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Why Is Diabetes So Expensive

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 >>

Soaring Insulin Prices Have Diabetics Feeling The Pain

Soaring Insulin Prices Have Diabetics Feeling The Pain

Insulin price spike leads to lawsuitInsulin is fast becoming a medication that only the well-insured or well-heeled diabetic can afford. With the price of insulin more than tripling in a decade, some diabetics are having to make tough choices about how to pay for the medication. In some cases, diabetics are cutting back or even going without the drug. Many of the 26 million Americans with diabetes must use insulin daily to treat the disease, or else risk illnesses such as kidney failure and disabilities such as blindness. While American diabetics may have faced monthly costs of $100 to $200 several years ago, some are now grappling with costs of $400 to $500 per month. Insulin prices for American patients are far higher than in other countries, a recent survey of patients from the advocacy group T1International discovered. American diabetics said they pay $13.47 per milliliter for Eli Lilly’s (LLY) Humalog insulin, the highest price among the countries surveyed and about four times more than what Canadian diabetics pay. “People are suffering a lot,” said Allison Bailey, a college student in Iowa with Type 1 diabetes. “There are no generics. We have to go through these big companies, and they charge so much.” Bailey said she paid about $130 for several vials of Eli Lilly’s Humalog in 2010. This year, her insulin prescription has a price tag of about $495. She noted that she switched from using pump therapy in 2010 and now injects insulin with a pen, and that while the prices aren’t apples-to-apples, costs have overall sharply increased. She said she should go back to pump therapy, but she doesn’t believe she can afford it given the higher cost of insulin as well as the expense of a pump, which can cost more than $5,000. Others are also caught in a bind. B 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 >>

Why Insulin Is So Prohibitively Expensive To The 29 Million Diabetes Patients In The Us

Why Insulin Is So Prohibitively Expensive To The 29 Million Diabetes Patients In The Us

Even if it was first discovered more than 90 years ago, insulin is still out of reach for a shocking 29 million diabetes patients in the United States. Yes, this is the 21st century, but even so a staggering number of human beings are forced to live in life threatening conditions. But why is insulin so prohibitively expensive? According to Jeremy Greene, M.D., Ph.D., and Kevin Riggs, M.D., M.P.H., it’s all because of a series of perverse updates to insulin treatments. While insulin made today is more effective in some instances, previous versions weren’t that bad. In fact, they saved lives. Yet, these were replaced with very expensive versions, while the older, much cheaper versions are nowhere to be found on the market anymore. The two authors explore all that’s wrong with today’s insulin big pharma. A brief history of insulin Image: CNN In their study published in the New England Journal of Medicine, the two authors outline the history of insulin manufacturing until present day to build up the context which describes the present state of affairs in the big pharma business. Diabetes is diagnosed when a person has too much glucose (sugar) in the blood. This happens because the pancreas cannot make enough insulin. Insulin is produced in the pancreas and has two jobs in the body – the first is to transport glucose from the blood supply into fat and muscle cells, where it can be used for energy. The second is to switch off the liver once the level of glucose in the blood is high enough. In 1910, Sharpey-Shafer of Edinburgh suggested a single chemical was missing from the pancreas in diabetic people. He proposed calling this chemical “insulin”, and the name stuck and was later taken up by Frederick Banting and Charles Best, two Canadian researchers credited wi Continue reading >>

Why Are Diabetes Medications So Expensive And What Can Be Done To Control Their Cost?

Why Are Diabetes Medications So Expensive And What Can Be Done To Control Their Cost?

Abstract PURPOSE OF REVIEW: The purposes of this study were to describe how medication prices are established, to explain why antihyperglycemic medications have become so expensive, to show trends in expenditures for antihyperglycemic medications, and to highlight strategies to control expenditures in the USA. RECENT FINDINGS: In the U.S., pharmaceutical manufacturers set the prices for new products. Between 2002 and 2012, expenditures for antihyperglycemic medications increased from $10 billion to $22 billion. This increase was primarily driven by expenditures for insulin which increased sixfold. The increase in insulin expenditures may be attributed to several factors: the shift from inexpensive beef and pork insulins to more expensive genetically engineered human insulins and insulin analogs, dramatic price increases for the available insulins, physician prescribing practices, policies that limit payers' abilities to negotiate prices, and nontransparent negotiation of rebates and discounts. The costs of antihyperglycemic medications, especially insulin, have become a barrier to diabetes treatment. While clinical interventions to shift physician prescribing practices towards lower cost drugs may provide some relief, we will ultimately need policy interventions such as more stringent requirements for patent exclusivity, greater transparency in medication pricing, greater opportunities for price negotiation, and outcomes-based pricing models to control the costs of antihyperglycemic medications. Continue reading >>

Why Are Diabetes Products So Expensive In The U.s.?

