Treating Diabetes has become Impossibly Expensive!

A patient came in this month with insulin-dependent diabetes.  Her Endocrinologist had placed her on a combination of a long-acting insulin (Lantus) and short-acting insulin (Humalog).

She stated her situation bluntly: “I can’t afford it. It’s $300 a month!”Her insurance seemed like a reasonable plan.  I looked on GoodRx to check out the cash price.  Each of the two insulins were about $500 per month each.  In other words: ONE THOUSAND DOLLARS a month! That’s insane!  Her insurance was covering 70% of the high price, leaving her a price that was still too much.I knew insulin was expensive, but I had no idea.We sat down to figure out a way to switch to the old fashioned and cheaper insulin we used in the 1980s: NPH and REGULAR.  Walmart sells this under the Relion brand. The price is dramatically lower. Unfortunately, this old style Walmart insulin is harder to dose.  You inevitably end up with too much or too little. If you can’t afford insulin, this is better than nothing….maybe…Diabetes experts are calling attention to the dangers of cheap insulin.  Adequate sugar control is simply not possible with the Relion NPH and Regular.  High sugars are slowly killing our patients while low sugars kill them much faster.What about diabetics who take only pills?  Medications like Januvia, Invokana and every other diabetes pill you see advertised on CNN or the Weather Channel is….. $500 per month each.What a coincidence…. $500 seems to be the going rate.  Thank goodness for competition?

Then, there are the sneaky high priced drugs:  If you really want to freak out your patients, order brand name Glumetza (metformin) for $3000 per month.  METFORMIN?!? REALLY?!?!?!? Generic metformin is $4 per month at Walmart.  Few prescribers have any idea of these costs.  It’s crazy!!

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Steven Mussey MD

Steven Mussey, M.D. is a physician in Internal Medicine, practicing in the Fredericksburg area for more than twenty years. He grew up in Springfield, Virginia and earned a degree in Physics from The University of Virginia, Phi Beta Kappa. He earned his medical degree at The George Washington University and was inducted into the medical honor society AOA. He is Board Certified in Internal Medicine. He served in the Air Force for four years before entering into private practice. He particularly enjoys geriatric medical care and working with complex patients. For almost a quarter century, he has been practicing with one other Internist. Both doctors enjoy practice in a small, but busy office, and plan on working into their 70s, as long as they can still find their way to the office. Dr. Mussey is also an avid cartoonist and has a weekly cartoon in the local newspaper. He also enjoys cartoon animation and has had several public service cartoons playing regularly on the television cable systems. 

  5 comments for “Treating Diabetes has become Impossibly Expensive!

  1. arf
    February 2, 2020 at 2:44 am

    Lantus was introduced to the market in the year 2000. The drug is approaching it’s 20th birthday.

    I thought drug patents were good for 20 years, do I misunderstand?

    When I Google “Lantus patent status”, what I read is the patent has been extended to the year 2031.

    Why are we allowing this abuse of patent law?

  2. Philip
    January 30, 2020 at 12:19 pm

    The cash price “down under” is about $140 and $170 respectively. How come there is such a discrepancy?

  3. JRDO
    January 30, 2020 at 12:07 pm

    Patent protection along with tacit collusion by the drug manufacturers is to blame.
    The system is designed to make a relatively few people rich and impoverish the rest.

    IMO healthcare is not widget manufacturing and should not be treated as such.
    It should be regarded a societal need similar to policing or infrastructure, not as a expendable luxury item.
    There are many countries whose healthcare systems deliver better more cost effective healthcare than ours.
    Why is it we are too stubborn to learn from them?

    • Pat
      January 31, 2020 at 8:20 am

      Redefining health care essentially as a utility is thus far the most logical approach I’ve heard toward advocating single-payer. But even then, there would have to be significant rationing, restraints on malpractice, and a great deal of personal freedoms would/should be called into question, if not lost.

      And then, what about those already in it, who don’t want to play?

  4. R Stuart
    January 30, 2020 at 11:37 am

    Obviously, the solution is to blame physicians and reduce their pay.

Comments are closed.