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The only reason for rationing insulin is that it is too expensive. The old-fashioned R, N, and 30/70 are cheap, like several people have posted, $25 a vial at Walmart. I suppose a patient could have extremely "brittle" (I think that is the term) blood sugar levels, but I think that most prescriptions for expensive insulin are because the physician does not consider its cost. People survived on pig insulin, back in the mid-Twentieth Century; it would be a very unusual patient who couldn't live on ordinary insulin now.
Everybody who takes insulin should be given nutritional counseling and should be told what to do if they can't get their medicine. You can survive hyperglycemia. People do for years when their diabetes is not yet diagnosed.
Everybody who takes insulin should be given nutritional counseling and should be told what to do if they can't get their medicine. You can survive hyperglycemia. People do for years when their diabetes is not yet diagnosed.
You're confusing type 2 diabetes with type 1 diabetes (which is what this kid had). Type 1 diabetics do not go for years before being diagnosed; they die from diabetic ketoacidosis fairly quickly when they don't receive insulin. The only thing this kid could do if he couldn't get his medication is die (which is exactly what he did).
Type 1 diabetes is much more dangerous than type 2.
Since this occurred in MN, why didn't the 26 year old get Medical Assistance when he turned 26 and appears to have lost coverage from his parents? He at least should have anticipated his financial situation.
And the same question for the 21 year old? Why didn't he get Medical Assistance if he was on his own?
Since this occurred in MN, why didn't the 26 year old get Medical Assistance when he turned 26 and appears to have lost coverage from his parents? He at least should have anticipated his financial situation.
And the same question for the 21 year old? Why didn't he get Medical Assistance if he was on his own?
I found this story on Alec/Alex. He made too much to qualify for Medical Assistance (though he did qualify for some tax credits under Minnesota Care). He could not afford a $450 per month premium with a $7600 deductible (he would also have had to pay $1300 per month for insulin until he met the deductible), so he chose to be uninsured while he looked for a better job with better benefits.
He was in the middle. He would have got Medical Assistance if he quit his job. Instead, as most Americans do, he was trying to make a living and improve himself, but it was not enough (the middle class is sinking).
Which kind of raises the question of why he was rationing. Anyone actually in the middle can afford 100 or so a month which is what insulin costs for someone using a lot of it, which isn't that unreasonable. If someone can't afford 100 that's one issue.
Insulin is interesting as it's relatively inexpensive. Long acting, sure, that's expensive but there are relatively inexpensive alternatives. It's not like say epi pens where the last alternative went off market in 2012. With no competition they just cashed in until the patent expired. Now you can get generic epi pens but that's only happened within the last year.
Which kind of raises the question of why he was rationing. Anyone actually in the middle can afford 100 or so a month which is what insulin costs for someone using a lot of it, which isn't that unreasonable. If someone can't afford 100 that's one issue.
Insulin is interesting as it's relatively inexpensive. Long acting, sure, that's expensive but there are relatively inexpensive alternatives. It's not like say epi pens where the last alternative went off market in 2012. With no competition they just cashed in until the patent expired. Now you can get generic epi pens but that's only happened within the last year.
You missed the part where his insulin cost $1300/mo. The inexpensive alternatives aren't necessarily appropriate for everyone. Insulin is not one-size-fits-all. There's also the cost of testing strips, which can certainly add up if someone has to test multiple times a day.
The only reason for rationing insulin is that it is too expensive. The old-fashioned R, N, and 30/70 are cheap, like several people have posted, $25 a vial at Walmart. I suppose a patient could have extremely "brittle" (I think that is the term) blood sugar levels, but I think that most prescriptions for expensive insulin are because the physician does not consider its cost. People survived on pig insulin, back in the mid-Twentieth Century; it would be a very unusual patient who couldn't live on ordinary insulin now.
Everybody who takes insulin should be given nutritional counseling and should be told what to do if they can't get their medicine. You can survive hyperglycemia. People do for years when their diabetes is not yet diagnosed.
As the spouse of a diabetic who has had insulin-dependent diabetes for fifty-five years I will speak to the issues involved with insulin.
