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Health/Medical Title: Insulin price spike leaves diabetes patients in crisis A massive spike in insulin prices is causing a health crisis for millions of diabetes patients who depend on the lifesaving drug, doctors say. Now, after years of rapid increases having nothing to do with available supply and not matched elsewhere in the world, those in the U.S. insulin supply chain are blaming one another. Tens of thousands of medical professionals are engaged in an intricate therapeutic ballet performed to protect the health, limbs and lives of the almost 30 million people in the U.S. suffering from diabetes. But their efforts have been dramatically complicated by the soaring increase in the cost of insulin. They find themselves balancing the cost of the essential medication and their patients ability to pay. The manipulation of insulin cost is a medical crisis in Montana and everywhere else in this country, said Dr. Justen Rudolph, a diabetes specialist at St. Vincent Healthcare in Billings. My patients having trouble with their insulin availability range from teenagers to a 90-year-old man, and theres not a day that goes by when Im not talking to a patient about the cost of their insulin. They try to spread out the insulin they have to make do, and thats not how you can control diabetes, said Rudolph. This hit-or-miss medicating concerns many practitioners. Precision is needed to ensure the patient is getting the best type of insulin for their specific condition, in the right doses, at the right time to achieve the greatest benefit, said Dr. Irl Hirsch, professor of medicine in the Division of Metabolism, Endocrinology and Nutrition at the University of Washington in Seattle. State statistics and those of the American Diabetes Association show that 65,000 to 70,000 people have been diagnosed with diabetes in Montana, and another approximately 26,000 are believed to have the disease but have not been officially diagnosed. In Missoula, Certified Diabetes Educator Carla Cox of the Providence Medical Group cautioned that switching to other forms of insulin can present a greater risk because it is less like the action of insulin produced by the pancreas. From 2011 to 2013 the wholesale price of insulin went up by as much as 62 percent. From 2013 to 2015 the price jumped again, from a low of 33 percent to as much as 107 percent, said Dr. Mayer Davidson, professor of medicine at the Charles R. Drew University of Medicine and Science in Los Angeles, who has carefully tracked the rapid and repeated increases. This borders on the unbelievable, Davidson said, citing an extremely concentrated insulin which in 2001 had the wholesale price of $45. By last year, the cost had skyrocketed to $1,447 for the same monthly supply. Susan Pierce, a diabetes educator at Philadelphias Chestnut Hill Hospital, said shes seeing similar increases, with her patients reporting that the cost of their insulin is doubling, tripling or worse. People who paid $200 or less are now getting bills of $400, $500 and even more for the same amount of insulin. Meanwhile, most insurance is paying less for medications and the required co-pays are higher, so it is a double whammy that prevents the patient from getting the insulin to stay alive, said Pierce. The medical community is concerned about patients who cant afford their insulin, so what they have to do is they ration it, said Davidson, who has been heralded for his creation of programs to get quality diabetes treatment to underserved communities. They take it only three or four times a week instead of every day, in order to make it stretch, and thats dangerous, he said. Diabetes specialists attack their patients increase or decrease of blood sugars with the finesse of a commander plotting how to use limited troops and supplies in a continuing battle. Patients and their practitioners live in a world where they must select and prescribe insulin which either institutes immediate changes in glucose or blood-sugar levels, or is long-lasting and doles out the vital medication over hours. We are not talking about concierge medicine, or just fine-tuning insulin therapy or something that a patent can live without. Were talking about survival. Dont let anyone sugarcoat it, warns Hirsch. The effects of diabetes are enormous. The disease is a leading cause of blindness, strokes, kidney failure, heart attacks, nerve pain and amputation of the feet and legs. Hirsch and many of his colleagues are not subtle when they describe what price gouging of a medication required for survival is doing to their patients. I had a patient tell me her insulin bill is suddenly costing her as much as her mortgage, Hirsch said. Others tell similar stories. Dr. Claresa Levetan, chief of endocrinology at Chestnut Hill Hospital, said just about 100 percent of them are having problems affording the higher cost of insulin. I see people every day in the hospital because they cant get their required doses of insulin. Many are in the ICU with what is called diabetic ketoacidosis, a life-threatening condition. This lack of insulin brings the patients to a critical juncture, where they will become extraordinarily sick, go into a coma and could ultimately die. I have patients who tell me that they have to make a decision between food and insulin, and their rent and insulin. I mean, seriously, food, rent or insulin, she said. Pricing of insulin, as with other medications, is controlled by the manufacturers, the insurance companies and pharmacy benefit managers the middlemen who negotiate the prices that the insurance companies pay. Both the pharma company and the pharmacy benefit managers jack up the cost, said Hirsch, a former editor-in-chief of the journal Clinical Diabetes, published by the American Diabetes Association. We dont know what the benefit manager is paying for the insulin from the pharma company. Its backroom deals, Hirsch said. You can call them rebates, you can call them kickbacks, you can call them bribes, but those are secret deals on which we dont have the details. Poster Comment: Big Pharma & the Insurance industry are parasites, more obsessed with profits than lowering the cost of health care. Post Comment Private Reply Ignore Thread Top Page Up Full Thread Page Down Bottom/Latest Begin Trace Mode for Comment # 4.
#1. To: Willie Green (#0)
If you like your medicine you can keep your medicine.
If they ( Doctors, Hospitals, Pharmas, Ins Companies, etc ) like your money, they can get your money.
That part of Obamacare is working.
There are no replies to Comment # 4. End Trace Mode for Comment # 4.
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