How Do We Afford Our Insulin During an Economic Crisis?

COVID-19 has caused widespread panic across the globe, and that has quickly become apparent given the recent bear stock market, which hasn’t been seen since the Great Recession over a decade ago. You may have seen your IRAs and 401ks plummet in recent weeks because investors are scared.

Some economists are predicting that the United States could even see up to a 30% unemployment rate, as layoffs sore from the mandatory closings of restaurants, bars, gyms, coffee shops, and retail stores across the nation, trying to prevent the spread of COVID-19, the disease that is caused by the novel coronavirus. You may have experienced a recent layoff or reduced hours as a direct result of COVID-19, and if you have, your health insurance may have taken a hit as well (or gone away altogether). So, how can we afford our insulin during an economic crisis? Here is our (hopefully!) helpful advice:

If You’ve Lost Your Job

File for unemployment insurance immediately. Most states require that you’ve lived/worked in the state in which you’re applying for benefits for at least six months to qualify, and you don’t qualify if you quit or were fired from your most recent job. These bi-weekly payments have a cap (depending on your income and the state in which you live), but can definitely help you in the short term until you’re able to find new employment. Congress recently passed the COVID Stimulus Package, which includes expanded unemployment benefits (extending by 13 weeks), and enhances said benefits for four months. The program has also been broadened to include freelancers, furloughed employees and gig workers, such as Uber and Lyft drivers.

Special Enrollment Period

It’s well-known that one must sign-up for health insurance during “open enrollment”, which is a time period, usually once a year, when individuals and employees of companies and organizations may make changes to or buy different health insurance plans. Under the Affordable Care Act, a change in your personal situation, such as getting married, having a child, or losing your health coverage (by way of losing your job) makes you eligible for a Special Enrollment Period, which allows you to enroll in health insurance outside of the typical open enrollment period.

In response to COVID, many Governors are creating SEPs (Special Enrollment Periods) to specifically address people’s concerns over having health insurance and affording their medication during the global pandemic. If you currently do not have health insurance (by choice), but are worried about affording your insulin, or are particularly concerned about contracting COVID19, you may be able to take advantage of a SEP in your state.

See If You Qualify for Medicaid

As of now, 36 states have expanded eligibility for their state Medicaid programs (to 138% FPL), which offer extremely affordable insulin and diabetes care. If you’re a low-wage worker whose employer doesn’t offer health insurance, and you can’t comfortably afford to buy a plan, see if you qualify for Medicaid. Many Governors are looking into expanding Medicaid even further during the national public health emergency.

Cash Relief is Coming

Congress recently passed a $2 trillion Coronavirus Stimulus Package that includes direct cash payments to all American taxpayers. Lawmakers agreed to provide $1200 in a direct (single time) payment to taxpayers making up to $75,000 per year, with $5 less for every $100 per year a person makes all the way up to $99,000. Families will receive an additional $500 per child, in an attempt to create a safety net for people whose jobs and businesses have been negatively affected during this public health turned economic crisis. This bump of cash will help millions of Americans, including people with diabetes, afford their medications easier in the short term while longer-term policy solutions are worked out to help everyone during this crisis.

If All Else Fails, Reach Out for Help

If you’re still struggling to afford your medication, you can reach out to your insulin manufacturer for help: Lilly Cares, NovoCare, and Sanofi Patient Connection can help get you free or discounted insulin when you’re in a desperate spot. Currently, insulin manufacturers are not anticipating any supply-chain issues as a result of COVID-19.

Additionally, the diabetes online community (on Facebook, Instagram and Twitter) is an amazing resource of dedicated activists and helpful hands who are always more than willing to help fellow people with diabetes in need. Reach out to your friends and family and let them know you’re struggling. Ask your doctor if they have any samples of insulin you can take from the clinic for free. Let your struggle be known, so people can help you. Do not suffer in silence.

Have you had issues affording your medications and/or insulin during this global pandemic turned economic crisis? What strategies have helped you? Share this post and comment below, we love to hear your stories and suggestions!

Source: diabetesdaily.com

Insulin Co-Payment Cap Bills

America has a unique problem: prescription drug prices are too expensive for many people. In 2018 alone, 1 in 5 Americans (or 37 million non-elderly adults) went without a prescription drug due to cost. One of the most egregious examples of the high cost of prescription drugs is the rising cost of insulin in the United States. There are over 34 million Americans with diabetes, and at least 8 million are dependent on insulin to live. The list price of insulin has nearly tripled since 2002 and the average price of the drug has increased by 64% since 2014 alone. Most tellingly, a pivotal Yale study recently reported that as many as 1 in 4 people with diabetes have rationed their insulin due to cost. So, what are lawmakers doing about the problem?

Insulin co-payment caps have become a wildly popular idea by state lawmakers to curb the price of insulin for some insured patients in their states. Notably, Colorado was the first state in the nation to pass such legislation, making national news in May 2019. The bill, which caps monthly co-payments (for some insured patients) at $100, went into effect on January 1, 2020.

