Top Eight Tips For Managing Diabetes On An Affordable Budget
By Connor Keane and Alexander Wolf Twitter summary: Expert Dr. Irl Hirsch shares eight tips to optimizing #diabetes management on a budget Short summary: At Keystone 2014, we heard from diabetes expert (and fellow type 1!) Dr. Irl Hirsch on optimizing diabetes management on a budget. To cut costs, he suggested that patients consider buying generic brands; buying from bulk suppliers for discount deals; looking for different prices at local pharmacies; using companies’ financial assistance programs; reconsidering the type of insulin; and sensibly re-using supplies. He also shared several areas where cutting costs could be dangerous: prolonging infusion set life to more than three days, using “off-shore” blood glucose meters that may have issues with accuracy, reducing the frequency of blood glucose monitoring and fingersticks, and using NPH insulin without frequent testing. For many, diabetes care is a delicate balance between increasingly high costs of care and intensive management. This balance has become harder to handle as costs of insulin and other essential supplies have drastically increased in the past decade. According to Dr. Hirsch, the cost of type 1 diabetes management – covering insulin, syringes, and strips – has risen to $7,910/year for people without insurance. Even for those with insurance, high co-pay costs are unaffordable for many. Although the number of uninsured Americans has dropped from 18% to 13% over the past year, many people are still left without the financial means to fully care for their diabetes. At this year’s excellent Keystone conference, Dr. Irl Hirsch (University of Washington, Seattle) shared his views on the best ways to manage type 1 diabetes in the least expensive way possible. We’ve listed his eight tips below. Gener Continue reading >>
The Promise Of Generic Insulin
The headline you’ve probably read more than once, including here on A Sweet Life, is one of outrage surrounding rumors of price-fixing along with (surprise!) the escalating costs of insulin. People who take insulin rarely switch brands, which means that whatever Big Pharma wants, Big Pharma gets. Insulin is my medical version of water. I don’t go a day without it. So, when I learned about the Open Insulin Project, an evolving group of scientists working to democratize the life-sustaining hormone, I let out a small cheer. Today, the team at Counter Culture Labs in Oakland, California has made tremendous progress on how to “easily” make insulin and their network is growing to include biohacker groups Reagent in Ghent, Belgium and Biofoundry in Sydney, Australia, as well as Fair Access Medicines, a non-profit in the U.S. Biomedical research takes a village. Anthony Di Franco informally heads up the Oakland-based group. In between working towards a PhD in computer science at U.C. Davis, Di Franco is working to understand enough about producing insulin in a simpler and cheaper way to establish a protocol for enabling almost any business entity to produce insulin. Without the enormous R & D costs that Big Pharma likes to point to when they speak to costs, the Open Insulin Project hopes to open the market to cheaper insulin and happier people with diabetes. In a study published in the New England Journal of Medicine about why no generic versions of insulin exist, Dr. Jeremy A. Greene writes that economists estimate the average cost to bring a new drug to market at “$1 billion and rising.” Scientists at the University of Toronto first discovered insulin in 1921. That’s almost a century of small changes to one medicine that allow drug companies to continue their pa Continue reading >>
Desperate Families Driven To Black Market Insulin
Fourth grader Gabriella Corley is trapped. She has type-1 diabetes and is allergic to the kind of insulin her insurer makes affordable — and her family can't pay for the kind she needs every day to stay alive. Glancing at the cheerleader from Elkins, West Virginia, at a recent football game, held up on her teammates' shoulders, her grin as wide as her two fists in the air, you might not think anything was wrong. Then you might notice the insulin pump about the size of a pager tucked into her black compression shorts, clear tubes going under her shirt. It infuses insulin directly into her body through a tube connected to a site on her abdomen. "She's a beautiful, intelligent, amazing little 10-year-old girl who stands up in the face of adversity every single day without blinking an eye and does it with a smile," said her mother, 32-year-old Andrea Corley. Soaring insulin prices and inflexible insurance policies have forced this working-class mom to take desperate measures outside the system to keep her child alive. Gabriella is allergic to the kind of insulin her insurer covers at a $25 out-of-pocket cost. She can only take Apidra, but her insurance only covers 25 percent of the price, leaving the family to pay hundreds of dollars a month they can't afford. So her mom has turned to the black market, trading for the medication with other families with diabetes she meets online, a tactic that regulators and health experts warn is a health risk. And she cut a back-end deal with a sympathetic drug rep: If she bought one vial he would give her 10 vials from his sample kit, nearly a one year's supply. Gabriella's grandmother covered the cost. None of the Federal regulators NBC News contacted said that online trading of insulin is illegal, as it's not a controlled substance. Continue reading >>
Insulin For Less!