Why Are Diabetes Products So Expensive In The U.s.?

Amidst all of the current controversy over the state of our nations health care, one thing hasn’t changed. Receiving good health care is expensive. Especially if you have diabetes. As if living with this disease isn’t difficult enough, the diabetes products sold in the US are outrageously expensive. In fact, diabetes is the most expensive health condition in the US. Globally speaking, diabetes costs us $825 billion dollars annually. So let’s take a look at why diabetes products are so expensive and what we can do about it. The History of Diabetes Products In 1921, a group of scientists and researchers in Toronto, Canada discovered insulin. Realizing the potential to change diabetes into a manageable disease rather than a death sentence, they decided not to profit from their discovery. Shocking, right? Instead, they sold their patent to the University of Toronto for $1 per person. The total sum of their profits? Three dollars. They did that because they thought it would prevent companies from creating monopolies and profiting off the health of others. Cut to 2017 and those same scientists would be shaking their heads with sadness. Because insulin was taken over by the pharmaceutical companies. In 1997 a pharmaceutical company charged $17 per vial. Today that same vial now costs $138. Another charged $21 for a vial that now costs a whopping $255. What changed? After 75 years, the original patent expired. That opened the door to pharmaceutical companies developing improvements to insulin. Therefore, new patents were generated along with huge profits. Why Big Pharma Keeps Prices High Pharmaceutical companies feel that the steps they are taking are completely necessary. Older medication prices are kept high so they can afford the research and development necessary for Continue reading >>

Insulin Is Too Expensive For Many Of My Patients. It Doesn't Have To Be.

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 >>

Why Are Diabetes Medications So Expensive And What Can Be Done To Control Their Cost?

Why Are Diabetes Medications So Expensive And What Can Be Done To Control Their Cost?

Abstract The purposes of this study were to describe how medication prices are established, to explain why antihyperglycemic medications have become so expensive, to show trends in expenditures for antihyperglycemic medications, and to highlight strategies to control expenditures in the USA. In the U.S., pharmaceutical manufacturers set the prices for new products. Between 2002 and 2012, expenditures for antihyperglycemic medications increased from $10 billion to $22 billion. This increase was primarily driven by expenditures for insulin which increased sixfold. The increase in insulin expenditures may be attributed to several factors: the shift from inexpensive beef and pork insulins to more expensive genetically engineered human insulins and insulin analogs, dramatic price increases for the available insulins, physician prescribing practices, policies that limit payers’ abilities to negotiate prices, and nontransparent negotiation of rebates and discounts. The costs of antihyperglycemic medications, especially insulin, have become a barrier to diabetes treatment. While clinical interventions to shift physician prescribing practices towards lower cost drugs may provide some relief, we will ultimately need policy interventions such as more stringent requirements for patent exclusivity, greater transparency in medication pricing, greater opportunities for price negotiation, and outcomes-based pricing models to control the costs of antihyperglycemic medications. Continue reading >>

Why Diabetes Test Strips Are So Expensive

Why Diabetes Test Strips Are So Expensive

Diabetes Test Strips are the Most Expensive RX for Diabetics I have been diabetic for nearly 10 years. I have Type 1 diabetes, which means that I am 100% insulin dependent and there is no "cure" for my disease, no matter how much I diet or exercise. An auto-immune reaction attacked the healthy beta cells in my pancreas, killing them off for good so that they will never make insulin again. Because insulin is such a powerful drug, it is easy to overdose, causing life threatening hypoglycemia. Type 1 diabetics must calculate the amount of insulin to dose, based on a number of factors including: (1) how many carbohydrates will be ingested; (2) how long it has been since the last insulin shot; (3) activity level; and (4) stress level. You might think that insulin would be the most expensive prescription for diabetics. Or perhaps glucose meters. Nope. You can dose yourself and own a meter and lancet to poke your finger to measure blood sugar levels. However, without diabetes test strips, a diabetic cannot effectively manage this serious disease. Inexplicably, the test strips are the most expensive item that is required for diabetics to properly manage their disease. I find this frustrating, to say the least. Not only because I am out-of-pocket additional funds (even with health insurance it runs me about $75 per month), but because my insurance company doubts my dedication to frequent testing to keep me healthy - and alive. Every time, I seek to refill my prescription, I get grief. Why is this? Why are diabetes test strips so expensive? Some People Sell Excess Diabetes Test Strips I have been so frustrated with the expense of diabetes test strips. Then I realized that part of the reason is that people are selling excess test strips online. That fact adversely impacts people l Continue reading >>

