By Dorothy Pena / For The Herald
Picture this: You are being discharged from the hospital after having open-heart surgery. Your surgeon recommends taking insulin shots at home to control your high blood sugars, which can prevent further complications from your surgery. However, you find out from the hospital’s outpatient pharmacy that you will be paying more than a $400 copay for a 30-day supply.
The nurse discharging you that day talked to the pharmacist, and eventually, the price was adjusted to $250 for a 30-day supply. It was still expensive, but you thought it could be worse. Following your nurse’s advice, you immediately made an appointment with your primary care doctor for help in better controlling your blood sugar through means other than insulin. You realize you can never afford insulin in the long run, as your spouse is the only one working and is already paying out-of-pocket for her own insulin shots.
This is one of many issues with insulin access I have encountered over the last seven years of working as a nurse. Diabetes is the seventh leading cause of death in the United States. Of U.S. adults with diabetes 10.8 percent have reported using insulin within a year of their diagnosis. The covid-19 pandemic has worsened the problem, with many people losing their jobs and, consequently, their health insurance, which is necessary to cover life-saving medications, such as insulin.
I have had patients with diabetes dying from severe wound infections because their blood sugar was way out of control. The sad thing is that most of the time, these patients are often branded as “noncompliant” regarding their medications, when they simply cannot afford them.
Insulin is one of the most expensive medications. Even with a GoodRx coupon, you must still pay at least $100 in most pharmacies.
In response to the issue of insulin affordability, Executive Order 13937 was issued in July 2020, hoping to make insulin and EpiPens more available at a discounted price. However, despite the Department of Health and Human Services’ initial willingness to implement this order, it rescinded the plan due to a lack of funding.
There was some sliver of hope despite this. The Inflation Reduction Act of 2022 was passed to cap monthly insulin costs to $35 for Medicare patients 65 years and older. In our state, a similar law was passed in July 2022 when Senate Bill 5546 was passed to cap insulin prices at $35 for a 30-day supply, effective January of this year.
However, not everyone benefitted from these laws. For instance, those with insurance other than Medicare and the uninsured are not included in the Inflation Reduction Act and would not benefit from them. Furthermore, the state law passed in July 2022 does not include insulin price caps for uninsured patients. While these laws were created with good intentions, they are insufficient to fully address the increasing disparities in insulin access for all patients.
As a nurse, it’s frustrating to see patients suffer from preventable complications due to being unable to afford insulin. The inability to afford insulin is like a death sentence if you have diabetes.
Recently, Eli Lilly announced it would cap two of its insulins at $35 a month, including lowering the price of Humalog to $25 a vial. While this is a good start in decreasing disparities in insulin access, the fight continues to ensure that every person with diabetes has access to insulin.
I urge other insulin companies, including Sanofi and Novo Nordisk to follow suit, as well as everyone to write their legislators regarding improving current laws on medication access.
No one should have to ration their insulin and risk dying from uncontrolled blood sugar, so they don’t have to pay hundreds of dollars for a refill.
Dorothy Pena is a nurse and doctoral student at the University of Washington’s Family Nurse Practitioner Program. She lives in Everett.
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