get their blood sugar levels back up to non-emergency levels. Some also choose to use a Continue reading >>

Is Januvia Worth The Price?

Is Januvia Worth The Price?

The Type 2 diabetes drug Januvia (sitagliptin) has become a source of controversy after the drug’s maker, Merck, funded a letter to doctors by CVS Caremark, the pharmacy benefits manager, urging the physicians to add the drug to specific patients’ treatment regimens. Januvia costs as much as 10 times the price of older diabetes drugs such as metformin and glipizide xl. (Note: Januvia purchased from a Canadian pharmacy costs about half as much as from a U.S. pharmacy — though it is still significantly more expensive than metformin and glipizide.) Beyond the apparent conflict of interest in CVS Caremark’s letter, the question most important to patients is whether Januvia’s superiority over older, cheaper diabetes drugs makes it worth the additional cost. The answer is, it depends. Amy at Diabetes Mine points out that Merck has been pushing the drug very hard, and that while it appears to be effective, there are also concerns about safety and side effects. If you have Type 2 diabetes and are considering Januvia, or your doctor has already recommended it to you, make sure to discuss the pros and cons thoroughly — and don’t be afraid to remind your doctor of Januvia’s additional cost. Physicians often forget to factor cost into their decisions on which drugs to prescribe, so it’s important to speak up. And if you do end up taking Januvia, be sure to ask for free samples whenever you visit your doctor. Continue reading >>

You Can Get Off Of Your Expensive Diabetes Medications

You Can Get Off Of Your Expensive Diabetes Medications

Once you are diagnosed with type-2 diabetes, your doctor will usually reach for the prescription pad. You may already be taking a drug or two for high blood pressure since it commonly accompanies obesity and pre-diabetes. You may wind up on a statin drug for cholesterol, since heart disease is the major cause of death for people with diabetes. Additionally, you are given a number of other drugs to protect your kidneys (a major diabetes complication) and at least one to control your abnormal blood sugar. Insulin is often prescribed later in the progression of the disease. Whether it’s pills for blood sugar or a combo of pills and insulin injections, it is expected that these drugs will be a requirement for the rest of your life. Many doctors feel that every person with diabetes will ultimately need insulin due to the loss of insulin producing beta cells in the pancreas over time. This disease has a slow downward projection with ever-increasing costs falling on the patient, insurance companies, and ultimately taxpayers to cover. Drug Costs Continue to Rise The cost for diabetes drugs has been on the rise. Six well-known brand-name diabetes drugs have increased in cost by 150% in just five years. One reason being the practice of one drug company escalating costs that the others follow. Insulin has existed almost 100 years, but still has no generic alternative that could lower the price. An analysis by The Health Care Cost Institute reported annual health care spending for diabetics at $14,999. That’s $10,000 more per year than for those without diabetes. As this number is projected to continue rising, especially as younger people develop diabetes and our obese population remains high, out-of- pocket expense will also increase. A person with diabetes will spend an avera Continue reading >>

Why Many Generic Drugs Are Becoming So Expensive

Why Many Generic Drugs Are Becoming So Expensive

The high cost of prescription drugs is big news. You hear about it on television, in your doctor’s office, and even on the campaign trail. When you think about expensive drugs, you may think about novel therapies for lung cancer or hepatitis C. But in fact, prices are also skyrocketing for the generic versions of some commonly prescribed drugs. An article published last year in The New England Journal of Medicine reported that between 2012 and 2013, captopril — a generic drug used to treat high blood pressure and heart failure — increased in price from 1 cent to 40 cents per pill. During this same period, the cost of doxycycline, an older antibiotic, increased from 6 cents to $3.36 per pill. Connecture, a health insurance information technology company, reports that while the price of most generic drugs remained constant between 2008 and 2015, almost 400 generics saw price increases of more than 1,000%. At a time when 18% of prescription drug costs are paid for out-of-pocket and 8% of Americans report not taking their medications in order to save money, such dramatic increases in generic drug prices place a heavy burden on public health. Why are generics going up in price? Most of us think of generics as the less expensive alternative to the brand-name version of a prescription drug — and that’s often the case. The pharmaceutical companies that make generics can sell them for lower prices because they didn’t have to pay for the research and development that brought the drug to market in the first place. However, this cost advantage can take a back seat in situations such as the following, in which competition is reduced or delayed, enabling generic manufacturers to increase their prices: The market for some generic drugs is so small that it does not attract Continue reading >>

