The skyrocketing price of insulin has some diabetics scrambling to cover the cost of the life-saving medication.
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Others are skipping doses or using smaller amounts than needed, and sometimes landing in the emergency room, patients and advocates told Congress recently.
About 7.4 million Americans use insulin to keep their blood sugar at safe levels. Insulin needs vary by patient, as do costs depending on insurance coverage.
Amid the public uproar about costs, drugmakers and some prescription plans are starting to offer patients bigger discounts. Express Scripts and its parent company, insurer Cigna, just began offering a month's worth of insulin to eligible patients for $25 per month. Express Scripts is now lining up other insurers whose prescription plans it manages.
For most insulin and other diabetes medicines, manufacturers offer coupons reducing monthly out-of-pocket costs.
The American Diabetes Association connects patients to assistance programs through www.insulinhelp.org , though not everyone qualifies.
"We do not want anyone to skip or ration doses," says Dr. William Cefalu, the advocacy group's chief scientific officer.
If you are struggling to afford insulin, tell your doctors, says Cefalu. They might be able to recommend a free clinic or patient assistance plan, or suggest cheaper options.
If cost is an issue, here are other ways to save money:
TRY OLDER KINDS OF INSULIN
Talk to your doctor about switching to older, cheaper kinds of insulin, suggests Dr. Robert Gabbay, chief medical officer at Joslin Diabetes Center in Boston. Dangerous blood sugar plunges are more common with those, as they don't control blood sugar as tightly as newer, more expensive insulins. Patients using older products such as Novolin and Humulin R must test their blood sugar more often, and more carefully time when they inject insulin before meals, Gabbay stresses.
SWITCH TO VIALS
Patients who've been using insulin pens — injection devices containing multiple insulin doses — could switch to insulin vials. They are cheaper but less convenient. It requires drawing insulin out of the vial into a syringe, which makes doses less precise, and the abdominal injections hurt a bit more. Another option is Basaglar, a cheaper near-copy of the popular long-acting Lantus insulin pens.
Review your insurance company's list of covered medications for insulin with the lowest copayments; coverage and copayments often change in January and there may be cheaper choices. Other savings options include getting a 90-day supply instead of 30-day refills.
Check prices at different pharmacies. Prices can vary widely for insulin, other diabetes drugs and the testing strips and lancets needed to check blood sugar levels. Patients can look up drug prices at multiple drugstores and get coupons for big discounts at the pharmacy counter at www.GoodRx.com . Or try www.healthwarehouse.com , which sells medicines at cash prices, which can be cheaper even if you have insurance.
Medicare and Medicaid patients can't combine coupons with their insurance, but a coupon alone might be the cheapest option.
The three main insulin makers offer savings, including:
—Sanofi's Insulins ValYOU Savings Program offers uninsured and cash-paying patients one insulin vial for $99 or one insulin pen for $149 each month. Starting in June, it will offer up to 10 vials and/or pens of most of its insulins for $99. Its Sanofi Patient Connection offers low-income uninsured patients free insulin.
—Eli Lilly will soon sell Insulin Lispro, a half-price version of its top-selling insulin Humalog KwikPens, for $265 per month. Its Lilly Diabetes Solution Center helps patients find affordable options.
—Novo Nordisk has long sold an older insulin, ReliOn, through Walmart for about $25 a vial. It's now available through CVS Health and Express Scripts. Novo Nordisk offers copay savings cards for Tresiba and other insulins, plus patient assistance with generous income limits at www.NovoCare.com .
Follow Linda A. Johnson at https://twitter.com/LindaJ_onPharma