Nearly 50% of all people with diabetes use insulin. Everyone with type 1 diabetes uses it, and up to 42% of people with type 2 do too. Unfortunately, not everyone who needs insulin can afford it. The price of insulin has reached new heights. In the U.S., the per person cost of insulin has tripled in the past decade. But, we have options! Doctors offices often have free samples. You can ask your doctor if he/she has some samples you could have. Patient assistance programs offer free or low cost medicines to people who meet program requirements. Each program has it’s own rules. Most require being a U.S. citizen or legal resident, having no prescription coverage, and meeting income guidelines. – The Eli Lilly Patient Assistance Program offers discounts on Glucagon, Humalog, Humalin, Trulicity, among others. – Other drug companies like Novo Nordisk and Sanofi have their own patient assistance programs to consider. Drug discount cards are not insurance, but they may help reduce the cost of medicines. Most are available to anyone with or without insurance. Here are some free cards with apps: Coupons are available that reduce the cost too. Anyone can use them. These coupon apps compare prescription costs at local pharmacies, helping us pay the least amount: Will insulin prices continue to climb? Hopefully not. There are small signs it may be tapering off. For instance, last year, Express scripts reported the per unit cost of Lantus dropped 14%. Fingers crossed we’re getting close to a day when insulin is affordable for everyone who needs it. That day really can’t come soon enough! A light at the end of the tunnel… In the past 3 years, the patents for some insulins have expired. Manufacturers are racing to make generic versions of those insulins, which should cost l Continue reading >>
Insulin Prices Have Skyrocketed, Putting Drug Makers On The Defensive
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 medicine and 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 patients 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 pric Continue reading >>
Cvs Health Launches Reduced Rx Savings Program To Give Patients Access To More Affordable Medications
WOONSOCKET, R.I., March 16, 2017 /PRNewswire/ -- CVS Health (NYSE: CVS) today announced the company will launch Reduced Rx , a prescription savings program that will offer discounts on certain medications through CVS Health's pharmacy benefits manager, CVS Caremark directly to patients. The program will help patients with high out of pocket costs afford essential medications. Novo Nordisk will participate in the prescription savings program. Through this program, CVS Health and Novo Nordisk will offer Novolin R , Novolin N and Novolin 70/30 human insulin at a cost of $25 per 10ml vial, which reflects a potential savings of as much as $100 for cash paying patients. The Reduced Rx launch follows another affordability announcement made earlier this year by CVS Health. Working with Impax Laboratories, CVS Health announced in January that it has made the authorized generic for Adrenaclick, an epinephrine auto-injector for patients with allergic reactions, available at all CVS Pharmacy locations at the lowest cash price in the market, $109.99 for a two-pack. CVS Health collaborated to create both the generic Adrenaclick offering and the Reduced Rx program in response to consumer need for low cost options. "We developed the Reduced Rx prescription savings program with Novo Nordisk because we both recognized a need and an opportunity to make critical medications more affordable for patients," said Jonathan Roberts, Executive Vice President and Chief Operating Officer, CVS Health. "This savings program will leverage CVS Caremark's expertise in providing lower cost prescription drugs and fulfill our company's purpose of helping people on their path to better health." "This program underscores how important collaboration is to addressing the affordability challenges patients face Continue reading >>
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Soaring Insulin Prices Are A Case In Point: A 'free Market' In Healthcare Is Doomed
A key feature of Republican plans to replace Obamacare is allowing market forces to boost innovation and competition among healthcare providers. “Unleashing the power of choice and competition is the best way to lower healthcare costs and improve quality,” declares House Speaker Paul Ryan in his conservative manifesto “A Better Way.” The problem with that, however, is that the healthcare industry — hospitals, drug companies, insurers — have worked tirelessly to prevent the medical marketplace from functioning with sufficient transparency and efficiency to allow consumers to benefit from classic supply-and-demand economics. Instead, the opaque and frequently unfathomable healthcare market promotes runaway corporate greed that often can be countered only by shaming businesses into behaving fairly and responsibly. Insulin is a perfect example. Pharmaceutical giant Eli Lilly announced last week that people with diabetes in high-deductible insurance plans or who are otherwise paying full price for insulin will be eligible for a 40% discount. The move follows Danish insulin maker Novo Nordisk announcing it will limit annual price increases to single digits. However, it’s not like the heads of these companies woke up one morning and realized they’d been despicably taking advantage of people with a chronic disease. Rather, they’re facing heat from lawmakers and are desperate to make a show of sensitivity before anyone demands that they appear on Capitol Hill to explain themselves — as other drugmakers have been forced to do. Sen. Bernie Sanders and Rep. Elijah Cummings said in a letter to the Justice Department and Fair Trade Commission last month that officials need to look into whether drug companies “colluded or engaged in anticompetitive behavior” in Continue reading >>
Insulin Is Too Expensive For Many Of My Patients. It Doesn't Have To Be.