The main bill sponsor, Representative Dylan Roberts, said, “Colorado is leading the way with this measure, but this is just a first step. We won’t stop until all the pharmaceutical companies and drug middlemen start taking more accountability and stop gouging patients with their high costs.”

Other states have followed suit. The Illinois Governor signed into law similar legislation this past January (although the law doesn’t take effect until January 1, 2021), and there are currently similar bills pending in 36 other states.

insulin sensitivity

The average cost of a vial of insulin in America is over $300. | Photo credit: Adobe Stock

This is great news for many people with diabetes. The average cost of a vial of insulin in America is over $300, and people with insulin-dependent diabetes often require multiple types and vials of insulin per month, which can drive up the price (to live!) into the thousands. Capping co-payments, or essentially “carving” out a $100 co-payment (especially for people on high-deductible health plans who are paying the full list price of insulin until they hit their deductible, which can sometimes be in the high-thousands) can save people thousands of dollars and will undoubtedly help save lives.

Some people may think this solves the insulin pricing crisis, but it doesn’t. These bills are a great start to bring attention to the exorbitant cost of prescription insulin, but there are many people who don’t qualify under these new laws. State legislatures only have jurisdiction over state-regulated health plans, and thus cannot determine pricing on ERISA plans, or health insurance plans that are fully or partially managed by the federal government, such as Medicare, Medicaid, or the Veteran’s Health Administration. Additionally, any large, private employer plans would not fall under the law. Most importantly, anyone who’s uninsured does not receive protection under this law, and must still pay the full list price of insulin at the pharmacy counter.

For states that have expanded Medicaid, this doesn’t pose as much of a problem, as more people are covered by some sort of insurance (Medicaid co-payments are usually set between $1-3). States with robust exchange programs also benefit more under these laws, as by definition these are state-regulated plans that are subject to the co-payment caps. But for people who don’t qualify for Medicaid, cannot afford a health exchange plan, and find themselves without insurance, they’re still stuck paying these outrageous prices, which is sometimes a matter of life or death.

And the problem isn’t going away. The Health Care Cost Institute reported that the price of insulin doubled in a span of four years, between 2012 and 2016. According to their report, the average price a patient with type 1 diabetes paid for insulin in 2012 was $2,864 but that doubled to $5,705 by 2016.

Why is the cost for a nearly 100-year-old drug continuing to rise? For one thing, there are no generic competitors, and only three companies manufacture the drug. Secondly, insulin products are protected under patent laws, which allow the manufacturer to sell a product unchallenged in the market before a generic can be introduced. Novo Nordisk, Eli Lily, and Sanofi, the three main insulin manufacturers, have continued to “tweak” their insulin products in order to extend their exclusivity rights and hold onto their patent longer, without facing competition from generics. In fact, Sanofi has filed lawsuits in the past against Merck and Mylan to prevent them from going to market with a generic version of Sanofi’s Lantus insulin. Additionally, our government (unlike most other countries in the world) does not negotiate drug pricing with pharmaceutical companies, and thus there are no regulations on how high pricing can be set.

This national crisis has even gotten the attention of current and former Presidential hopefuls: Mayor Pete Buttegieg, Senator Amy Klobuchar, Senator Elizabeth Warren, Senator Bernie Sanders, Tom Steyer, and even Vice President Joe Biden have all called out insulin specifically when talking about outrageous drug pricing.

Congress has also started paying closer attention, and H.R. 3, the Lower Drug Costs Now Act has been introduced that would allow for The Centers for Medicare & Medicaid Services to negotiate drug prices on certain drugs (including insulin) to lower the costs, among other measures. Co-Chairs of the Congressional Diabetes Caucus, U.S. Representative Diana Degette and Representative Tom Reed, have also introduced the Insulin Price Reduction Act, which, if enacted, would decrease the price of insulin nearly 75% for Americans, to costs equal to those in 2006. These are all great first steps to addressing American’s cries for help, and to help reduce the burden millions of people with diabetes are facing every day.

Any legislation will have its pros and cons, but people with diabetes suffering due to high drug pricing don’t have to suffer in silence any longer. Politicians are taking note and action, and one day I hope we can all declare the crisis solved.

Have you been negatively affected by the high price of insulin in the United States? Share this article and post your story in the comments below, we’d love to hear from you!

Source: diabetesdaily.com

Traveling With Diabetes: 10 Ways to Prepare for Your Flight

This content about flying with diabetes originally appeared on SkyParkSecure.com. Republished with permission. Air travel can be stressful for anyone, but if you have diabetes, it requires more planning and preparation. Whether it’s your first time on a plane or you’re an experienced veteran, it’s always worth checking this guide before you next go away. […]
Source: diabetesdaily.com

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