It is no surprise to any certified diabetes educator (CDE) that many of our Medicare clients are struggling financially to afford their medications. In April and May of this year I was in contact with many who were already in the coverage gap (i.e. donut hole) due to the price of insulin. The cost of the newer long and short-acting bottles of insulin is over $100 per 1000 Units. So those, for example, who take over 150 Units of insulin every day may find themselves in the donut hole by April of each year and unable to afford this life-saving medication. I recently met a 65 year old woman who was admitted into the hospital for blood sugars over 750 mg/dl because she was in the coverage gap and could not pay for her insulin. She went without insulin for close to 48 hours.
Certain pharmacies sell NPH and regular insulin at approximately $30 per bottle of 1000 Units. With assistance from a physician and CDE, many Medicare recipients requiring insulin can utilize this combination to maintain blood sugar control and stay out of the coverage gap for the entire year. We know that clients who take NPH and regular need to learn about peaks, onsets, and durations of these insulin’s but with adequate support and education success can be achieved, inpatient admissions related to hyperglycemia avoided, and long-term complications minimized.
Please share your thoughts regarding this issue. What are your diabetes education programs doing to help people with financial challenges? Do you feel that changing to older, less expensive insulin is a viable option or should this change not be considered? Thank you in advance for your comments.