Affordability of insulin even more important during pandemic
When faced with paying rent or taking medications, many are forgoing insulin or cutting back, with drastic health complications.
As a nation we’ve reached a tipping point as to what patients can bear when it comes to the price of insulin, a drug used to control blood sugar levels for people with insulin-dependent diabetes. Millions of people who need this life-saving medication face affordability barriers in the form of rising insulin prices and out-of-pocket costs.
A new RAND Corporation study found that insulin prices are more than eight times higher in the United States than in 32 comparable nations combined, while the average list price nearly tripled between 2002 and 2013 and doubled between 2012 and 2016.
Related: Lawmakers’ focus on insulin prices ignores the bigger problem
Over the past 10 years, access to insulin due to cost, availability or both has brought increased attention and regulation. The most significant obstacle is the rising out-of-pocket costs stemming from insurance coverage changes. Access to insulin for those with diabetes varies depending on the type of health insurance and the type of insulin prescribed for a patient. As a patient is more likely to regularly fill and take medication if it is affordable, a physician may, in some cases, prescribe insulin that is more cost-effective, but not necessarily the best choice for their medical needs.
For those with insurance, especially in high deductible health plans, out-of-pocket costs can come in the form of upfront deductibles, copays, and/or coinsurance. For the uninsured, footing the bill for the entire cost of the drug is often required, making the drug out of reach. When faced with paying rent or taking medication as prescribed, many are forgoing insulin or cutting back on the prescribed amount, with drastic health complications including hospitalization, cardiac and other organ diseases, and even death.
Those with undiagnosed or unmanaged diabetes cost employers even more in both health care expenses and reduced productivity. With COVID-19, people with diabetes also face the added risk of poorer outcomes if infected, creating an even greater urgency to ensure proper management of overall health and chronic conditions.
It’s important to encourage employees to participate in the preventive care offered by their benefit plan to manage their health. For those on insulin, here are other actions employers can take:
- Ensure high deductible health plans include the addition of insulin and other glucose-lowering agents on the preventive drug list, allowing coverage before reaching the deductible.
- While state legislation does not impact self-insured employers, consider matching insulin copay limits.
- Adopt a diabetes management program through your pharmacy benefit manager to better control insulin costs and support employees and their family members.
- Make employees aware of resources available by the various insulin manufacturers. One allows patients with or without commercial insurance to receive their monthly insulin prescription for $35.
- Take advantage of free tools such as toolkits created for employers including our resource on insulin access and affordability.
People with diabetes that are insulin-dependent are truly in a life or death situation. It’s imperative that employers do their part to ensure access at an affordable price.
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