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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