Understanding Insulin Sticker-shock

Understanding Insulin Sticker-shock

Why are some forms of insulin so expensive, and what happens if you can’t afford the price? Mary Clark, a realtor in Cincinnati, has grown accustomed recently to being the center of attention at the pharmacy. An independent contractor, Clark has had trouble finding affordable health insurance that covers the costs of the insulin she needs to control her Type 1 diabetes. Since 2012, she’s noticed the price she must pay out-of-pocket has increased steeply; it’s been a big enough leap that even the pharmacists pause in their work when filling her order. “Everyone was just stunned and they would just stand and stare at me,” Clark says. Read “Can I Use Insulin Past the Expiration Date?” She knows many other people with diabetes that are in the same situation, especially those who use long-acting insulin like Lantus. She says she can’t afford pump therapy and she has cut out all other expenses, including doctor’s visits and dental care, to keep up with the cost of insulin. “We do without everything. There will be diabetics who will go without insulin and they can’t,” Clark says. “You won’t make it.” sponsor She’s not alone in worrying about the costs of insulin, although not everyone would notice the same price spikes as Clark, says David Kliff, who owns the newsletter Diabetes Investor.com. It’s the underinsured and the uninsured who feel the brunt of it. People with good health insurance might not even notice, as health insurance companies often demand lower prices from insulin makers for their customers, Kliff says. That’s why two people with diabetes standing in line at the pharmacy might pay dramatically different prices for insulin; the difference might even be a couple hundred dollars per vial of insulin, he says. Read about a woman Continue reading >>

High Cost Of Diabetes Drugs Often Goes Overlooked

High Cost Of Diabetes Drugs Often Goes Overlooked

When it comes to treating chronic conditions, diabetes drugs aren't nearly as sexy as say, Sovaldi, last year's breakthrough hepatitis C drug that offers a cure for the chronic liver infection at a price approaching six figures. Yet an estimated 29 million people in the U.S. have diabetes — about 10 times the number of people with hepatitis C — and many of them will take diabetes drugs for the rest of their lives. Cost increases for both old and new drugs are forcing many to scramble to pay for them. "Every week I see patients who can't afford their drugs," says Dr. Joel Zonszein, an endocrinologist who's director of the clinical diabetes center at Montefiore Medical Center in New York City. Although some of the top-selling diabetes drugs like metformin are modestly priced generics, new brand-name drugs continue to be introduced that act in different ways to control blood sugar. They may be more effective and have fewer side effects, but the advances come at a price. For the fourth year in a row, per person spending on diabetes drugs in 2014 was higher than it was for any other class of traditional drug, according to the Express Scripts 2014 drug trend report. Fewer than half of the prescriptions filled for diabetes treatments were generic. "The cost of diabetes treatment has been increasing pretty rapidly," says Dr. Glen Stettin, senior vice president for clinical, research and new solutions at Express Scripts, which manages the pharmacy benefits for many companies. An analysis of per capita health care spending in 2013 for people with diabetes found average costs were $14,999, roughly $10,000 higher than the average $4,305 in per capita spending for people without the disease. The study by the Health Care Cost Institute examined the health care claims of nearly 40 Continue reading >>

