People are dying from insulin rationing – even tv dramas are talking about it


#21

There are PLENTY of patients that are non-compliant despite having insurance to cover all or most all of their diabetic expenses. It isn’t about money in those cases–it’s about attitude, despair, laziness, or a lack of understanding of how important good control is to one’s long-term prospects for a normal life span. No one is going to make it for 30-50 years with A1c’s in the double digits.


#22

I spoke to the CVS manager yesterday (she had been out of the store for a few days when my issue first came up) --using Part B should work out. She just had to be educated. Communication is key.


#23

This can pretty much be dismissed as fake news.

The problem is that, while diabetes supplies may cost as much as that when you get then through US insurance the problem with the basic supplies with no insurance is very different.

Firstly Humulin R is available over-the-counter; that is the first place a T1 with limited resources should go. Even with the attempts by the pharmacists to elevate the price I don’t think it goes that high, certainly the price of Humulin R to treat pets is not exorbitant (these days pets get human insulin, because it is cheaper and more readily available than the porcine insulin we all used to use).

The second part of the problem is an effective long acting insulin. This is actually, I think, the biggest potential problem, although it is true that MDI of Humulin R can be used in place of any long acting insulin the issue I faced while growing up (when what I was prescribed was essentially exactly this) was fairly dangerous nighttime lows. Neverttheless I believe (I haven’t looked at this for a long time) that viable OTC long term insulins are still available in the US; I don’t know about the price.

The third part of the problem is test strips. Again they are readily available OTC but it seems to me that some local pharmacists are bumping the price. All the same so far as I have been able to see over the last couple of years Walmart has OTC test strips at a price that might be described as “affordable”, although still inflated compared to the rest of the world.

No one would deny that the US health care system really sucks, but it sucks for everyone. No one would deny that diabetics in the US have a significant expenditure to stay alive, but it isn’t $2000, or $1000, per month; that is apparently someone’s misguided attempt to boost it above the medicaid level.

Here’s an OTC breakdown:

  1. Humulin-R, I pump so I don’t use longer acting insulin. Using my per-month of never more than 1500IU and subtracting 600IU for longer acting (2) I get https://www.walmart.com/ip/Pharmacy-Novolin-R-Insulin-Dsd/150816409 $130/month. Notice that this walmart price IS inflated - $144/10ml; compare with Novolin-N below.
  2. Humulin-N; https://www.walmart.com/ip/Novolin-ReliOn-Insulin-N/167672445 ($24.88 at my local Walmart). Net cost at 20IU/day per month $14.93
  3. Test strips. Various options at Walmart, basically about $9/50 or 18c each. I would recommend aiming to use about 10 a day (note that US insurance policies will only pay for 6 a day) for a cost of $54/month.

Syringes are also required. I have to admit for most of my life I just used the same one again and again. Indeed, when I was initially diagnosed I had one glass syringe and about five 18G needles, my mother had to boil them to disinfect on a regular basis and they were stored in what was called (this is the UK) “surgical spirit”, which added to the pain. My local walmart appears to be out of stock of syringes, I guess they have uses for other than T1s, but the cost seems to be between 15c and 30c each, so at four per day that’s $18 to $36, say $30.

Isopropyl alcohol is cheap (99c/quart, 70%), you can use paper towels for cleaning, but I get big cotton swabs from the local Grocery Outlet.

So, per month; $229.

This price is certainly inflated; the $130 for Humulin-R is ridiculous and the price in the rest of the world is a fraction of the US price, including the supposedly developed world, e.g. see the wikipedia.org prices for Humulin-N:

Note that wikipedia quotes a US amount which is actually 5 times the price at my local Walmart but matches the price that Walmart has for Humulin-R. The wikipedia page for Humulin-R has exactly the same numbers as -N; that should make us all suspicious.

Also notice that for someone on the poverty line $229 per month is a lot of money; an extra $2750 per year which, given that the poverty line is about $16,000, means that without Medicaid T1s are VERY VERY threatened and that if you do just pass the Medicaid limit then you really do need the health care subsidies to simply stay alive.

Like I said, our health care sucks, but as a lifelong T1 I really hate it when people try to make fake news political points out of diabetes treatment so that they can advance whatever industry interest Fox was trying to advance. It is NOT expensive to treat diabetes; most of my life in the US I used MDI and very little testing and I never met my deductible (a couple of $K), let alone the OOP max (but then that was about $30K before the ACA).

John Bowler


#24

I also caught the episode of “The Resident.” Was waiting for them to misrepresent diabetes AGAIN. BUT was pleasantly surprised.
Like the recent price-gouging of the Epipen, there desperately needs to be concentration in the price-gouging of insulin! No doubt that people need the Epupen so that they MAY live, but we diabetics WILL DIE if we do not have insulin! Get with it!


#25

I’m two years out from Medicare and Tricare for LIfe (TFL). Does anyone have experience with Meidcare and Tricare for Life concerning insulin and pumps?


#26

Monthly supplies of $1300 per month, how does he come up with that number. That seems a little too high. I have no insurance coverage and my costs are maybe half of that with the pump and Dexcom.


#27

Good thing both parties have stated they except pre-existing conditions. We need that


#28

It is at least 1300 - how you get half is bewildering


#29

if you meant “accept” then I’m with you. :slight_smile:


#30

FAKE NEWS, right there.


#31

My doctor has had a continuous battle with my insurance company over the number of strips he prescribed - 12 a day. A pharmacist working for a well known US corporate pharmacy disclosed the “6” number to me (no, I’m not giving sources at this point for, I hope, obvious reasons.)

That’s why I gave in and got the G6 - not because I felt I needed it but because, believe it or not, they will (eventually) pay over $5000 for three months CGM without continuously challenging the prescription. I’ve now got a re-written test strip prescription for six a day. Believe me I wouldn’t be doing this if I could find another way.

The up-side is that so far my results with the G6 have been excellent - the previous major disaster area I had with an earlier Dexcom CGM seem to be fixed by the G5/6 system simply working better with calibration.

John Bowler


#32

I wonder if starvation ketones have anything to do with this, or if it is related to just high blood sugars (dka). Either way I feel the acidosis is very relevant to this situation. Because when the stomach shuts down, it won’t let anything in. Diet can reduce the amount of insulin therapy. But diabetes never acts only one way all the time. GAPS diet is interesting imo, but needs to be modified for diabetes. Either way insulin therapy is still needed. There are a lot of complaints about the price of insulin. I have at times needed to buy insulin otc. I think the largest factory in the U.S. is Eli Lilly’s insulin factory. Interesting yes. Not really profiteering by definition, but still. It should be available to those who can’t afford it, because it is life jeopardizing.


#33

I’ve had no trouble with a variety of insurances, with my doc giving me Rx’s for 15 or more per day. that’s been going on for more years than I can count–but no less than 30 years. And the number of insurance companies, including Medicare–no less than 7. For the life of me, I can’t understand why others have issues with quantity. All that is generally needed is for your doc to fill out a “Quantity Override” form.


#34

@Dave44 - Similar. We used to get 10 strips per day. Insurance never gave us a problem. Our Endo wrote the script for 10 strips per day and it was simply filled as such and reimbursed as such by the insurance with no issues.

When the G5 had the label change for the non-adjunctive dosing, we had substantially reduced testing, so we dropped our re-order from 18 boxes (900 strips) every 90 days down to 6 boxes (300 strips) every 90 days.

That might still be a little high so I don’t bother reordering strips until we are down to one unopened box (50 strips). Since switching to the G6 from the G5, we have been using even fewer strips although we still do use them.