Are Expensive Diabetes Drugs Worth It?

Are Expensive Diabetes Drugs Worth It?

With the availability of new treatment options for type 2 diabetes, new questions are being asked about cost and effectiveness. Following last week's announcement that liraglutide (Victoza) was associated with a reduction of major cardiovascular events and all-cause mortality, physicians now have another option -- along with empagliflozin (Jardiance), the only other drug to show cardiovascular superiority in a postmarketing trial -- to help patients mitigate the cardiovascular risks that come with diabetes, with an agent mainly targeted at diabetic processes. Even some cardiologists are considering prescribing diabetes drugs as well. But an analysis of the fine print reveals that there is a relatively high number needed to treat for the drugs, both of which aren't cheap. According to GoodRx, which collects pricing data from pharmacies for consumer use, the cost of empagliflozin is $405 for 30 25-mg tablets, while the cost of liraglutide is $702 for a single carton of three pens (each pen can deliver 10-30 daily doses). A spokesperson for GoodRx said these figures come from taking the lowest price available at each U.S. pharmacy -- a total of about 75,000 prices -- and from that they take the 25th percentile to calculate their "fair price," or what consumers should be capable of getting if they're conscientious about pricing. This method, repeated every 2 weeks, excludes online and membership prices (from programs at CVS or Rite Aid, for example). The number of patients who would need to be treated with liraglutide, a glucagon-like peptide 1 (GLP-1) receptor agonist, to prevent one coronary event over a 3-year period was found to be 66, while the number to treat to prevent one death was 98. Empagliflozin, a sodium glucose cotransporter 2 (SGLT-2) inhibitor, fared better 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 >>

Why Is Lantus So Expensive? And How Can You Save?

Why Is Lantus So Expensive? And How Can You Save?

One of the only ways to treat diabetes type 1 and 2 are through insulin injections, like Lantus (insulin glargine), that help to control blood sugar. Unfortunately, doctors consistently report low levels of adherence to insulins, Lantus included. The main reason? The cost. Lantus is a prime example of an expensive insulin—averaging around $274 per month, it is unaffordable for many. But GoodRx is here to help. Here is some information on Lantus, and how you can save Why are insulins, and Lantus, so expensive? The case of insulin prices is an interesting one. In the 1920s, insulin was extracted from cattle pancreas, which led to negative reactions in some patients. So, scientists made it better. In the 1970’s a new type of insulin was developed using a technique called recombinant DNA technology. This technique uses human DNA to create the insulin needed and ultimately reduced complications. But the catch? After the new insulin with human DNA was created, the older and more affordable insulin was taken off the market in the US. Since then, the demand for diabetes medications has increased, and the cost of insulin has skyrocketed, leaving many paying an anywhere from $300-$900 per month for their life-saving injection. How popular is Lantus? Lantus is currently the most popular insulin, a class of medications that are used to lower blood sugar and treat diabetes type 1 and 2. Lantus was developed by Sanofi in 2000, and for many years was one of Sanofi’s top-grossing drugs. However, in recent years, with the development of other insulins, Sanofi has seen a decline in Lantus sales. While we haven’t seen the effects of this decline quite yet, it could mean that Sanofi will need to reduce the price for Lantus to stay competitive. Stay tuned. Does Lantus have a generic Continue reading >>