Diabetes Medication Cost

Diabetes Medication Cost

For patients not covered by health insurance, diabetes medication costs $4 to $100 per month for metformin, the most commonly prescribed and recommended first-line diabetes drug for patients who have been unable to achieve target glucose levels with diet and exercise. The price of generic metformin would be at the lower end of the range, while a brand name such as Glucophage or Glucophage XR would be on the higher end. For patients without health insurance, diabetes medication costs $8 to $200 per month or more for metformin taken along with another diabetes drug, such as one of a class of medications called sulfonylureas -- such as brand name Glucotrol or Diabinese -- or one of a class of drugs called alpha-glucosidase inhibitors, such as brand names Precose and Glyset. It is common for a doctor, if metformin alone does not control blood glucose sufficiently, to add another drug. For patients without health insurance, diabetes medication costs $200 to $500 or more a month for a multi-drug regimen that could include other classes of oral medications, including newer medications such as the brand name Januvia, or injectable medications such as the brand name Byetta. If first-line medications do not achieve target blood glucose levels, or if the patient cannot tolerate the side effects, or if certain drugs are contraindicated for a patient for reasons such as heart disease or other illnesses, a doctor might try other medications, often in combinations. Doctors often will take cost into account when prescribing medications if the patient requests it. The Mayo Clinic[1] has a cost comparison chart for diabetes medications. Diabetes medications are covered by most health insurance plans because they are considered medically necessary. Medicare generally covers diabetes medic Continue reading >>

What’s Behind Skyrocketing Insulin Prices?

What’s Behind Skyrocketing Insulin Prices?

Here’s a sticking point for diabetics: the cost of insulin more than tripled — from $231 to $736 a year per patient — between 2002 and 2013, according to a new analysis. The increase reflected rising prices for a milliliter of insulin, which climbed 197 percent from $4.34 per to $12.92 during the same period. Meanwhile, the amount of money spent by each patient on other diabetes medications fell 16 percent, to $502 from $600, according to a research letter published Tuesday in the Journal of the American Medical Association. “Insulin is a life-saving medication,” said Dr. William Herman, a coauthor of the analysis and a professor of epidemiology at the University of Michigan School of Public Health. “There are people with type 1 diabetes who will die without insulin. And while there have been incremental benefits in insulin products, prices have been rising. So there are people who can’t afford them. It’s a real problem.” The analysis also found that the cost of various widely used oral diabetes drugs either dropped in price or did not rise nearly as significantly as insulin. Metformin, for instance, which is available as a generic, fell to 31 cents in 2013 from $1.24 per tablet in 2002. And the newer class of diabetes drugs known as DPP-4 inhibitors rose 34 percent since becoming available in 2006. The researchers analyzed data from nearly 28,000 diabetes found in the Medical Expenditure Panel, a database on health care costs maintained by the US Department of Health and Human Services. About 1 in 4 people used insulin and two-thirds took a pill. Toward the end of the study period, a small percentage began taking new injectable medicines that are designed to complement pills. There have been previous efforts to track insulin prices in recent years, bu Continue reading >>

Diabetes Has Become One Of America’s Most Expensive Diseases

Diabetes Has Become One Of America’s Most Expensive Diseases

With an estimated 30 million Americans struggling with diabetes, the disease is one of the nation’s most entrenched chronic conditions. It’s also one of the most expensive. Consider these facts: ▪ In California, roughly 55 percent of adults either have diagnosed diabetes or blood-sugar levels that put them at high risk of developing the disease. That includes roughly 1 in every 3 adults ages 18 to 39 – a finding researchers call alarming. ▪ In terms of personal health care spending, diabetes tops the nation’s list of 155 chronic conditions, hitting $101.4 billion in 2013. According to the American Diabetes Association, average medical expenditures for people with diabetes are an estimated 2.3 times higher than for those without it. Never miss a local story. Sign up today for a free 30 day free trial of unlimited digital access. SUBSCRIBE NOW ▪ The cost of insulin alone has spiked by triple-digit percentages in the past 20 years. “It’s horrible for patients,” said N. Chesney Hoagland-Fuchs, a registered nurse and chairwoman of the Diabetes Coalition of California. She said prices for insulin medications began a slow climb after the recession and started “shooting up” around 2013. Over the past 20 years, the price of human insulin produced by two major manufacturers – Eli Lilly and Novo Nordisk – rose 450 percent, after accounting for inflation, according to a 2016 Washington Post analysis of data from Michigan-based Truven Health Analytics. A single 10-milliliter vial of Eli Lilly’s Humalog insulin – less than a month’s supply for many adults – was listed at $254.80 last year, compared with $20.82 in 1996, a Truven Health representative said. Insulin is only one sliver of the cost of living with Type 1 and Type 2 diabetes. Depending on Continue reading >>