Yes, it is possible to go to Walmart and buy insulin for approximately $25 a bottle. This is old insulin. Known by names such as regular, nph, and lente. In the last ten years advances have been made in insulin. No physician that I know of today prescribes the old regular insulin to his diabetic patients. The new insulins that are available make controlling diabetes considerably easier.
Controlling blood sugars is critical to a diabetic. There is a huge amount of evidence that poor control results or worsens problems like neuropathy, retinopathy, and nephropathy. The use of new insulins such as Lantus, Toujeo, and Novolog makes controlling blood sugars a much easier process. Over time, the use of these insulins plus regular blood glucose monitoring will significantly reduce diabetes complications. The problem is that these new insulins are protected by patent and the manufacturer is able to charge whatever the traffic will bear. In the case of a life saving medication, the price that some are willing to pay is high and many health insurers have no choice, but to pay. Its a perfect storm which is literally fatal for diabetics that do not have a means to obtain these drugs.
Its time for this country to face up to what the problem really is: Our system which allows drug companies to charge whatever they want for lifesaving medications is not only morally wrong its bankrupting us. The solution is some type of price regulation. Rather, than being an example of "socialism" this is what we do in all fifty states when it comes to public utility rates. A government agency generally known as the public utilities commission sets utility rates in all fifty states. This process has not destroyed utility companies. Nor would price regulation destroy pharmaceutical companies. It would make the price of life saving drugs affordable though. That is what is needed and what we need to face up to. It may five years or fifty years, but its the direction we need to move in.
Last edited by markg91359; 07-16-2019 at 08:29 AM..
As I said before, any physician who prescribes an expensive insulin should be REQUIRED to tell the patient what dosage and what kind of INEXPENSIVE insulin he should use in an emergency. The old insulins should be OTC just because of these possible emergencies (and because they have very little potential for abuse).
We can't have people dying because there's a bureaucratic mixup in their prescriptions. I had one primary care physician whose nurses never got my prescriptions right.
As I said before, any physician who prescribes an expensive insulin should be REQUIRED to tell the patient what dosage and what kind of INEXPENSIVE insulin he should use in an emergency. The old insulins should be OTC just because of these possible emergencies (and because they have very little potential for abuse).
We can't have people dying because there's a bureaucratic mixup in their prescriptions. I had one primary care physician whose nurses never got my prescriptions right.
He’s had diabetes his entire life. I’m sure he, his family and his doctor discussed the kind of insulin he’s on with the family. I’m sure raising a child with diabetes he and his family is quite aware and knowledgeable about his drugs and dosages.
As the spouse of a diabetic who has had insulin-dependent diabetes for fifty-five years I will speak to the issues involved with insulin.
Yes, it is possible to go to Walmart and buy insulin for approximately $25 a bottle. This is old insulin. Known by names such as regular, nph, and lente. In the last ten years advances have been made in insulin. No physician that I know of today prescribes the old regular insulin to his diabetic patients. The new insulins that are available make controlling diabetes considerably easier.
Controlling blood sugars is critical to a diabetic. There is a huge amount of evidence that poor control results or worsens problems like neuropathy, retinopathy, and nephropathy. The use of new insulins such as Lantus, Toujeo, and Novolog makes controlling blood sugars a much easier process. Over time, the use of these insulins plus regular blood glucose monitoring will significantly reduce diabetes complications. The problem is that these new insulins are protected by patent and the manufacturer is able to charge whatever the traffic will bear. In the case of a life saving medication, the price that some are willing to pay is high and many health insurers have no choice, but to pay. Its a perfect storm which is literally fatal for diabetics that do not have a means to obtain these drugs.
Thank you for your response!
The risks from diabetes is so much more than dying.
Blindness (retinopathy) is a risk from poorly controlled diabetes. With dogs, there is limit to how well diabetes is controlled with a $25 bottle of insulin (even with vet blood tests, urine strip tests, control of food).
However, blind dogs can cope just fine, people not so much.
Quote:
The old insulins should be OTC just because of these possible emergencies (and because they have very little potential for abuse).
They are OTC, it is the syringes which need a script.
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