The Real Reason Insulin Is So Expensive

The Real Reason Insulin Is So Expensive

Insulin costs continue to rise and this is unfortunate considering millions of people desperately rely on it. Insulin is the hormone in our body that allows glucose (sugar) to get into the cells of our body that need glucose for energy. Produced in the pancreas, insulin is considered the “most powerful” hormone in the body. It was first discovered in 1922 and first derived from pigs and cows. In an article published by Estay Greene, director of pharmacy programs at Blue Cross Blue Shield’s North Carolina, Greene explains that about 30 years ago insulin manufacturers eventually created biologic insulin that saved us from our reliance on animals for insulin and brought huge improvements in insulin quality. He writes, and this is a fun fact, that “most insulin is made from E. coli bacteria.” These new insulin are much more similar to what we produce naturally as humans but they are incredibly expensive. The cost of insulin has been consistently rising throughout the life of a now 14 year old, tripling in fact, between 2002 and 2013. This isn’t quite the case for other countries outside the United States, however, so what is happening here that is causing Americans to pay so much? Has Competition Been a Negative Factor? Greene writes that “In the 95 years since insulin was developed, a number of drug companies have been making and selling it. But even with all those companies making insulin, competition hasn’t resulted in lower prices – it’s had the opposite effect. In fact, some brands of insulin have seen prices increase by more than 150 percent in the last five years alone.” He explained that “these price increases can spread like wildfire” with any competitors raising their prices in step with one another. Senator Bernie Sanders along with Repr Continue reading >>

The Cost Of Diabetes

The Cost Of Diabetes

In July, I went to order a refill of my pump and was refused. My account was overdue, and my pump company wouldn’t issue a refill until I could pay at least $400 of the $1200 I owed. I didn’t have $400. I am a freelance writer and stay-at-home mom with a knack for stretching my husband’s paycheck. I’d been making small monthly payments of about $50 because that was all we could afford, but now they wouldn’t send me any more. So I went to the pharmacy and bought a box of syringes for $25. I didn’t want to go back to multiple daily injections, but I didn’t see that I had a choice. It turns out that I’m not alone. A member of tuDiabetes writes, “I am no longer pumping…the supplies are too expensive, since I am starting my first semester of college. I just can’t afford it…which makes me really sad.” Another member writes, “My survival has come to rely on the kindness of others. Sometimes I have to choose to live without heat in the winter or electricity in order to afford my insulin and test strips. I wait for months and endless hours to attend the free clinic (which is overloaded with patients) and I haven’t seen an endo in years because I can’t afford it. There has to be another way…” One of the first things my pediatrician told my mom when I was diagnosed in 1985, at 14 years old, was that diabetes is one of the most expensive diseases. The expense didn’t really register with me until I graduated from college and was kicked off my parent’s health insurance plan. I had to find a job so that I could pay for test strips, insulin, and syringes instead of new clothes and shoes like my friends. Suddenly I was thrown into the adult world of trying to manage my finances. The cons (money spent on visits to the doctor and medical supplies) w Continue reading >>

Just How Expensive Is Diabetes?

Just How Expensive Is Diabetes?

New cost-effective analysis attempts to determine blood glucose targets to determine persons at high risk for type 2 diabetes development and for diabetes prevention…. Diabetes is an expensive disease with estimated total annual costs due to diagnosed diabetes in the U.S. at $245 billion in 2012. So what can we do to lower this economic burden? Researchers at the U.S. Centers for Disease Control and Prevention (CDC) assessed data of people without diabetes from the 2006-2010 National Health and Nutritional Examination Survey and used simulation models of cost-effectiveness as compared to different fasting plasma glucose (FPG) goals/targets in order to identify the most cost-effective blood glucose target of persons at high risk for developing type 2 diabetes. They investigated the change in lifetime quality adjusted life years (QALYs) and the medical costs associated with different FPG thresholds between 90-120 mg/dL (in 5mg/dL increments). Adults aged >45 years old were included in the study and researchers found that as FPG targets were reduced, QALYs, cost and cost per QALY increased. The cost per QALY gained increased from $30,100, to $32,900, $42,300, $60,700, $81,800, and $115,800 respectively as FPG targets decreased in increments of 5 from 120-90 mg/dL. If one is to use the standard of $50,000/QALY as cost-effective, then FPG levels at 105mg/dL and higher would be considered cost effective to determining persons at high risk of developing diabetes/preventing diabetes. These numbers show us a nice trend and demonstrate that lower FPG targets can lead to improving diabetes prevention but at a higher cost. But really, what is the value of someone’s life? Can you put a true cost/number on preventing diabetes? The costs associated with diabetes are astronomical a Continue reading >>

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