Nhs Spends Tens Of Millions On Expensive Diabetes Drugs

Nhs Spends Tens Of Millions On Expensive Diabetes Drugs

A joint investigation by Channel 4 News and the BMJ reveals the NHS spends tens of millions more than necessary on modern insulins to treat diabetes despite guidance from NICE to use cheaper products. For many of the 2.8 million diabetes sufferers in the UK synthetic insulin, to moderate their blood sugar level, is a crucial drug. But with the numbers of diabetics set to rise it’s a growing area of research, investment and profit for the pharmaceutical industry. Now a joint investigation by Channel 4 News and BMJ (British Medical Journal) estimates that the more expensive type of insulins for people with Type 2 diabetes has cost the NHS tens of millions extra over the past five years. Our estimate reveals that if half of diabetics used a cheaper version then it could have saved the health service as much as £250 million during that period. Yet for most patients the extra cost does not correspond to equivalent extra health benefits. If I spend twice the price for something, I sort of more or less expect to get twice the benefit – Dr Adler, NICE Central to the Channel 4 News/BMJ investigation is the role of so-called modern insulins known as analogue insulins. They are molecularly tweaked to change the rate of absorption in the body. So the ones designed to give quick hit of insulin – say around a meal time – are swifter acting than the older versions, and those that are designed to give a low background level are a little longer lasting. These tweaks undoubtedly give them some advantages over older insulins. Their makers claim that, amongst other benefits, they have smoother, more predictable action, the risk of low blood sugar levels (hypoglycaemia) is reduced and the convenience and ease of these insulins help patients to gain good control over their diabetes. Continue reading >>

Why Are Diabetes Medications So Expensive?

Why Are Diabetes Medications So Expensive?

You can’t reverse diabetes by eating meat, dairy products, and oil. Especially in the case of Type 1 diabetes, where the body can no longer produce insulin, or doesn’t produce enough. If anything, doctors recommend limiting carbohydrates, rather than protein and fat, as firstline diabetes management. Many carbs can cause glucose to rise, to dangerous levels if the diabetic has lost insulin sensitivity. Exercise and weight loss can increase insulin sensitivity in certain patients, and in some cases put the diabetes into remission. But not always, and in the meantime, high glucose levels can have a corrosive effect on the body. Heart disease and diabetes are two different diseases, though heart disease is a common complication of long-term, poorly-controlled diabetes. As far as why medications are so expensive, it’s partially what the market will bear and partly due to the fact that a lot of newer medications are not on formulary (so insurance or Medicare doesn’t cover the cost), or that there is not a generic version yet available, which also drives up costs. Medications, in general, are much more expensive in the U.S. than in other countries. But if you need diabetes medications, you should take them, and follow other dietary instructions from your doctor or diabetes educator, not something you read on the internet. Continue reading >>

Why Diabetes Drugs Are Expensive

Why Diabetes Drugs Are Expensive

Practically everyone who has diabetes uses one or more drugs to help to manage it. But most of these medications are expensive, and the U.S. Food and Drug Administration approved far fewer diabetes drugs in the past 10 years than between 1995 and 2004. At the annual meeting of the American Diabetes Association in Boston earlier this month, thousands of diabetes professionals listened with interest as four experts explained why. I represented HealthCentral.com during the entire conference and made a point to be in the audience as four experts brought us up to speed about the “Costs of Medications for Diabetes.” One of the most interesting and important talks of the entire conference was the first of these. Joseph DiMasi, PhD, the director of economic analysis at the Tufts Center for the Study of Drug Development, is the expert in this area. Drug costs have gone way up recently, Dr. DiMasi says. And in the question and answer session after he talk he said he expects the trend to continue at least in the short term. Diabetes drugs between 2000 and 2014 have taken the FDA an average of 5.7 years to approve, Dr. DiMasi told us. While this may seem to be a long time, it is less than the average for all drugs, which is 6.8 years. Diabetes Is Low Priority But the FDA has a system of prioritizing drugs by class, and diabetes drugs come in last. They have the lowest priority. “Strikingly, none of the 17 diabetes drugs approved since 2000 had a priority rating from the FDA.” Since 2008, the FDA has taken 2 years more to approve a diabetes drugs than it took earlier. In the question and answer period following Dr. DiMasi’s talk one doctor commented that he was astonished by the low prioritization of diabetes. “I was astonished too,” Dr. DiMasi replied. “The burden o Continue reading >>

