health care

Local Pharmacists Concerned About Soaring Cost of Insulin

It’s putting more financial strains on local families, who have to choose between insulin doses and paying other bills

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The cost of insulin, a lifesaving drug used by 34 million people in the United States for Type 1 and Type 2 diabetes, is continuing to skyrocket.

It’s putting more financial strains on local families, who are already dealing with inflation and price increases on just about everything.

Insulin helps keep diabetics control their blood sugar and if you are reading this, you most likely know someone with diabetes or are diabetic yourself.

According to the American Diabetes Association, 1 in 10 Americans has diabetes. More than 11% of Texans have diabetes, and another 34% have prediabetes,

The cost of the drug has soared for decades as a result of pharmaceutical price gouging, according to experts. Most of the insulin supply in the U.S. is supplied by just three companies, Eli Lilly, Sanofi and Novo Nordisk.

According to the American Diabetes Association, diabetes is the most expensive chronic disease not just because of the high cost of insulin, but because it contributes to major health issues like kidney disease and high blood pressure.

“It's not just medication. They have to the machine that tests their blood sugar, the test strips, the lancets, the alcohol, the needles – it's a whole package that's involved,” said pharmacist Dr. Hussam Hamoush, who runs Stonebriar Pharmacy in Frisco.

He said the current prices for insulin are the highest prices he's ever seen.

“It's something that has been close to my heart. I've had family members that have had to deal with buying insulin,” Hamoush said.

Hamoush added that it’s even more difficult for patients right now because it’s the beginning of the year and many people have not met their insurance deductible yet.

For example, one of his patients had to pay $1,500 for just a month's supply of insulin out-of-pocket.

The cost is so high, he says people are left to choose between skipping doses or paying other bills.

“So it's painful to see because I am a diabetes expert. I've been counseling patients for diabetes for years. To watch this happen, it's tough because they have to decide between lifesaving medication or you know, living,” he said. “That's more than a car payment, that's more than some people's rent. So it's tough all the way around."

According to government data, insulin costs about 800% more in the U.S. than in other developed economies.

Hamoush said his pharmacy has been helping people get connected with special discount programs, copay cards and even calling the insurance companies to find cheaper medications.

He also works with patients to form diet plans and establish vitamin regimens to help manage diabetes.

The rising cost of insulin has become a hot-button issue for President Joe Biden and lawmakers in recent months.

“I have Google sheets that I share with patients to help with vitamins and help with supplements. It's a whole approach that comes to diabetes management, so it's not just eating right or taking your medication,” Hamoush said. “There’s exercise regimens that we help with patients and protein powders and stuff like that. We try to look at the body holistically and functionally and help with all sorts of management to hopefully get patients off insulin, which is always a possibility.”

The rising cost of insulin has become a hot-button issue for President Joe Biden and lawmakers in recent months.

Biden has also been tweeting about it multiple times lately, most recently this week.

Right now, his Build Back Better Act, which includes a provision on capping insulin costs, has passed the House but hit a roadblock in the Senate.

The provision limits the out-of-pocket copay cost of insulin to $35 a month for those with private insurance, a plan in the Affordable Care Act marketplace or Medicare.

And that would apply, regardless of anyone meeting deductibles – which Hamoush said can’t come soon enough.

"Right now, it's kind of the beginning of the year. Most patients haven't met their deductibles yet and so they're paying the maximum out-of-pocket for these medications,” he said. "I've seen deductibles [as low] as $2,000 but I've had other patients that can't afford their premiums. So they have a lower premium but they have a $15,000 deductible.”

President Biden also wants lawmakers to allow Medicare to negotiate better prices with drug manufacturers, which isn't currently permitted.

Negotiations on Biden’s plan are still underway. This week, Senate Majority Leader Chuck Schumer, D-N.Y., wrote to colleagues that “negotiations are underway with Senate Republicans on legislation to lower the cost of insulin,” as part of an urgent push to address economic pain points for American families.

Several other lawmakers are also bringing up more legislation on insulin, some even aiming to help uninsured patients.

In the past year, there have been other hopeful signs of support for those with diabetes.

Last year, legislation during former President Donald Trump’s time in office took effect, cutting out-of-pocket costs for seniors on Medicare. Trump also signed executive orders in 2020 to allow imports of cheaper medicines.

And just months ago, Gov. Greg Abbott signed a new bill limiting out-of-pocket co-pays to $25 for each insulin prescription per month for insured Texans on state-regulated health plans.

If you are struggling to pay for insulin or know someone who is, the ADA has resources to help at www.InsulinHelp.org.

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