Multiple Perspectives on Nation's Insulin Crisis Reported in Special Issue of Evidence-Based Diabetes Management™

(CRANBURY, N.J. ) — There’s no shortage of ideas and policy proposals to lower the cost of prescription drug prices, particularly insulin, which people with type 1 diabetes (T1D) need in order to stay alive. But while conversation and debate about insulin pricing continue to drag on without a resolution, patients suffer, sometimes with deadly consequences. In the September special issue of Evidence-Based Diabetes Management™ (EBDM), called Perspectives on Insulin Pricing, young adults speak about the effect the disease has had on their health and finances, the head of JDRF discusses legislative reform, the editor-in-chief describes the consequences of rationing and researchers outline improved adherence and cost savings by switching from analogue insulin to human insulin.

Articles featured in the issue include:

Young adults defer career dreams and scramble for steady health benefits. Young adults are grateful for the Affordable Care Act (ACA), which allowed them to stay on their parents’ health plan until age 26, but they tell of struggling under the weight of high-deductible health plans and high cost sharing, if they can obtain a position with benefits at all. Some worry about what will happen if the ACA is overturned and, with it, protections for people with preexisting conditions like diabetes.

Teenage recalcitrance over a diabetes diagnosis leads to adult complications. A college graduate describes the common circumstance of teenagers struggling to become responsible for a life-threatening illness, which in her case caused temporary vision loss and a rare gastrointestinal illness that led to unemployment.

We may not know the total cost of today’s insulin crisis until tomorrow. Robert A. Gabbay, MD, PhD, FACP, the editor-in-chief of EBDM, says the consequences of rationing, such as more time in hyperglycemia or greater risk of diabetic ketoacidosis, increase the likelihood of future complications such as blindness and kidney failure. The total costs of diabetes complications borne by health systems triggered by today’s high insulin prices may not be fully known for years.

Action is needed by Congress, insulin makers, health plans and the federal executive branch. Aaron Kowalski, PhD, the first chief executive officer of JDRF, who has T1D himself, discusses his support for a new bill that would ban rebates on insulin formations that sell above their 2006 prices.

It’s possible to improve adherence and lower costs by switching insulin. The high cost of analogue insulin hurts patients by limiting affordability, worsening medication adherence and leading to microvascular and macrovascular complications, say CareMore Health researchers. The authors write about the experience of switching Medicare Advantage patients to a new regimen of human insulin, with less frequent injections and a delay in reaching the so-called “donut hole,” or coverage gap, in Medicare Part D.

Find these and other articles in EBDM’s Perspectives on Insulin Pricing issue here.

About The American Journal of Managed Care^®

The American Journal of Managed Care^® (AJMC^®) is a peer-reviewed, Medline-indexed journal that keeps readers on the forefront of health policy by publishing research relevant to industry decision makers as they work to promote the efficient delivery of high-quality care. AJMC.com is the essential website for managed care professionals, distributing industry updates daily to leading stakeholders. Other titles in the AJMC^® family include The American Journal of Accountable Care^® and two evidence-based series, Evidence-Based Oncology^™ and Evidence-Based Diabetes Management^™. These comprehensive offerings bring together stakeholder views from payers, providers, policymakers and other industry leaders in managed care. To order reprints of articles appearing in AJMC^® publications, please contact Gil Hernandez at 609-716-7777, ext. 139.

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