Doctor's Attempt To Bring Lower-price Diabetes Drug To Market Thwarted

Doctor's Attempt To Bring Lower-price Diabetes Drug To Market Thwarted

Dr. Mayer Davidson has long been frustrated by the rising cost of prescription drugs, especially in his area of expertise — diabetes. He's a professor of medicine at Charles R. Drew University and director of the diabetes program at the Martin Luther King Jr. Outpatient Center in South Los Angeles. There must be a way, Davidson believed, to reduce the cost of treating what's now one of the country's fastest-growing illnesses. Only heart disease and strokes are more expensive to treat on average, according to the Centers for Disease Control and Prevention. Davidson had reason for hope after he and colleagues came across research suggesting that a World War II-vintage malaria drug called Plaquenil, or hydroxychloroquine, could improve the blood-sugar counts of people with Type 2 diabetes. "The meds coming out now are just too expensive," he told me. "Our hope was that an old generic med like this would make it easier and cheaper to treat people." Unfortunately, even though Davidson received a research grant, he never got to fully test his hypothesis. As with many generics, the price of Plaquenil has risen in recent months. Davidson said the wholesale price of the drug was 50 cents a pill last year. It's now $1.75 — a 250% increase. The retail price is about $3 for each 200-miligram dose, according to price-comparison site GoodRX.com. Davidson said his team's modest funding couldn't support such a price hike. They were unable to buy enough Plaquenil, even at the wholesale price, to study its long-term effect on a meaningful number of diabetic patients. "We had to close down the study," Davidson said. A decision like that has enormous ramifications. The more than 29 million people with Type 1 or Type 2 diabetes represent about $176 billion in annual medical treatment an Continue reading >>

The Top 10 Best-selling Diabetes Drugs Of 2013

The Top 10 Best-selling Diabetes Drugs Of 2013

Everybody knows that diabetes is an epidemic in this country that is costing lives and money. New stats from the U.S. Centers for Disease Control and Prevention (CDC) peg at 29.1 million the number of people in the U.S. who have either Type 1 or Type 2 diabetes, with roughly 9 million of those undiagnosed. Most have Type 2 diabetes, which is more prevalent among minorities. On the other hand, a study found that non-Hispanic white children are diagnosed more often with Type 1 diabetes than other groups. And that is just in the U.S. The rest of the world also is developing diabetes at what many see as alarming rates. Pharma, seeing opportunity, has responded. There are pills as well as injected drugs. Many are incretin mimetics. There are now 12 classes of drugs, including the GLP-1 class drugs like AstraZeneca's ($AZN) Byetta and Novo Nordisk's ($NVO) blockbuster Victoza, and DPP-4 inhibitors like Merck's ($MRK) Januvia, Eli Lilly ($LLY) and Boehringer Ingelheim's Tradjenta/Trajenta and AstraZeneca's Onglyza. These widely used drugs, some of which are on this list, have stirred safety concerns. The FDA and European regulators announced in February that a new round of safety reviews found little evidence that they cause pancreatitis or pancreatic cancer, as some have suggested. But criticism persists, and this month consumer advocacy group Public Citizen again asked the FDA to pull Victoza from the market, saying the FDA's review of adverse reports was not as extensive as its own. What is perhaps becoming a bigger deal for Big Pharma, however, is that with so many treatment options, and more coming, the market has gotten crowded and doctors and patients a bit confused. That has led to some studies to sort out which drugs work the best, and that in turn has led some resear Continue reading >>

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