Cheaper than Water
January 1, 2021 • 18 Comments • Posted in politics, radioI have a confession to make. For the past couple of years, I’ve been involved in a drug trade.
I trade insulin.
It all started in 2019. Well, I take that back. It all started in 1966, when I was diagnosed with juvenile diabetes (now referred to as Type 1 diabetes). I’ve been injecting insulin ever since. Early on, Flo, my mom, was my supplier. They knew us at the local Rexall drug store: I’d walk with her there every month, she’d plunk two dollar bills on the counter, and they’d hand her a vial of “regular” insulin along with two cents change. In my college years, the university health system supplied insulin free-of-charge. After graduation I narrowed my job search to employers who provided good health insurance. The cost of insulin rose slowly over the years, but with health insurance, I was only asked to pay $30 per vial.
Until that one day last year when now-retired Seeing Eye dog Whitney led me to our local Walgreens. Our mission? Replenish my dwindling supply of short-acting insulin (the kind you inject every time you have a meal or a snack). I’d ordered three vials. “Okay, that’ll be $939,” The pharmacist said as he slid them my way.
You can imagine my reaction. I had a credit card, but I knew not to use it. You can’t return prescriptions you’ve paid for. The pharmacist suggested I contact my insurance company when I get home. I did. “We can straighten that out for you,” the woman at the insurance company told me. “But it might take a couple weeks.”
A couple weeks? I only had enough to get me through the next three days!
So I called a friend who takes insulin. He had extra, met me in our neighborhood park, and handed me a bag to get me through. .
Things got worse in 2020. Not for me, but for other diabetics I know. One of them was a server at a local restaurant/bar we go to. The place had to cut back on staff due to COVID, he didn’t have health insurance, and I got word he was having a hard time affording his long-acting insulin. I had extra long-acting insulin at home. Pay it forward, right? After rubber-banding my extra vials together, I set up a meeting time and slipped the contraband to the young man in need.
A Side Effects Public Media story I heard on the radio last week explains the high cost of insulin like this:
Drug companies have largely thwarted creating generic versions of insulins — which could dramatically reduce the price — by renewing drug patents. Drug companies say this is needed to defray the cost of development, while critics say it’s designed to maintain high profit margins.
An interview the Side Effects reporters had with Travis Paulson, who has Type 1 diabetes, brought up something that hadn’t occurred to me before. Unable to find work with health insurance during the 2008 housing crisis, Paulson often rationed his insulin supply — a risky practice that can be fatal — to make ends meet. As finances dwindled, he started traveling 90 miles away from home to cross the border into Canada to buy insulin. “I found out that I could get insulin up there for about $25 a bottle,” he told the reporters. “The same insulin costs $350 to $400 a bottle here.”
But then COVID-19 hit. Canada closed its border with the U.S. It’s been nine months since Paulson has been able to cross into Canada to buy insulin. “So that was unsettling,” he told the reporters. “It not only cut me down on insulin, but it cut down on anybody I could assist with insulin, too.” You read that right. Travis Paulson has been involved in drug trafficking, too.
The Canada – U.S. border is still closed, but the Side Effects story reports Paulson recently found a pharmacy in Vancouver where he can place large orders for insulin to be shipped his way. “Otherwise, yeah, I’d be seriously hurting right now,” he said.
Three pharmaceutical companies supply the U.S. with insulin: Eli Lilly, Sanofi and Novo Nordisk. Each offers financial help with insulin costs, but you have to register individually with the companies to qualify. A 2019 Washington Post story quoted a spokesperson for the Pharmaceutical Research and Manufacturers of America saying that “Too often, these negotiated discounts and rebates are not shared with patients, resulting in the sickest patients paying higher out-of-pocket costs to subsidize the healthy.” Isn’t this the opposite of how health insurance is supposed to work?
I can tell you firsthand that despite what the outgoing president said in a September 2020 presidential debate, whether you are insured or not, insulin is still more expensive than water. I’m holding out hope for 2021, though. Happy New Year!
This just in: the January 1, 2021 edition of the Chicago Tribune reports that a Illinois law took affect on New Year’s Day (January 1, 2021) making our state one of the first states to limit the out-of-pocket price of insulin. The Tribune reported that the cost will be limited to $100 for a 30-day supply. Still not cheaper than water, but getting closer.