At age 15, I developed an unquenchable thirst and frequent urination, and lost 20 pounds. I had developed Type 1 diabetes, an autoimmune disease that destroyed my body's ability to produce insulin. Without insulin, I would have eventually developed a condition called diabetic ketoacidosis, which is lethal without (and even sometimes with) treatment. Years later, I'm a practicing endocrinologist. I could never have imagined back when I first started taking insulin that one day I would have so many patients who could not afford the medication because of skyrocketing prices. When the drug was discovered in 1921, the original patent was sold to the University of Toronto for $1 so that no one else could patent it and "secure a profitable monopoly." Numerous improvements later, insulin is produced by a three-company oligopoly. When the first of the newer insulin "analogs," Humalog, hit the market in 1996, it sold for $21 a vial. Today, vials of analog insulins, including Humalog, sell for about $300. Patients with Type 1 diabetes typically require two or three vials of insulin per month, but patients who are more resistant to insulin, such as those with Type 2 diabetes, may require six or more. A recent paper in the Journal of the American Medical Association found that insulin nearly tripled in cost from 2002 to 2013. A lawsuit filed in January accuses insulin companies of price collusion for allegedly raising prices repeatedly and in lockstep to match their competitors. Prices have gotten so bad that the American Diabetes Association recently launched an online petition at MakeInsulinAffordable.org, which has been signed by more than 248,000 people. Because insulin is so expensive, some people take less than their prescribed dose, causing higher blood sugars, which may lead Continue reading >>
How Much Do Diabetes Supplies/medications Cost In The U.s.?
While everyone’s diabetes treatment plan, medications, and technology may be different, there is one thing we can all agree on: diabetes is expensive. In two previous posts at The Perfect D, I gave some sense of what the bare minimum of care for a U.S. adult with Type 1 diabetes would be and also financial resources and programs to help with the financial burden of living with diabetes. However, this post is about how much it could cost an adult with Type 1 diabetes if they used the technology and medications that are currently out on the market (and thought of as “the latest and greatest”) and paid out of pocket with no insurance. Research on this topic has shown me that: 1) prices can fluctuate wildly, so it pays to shop around and 2) there is a very big gap (financially, medically, and technologically) between the bare minimum and “surviving” and actually utilizing the tools and latest technology that is out there. So, the hypothetical person for this exercise is a Type 1 adult in the United States who weighs 60kg, just like the other calculation post I did. Ground Rules These prices are accurate on the websites I have referenced for December 1, 2014. They may change, they may add shipping, they may not offer the services, technology, or drugs on their website after this is posted. These prices are not a guarantee. They are to be used as a reference. The listing of prices/websites on this post does not mean that I endorse the company or product or service. I have not listed all the products available on the market for people with Type 1 diabetes. I have listed major ones to give you an idea of major manufacturers’ costs for the products that are available for general public viewing. I did not call any companies and ask for pricing. Why? Because I believe Continue reading >>
Biosimilar Insulin And Costs
Biosimilars are approved copies of already marketed biological medicines. They provide an alternative to existing biological medicines that have lost their patent protection. The first biosimilar insulin (BioIns) will soon be launched on the EU market (Abasaglar, an insulin glargine developed by Eli Lilly and Boehringer Ingelheim). As the lawsuit with Sanofi has come to an end, this same insulin will be released on the US market soon but under a different name (Basaglar). Interestingly, this insulin was not approved following the new 351(k) biosimilar pathway (see below). It is of note that a major pharmaceutical player (and not a generics or specialty biotech company) has won the race to have the first BioIns approved. An Indian pharmaceutical company tried twice in the past to get approval in the EU, but failed both times.1 From the approval process seen with Abasaglar and the previous attempts to get an insulin approved in the EU, this is not an easy task. However, it can be expected that more BioIns will come to the markets over the next years, that is, a number of different insulin glargines, but also BioIns of rapid-acting insulin analogs. Nevertheless, it is of note that a large pharmaceutical company like Pfizer has stepped back from codeveloping a BioIns with an Indian company after being in cooperation with them for a while. As with the reduction in price seen when biosimilars of other drugs outside diabetes care came to the market, the expectation is that the market introduction of these BioIns will also have an impact on the price of insulin. The question is, will insulin costs decline in the next years to a similar extent as with other biosimilars or even to an extent as was observed with generic drugs? Or in other words, what savings are to be expected wit Continue reading >>
2055 L Street Nw Suite 600
INTRODUCTION Diabetes is a life-threatening disease affecting more than 20 million Americans. Individuals with diabetes must manage and treat their condition on a daily basis with the guidance of physicians and other medical professionals. Multiple studies have shown that, in order to successfully manage the disease and stave off complications, people with diabetes must frequently check their blood glucose levels. Unfortunately, many patients do not have affordable and adequate access to blood glucose test strips and other related supplies required to effectively manage their condition on a daily basis. Endocrinologists and other physicians, while able to provide guidance to patients on how to manage the disease, are frequently unable to provide direct assistance to individuals who cannot access or afford these supplies. BACKGROUND The Diabetes Control and Complications Trial (DCCT)1 and the UK Prospective Diabetes Study (UKPDS)2 demonstrated that in patients with diabetes, complications of the disease could be avoided or significantly reduced when blood glucose levels are strictly regulated. Complications such as diabetic retinopathy, kidney disease, and nerve disease can result when blood glucose levels remain uncontrolled. With access to the vital and necessary tools a person with diabetes needs to manage their condition, such as blood glucose testing meters and strips, these expensive complications can be avoided. People with diabetes require medications and supplies on a daily basis, including such things as insulin, oral medications, lancets, syringes, and testing supplies including a blood glucose meter and blood glucose testing strips. Even with generous health coverage, co-pays for such supplies, as well as periodic doctor appointments, and any care required fo Continue reading >>
Why Treating Diabetes Keeps Getting More Expensive
Laura Marston is one of the 1.25 million Americans who suffer from Type 1 diabetes, an autoimmune disorder in which a person's pancreas can't make insulin. She hoards vials of the life-saving medicine in her refrigerator to protect herself from the drug's rising prices. (Jorge Ribas/The Washington Post) At first, the researchers who discovered insulin agonized about whether to patent the drug at all. It was 1921, and the team of biochemists and physicians based in Toronto was troubled by the idea of profiting from a medicine that had such widespread human value, one that could transform diabetes from a death sentence into a manageable disease. Ultimately, they decided to file for a patent — and promptly sold it to the University of Toronto for $3, or $1 for each person listed. It was the best way, they believed, to ensure that no company would have a monopoly and patients would have affordable access to a safe, effective drug. “Above all, these were discoverers who were trying to do a great humanitarian thing,” said historian Michael Bliss, “and they hoped their discovery was a kind of gift to humanity.” But the drug also has become a gift to the pharmaceutical industry. A version of insulin that carried a list price of $17 a vial in 1997 is priced at $138 today. Another that launched two decades ago with a sticker price of $21 a vial has been increased to $255. [This 90-year-old fight over insulin royalties reveals just how much has changed in medicine] Seventy-five years after the original insulin patent expired — a point at which drug prices usually decline — three companies have made incremental improvements to insulin that generate new patents and profits, creating a family of modern insulins worth billions of dollars. The history of insulin captures Continue reading >>
Insulin And The Donut Hole: Lifesaving Drug Often Spikes Medicare Patients' Share Of Costs
Many diabetes patients requiring insulin will end up in the Medicare coverage gap known as the “donut hole,” where they’re responsible for a greater share of the drugs’ costs. When this happens, a patient’s out-of-pocket costs at the pharmacy spike dramatically — for example, from a $40-per-month co-pay to $350 a month. Even worse, some patients struggling with the expenses will drop or stop dosages or switch brands — decisions that can be dangerous to their health if not overseen by their doctor and can actually keep them in the donut hole, costing even more. These erratic costs can be a financial and emotional rollercoaster. Understanding how Medicare Part D Prescription Drug coverage works in regard to insulin can help you plan for price increases and the likelihood that you’ll enter the donut hole coverage gap. To help you, we’ll take you — chronologically — through a calendar year of expenses that a typical patient with diabetes on two forms of insulin may pay, so you can see real-world examples of how the four coverage phases can impact finances. But keep in mind that everyone’s situation can vary greatly, depending on their individual drug plans, other prescriptions and multiple other factors. The four Part D coverage phases First, it’s important to understand how your coverage works. Medicare Part B (medical insurance) does not cover insulin — unless use of an insulin pump is medically necessary. (If you use an external insulin pump, Part B may cover the insulin and the pump.) So having Part D — supplemental prescription drug coverage — is critical for many people to afford injectable insulin. Medicare Part D Prescription Drug coverage has four phases: The deductible phase — you pay the full drug cost until you hit your deductib Continue reading >>
Cost Of Insulin Just One Hurdle For Seniors With Diabetes
Dolores Suvak retired from her job as a high school English teacher in the Woodland Hills School District in 2006 with a generous retirement package that included an additional 10 years of health coverage under her school employees’ plan. Then came year 11. Ms. Suvak, 68, is diabetic, one of an estimated 11.2 million seniors — 25.9 percent of Americans 65 or older, according to the American Diabetes Association — who have the condition that can result in serious infections as well as nerve, kidney and eye damage, and life-threatening heart disease. For her, diabetes has meant daily testing, multiple injections and regular monitoring of her blood sugar. It also has meant the expense of test strips, lancets, needles and life-sustaining insulin, all of which have dug deep into the fixed retirement income that she and her husband Ronald live on. The switch to Medicare came with a financial trapdoor — Medicare Part D’s prescription drug “doughnut hole” coverage gap — that she says doubled her diabetes-related costs that first year. “It knocked the socks off of me. It just devastated me,” the Swissvale resident said last week. Patients and providers alike have noted the rising cost of insulin, which the American Diabetes Association says nearly tripled in price between 2002 and 2013. But that is only one of the hurdles that seniors with diabetes face. There’s also the emergence of high-deductible insurance plans, shifting more of the cost of care to patients, plus formularies that may change which insulin brands are covered at a lower cost. “This isn’t just about the increase in cost. It’s about Part D not covering every form of insulin in the same way or even covering them at all,” said Bill McKendree, coordinator for the Allegheny County Appris Continue reading >>
Drug Makers Double Insulin Prices Since 2012
Roughly six million Americans with diabetes require insulin to survive, and many say the rising cost of the life-sustaining medication is forcing them to make hard choices. KING 5 examined the National Average Drug Acquisition Cost database and found insulin prices had roughly doubled since 2012. On Facebook, Christina Hewitt wrote to KING 5, "My son is type 1 diabetic. Each vial of his insulin is 800 dollars. He goes through 3-4 per month. If he doesn't take insulin, he will die in about 48 hours. That's only 1 of his prescriptions, the supplies to administer his insulin can be just as pricey. I remember the uproar of people over the Epipen, but how about the other drugs!" Amelia Jordan also reached out to KING 5 on Facebook and wrote, "I've had to make that decision between insulin and food, gas, or rent more than once. It's not a good feeling." "Here we go. Come on blood," said Molly Boll, as she checked her blood glucose. Doctors diagnosed her with diabetes about three decades ago. "This is not going to work on this one because it's used so much." She pricks her finger at least three times a day to check her sugar, and when the numbers are high, she takes insulin to help her body process sugar. "I live on a very fixed income with no margin of error for having to spend about $1,400 a month on drugs." Lately, Boll admits she's been cutting back on her dose hoping to stretch out her insulin. "When I cut back on the insulin, it made my sugar go up really high," Boll said. Boll is among the more than 19 million Americans the Centers for Disease Control estimates do not take their medication as prescribed because of the cost. "There are many examples that we know of patients ending up very sick in the hospital because they couldn't afford their insulin," said Dr. Irl Hirs Continue reading >>