Tag Archives: diabetes

Why limiting insulin out-of-pocket costs solves only part of the problem

Last fall, the U.S. House of Representatives narrowly passed a $2.2 million domestic spending plan called Build Back Better (BBB) that included several health care provisions including one that would limit what patients with diabetes would pay for insulin to $35 per month. One month later, Sen. Joe Manchin (D-West Virginia) effectively killed the legislation when he announced that he could not support the law.

Source: Comparing Insulin Prices in the U.S. to Other Countries, Prepared for the Office of the Assistant Secretary for Planning and Evaluation at the U.S. Department of Health and Human Services by RAND Health Care. September 2020.

Efforts to cap what patients pay for insulin, however, are still under consideration in Congress; some legislation could pass in the coming weeks. If so, health care journalists will need to know how any new law would work. One useful source could be a report last week from the Peterson Center on Healthcare and the Kaiser Family Foundation (KFF), “Out-of-pocket spending on insulin among people with private insurance.”

For health care reporters, there are at least three important concerns to understand about  efforts to limit what patients with diabetes pay for their care.

First, putting a cap on out-of-pocket costs is crucial but amounts to little more than tinkering around the edges of the issue. Patients with diabetes need insulin and supplies to monitor their blood sugar and store and inject insulin. In 2020, researchers for the Commonwealth Fund reported that some 30 million Americans have diabetes, and about 31% of them need insulin to manage the condition. The list prices of many of the newest forms of insulin have risen by 15% to 17% each year since 2012, the report noted.

Second, it’s important to understand that any limit on what patients pay out of pocket for insulin would not address the underlying price of insulin in the U.S., as the Peterson-KFF report explained. What diabetes patients pay for insulin in the U.S. is much higher than it is in other countries, according to a report that the U.S. Department of Health and Human Services (HHS) issued in 2020. For that report, HHS contracted with RAND Health Care to compare what pharmaceutical companies charged for insulin in the U.S. in 2018 against what drug companies charged in 32 other countries that are members of the Organisation for Economic Co-operation and Development (OECD).

The RAND researchers found that the average gross manufacturer price for a standard unit of insulin in 2018 was $98.70 in the U.S., which was more than 10 times higher than the $8.81 price of a standard unit of insulin in 32 other countries.

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Bias or comorbidity? Risk factors for respiratory disease aren’t always what they seem

Bias or comorbidityBy this point, anyone who’s been covering or following COVID-19 knows that several comorbidities substantially increase the risk of complications and severe disease. Among those mentioned most often are diabetes, heart disease and obesity.

We learned of the associations between those conditions and more severe disease first from clinical anecdotes, then case series, then observational studies. But observational studies can almost never show causation. (I don’t think they can ever, on their own, show causation, but I add the “almost” because nothing in science is ever absolute.) Although diabetes is linked to poorer outcomes with COVID-19, it doesn’t mean having diabetes causes poorer outcomes. Continue reading

California reporter followed one lead after another to an award-winning series

Photo: Attila Malarik via Flckr

To some of us, this procedure might have sounded too good to be true: A national network of infusion clinics offers to relieve just about any complication from diabetes, including neuropathy, nephropathy, cardiovascular problems and erectile dysfunction. It can do so as long as each diabetes patient enrolled is willing to sit for four hours every week or two while a pump pushes insulin through the patient’s veins.

Offered by Trina Health, this procedure was said to mimic the effect of the pancreas. But there was no data showing it worked; only testimonials from people who said they had been patients. But, to some desperate patients, it seemed plausible. Continue reading

Covering urban health through data and history

Photo: Thomas Hawk via Flickr

Cities provide unique views on the concentrated nature of how policies play out in the everyday lives of their citizens. Attendees at AHCJ’s Urban Health Journalism Workshop in October were treated to an overview of the Big Apple’s public health initiatives and efforts to address disparities, as part of the workshop’s opening session. Continue reading

Young women falling short of exercise recommendations

Photo: Peter Dutton via Flickr

Many young women in recent weeks have walked across a stage in cap and gown to accept their hard-earned high school diplomas. But recent research says the transition into adulthood comes with quickly forgetting lessons from their physical education classes.

Recent data analysis of findings from a long-running health study finds that women in their late teens and 20s are less physically active than their male counterparts, failing to meet minimum recommendations for exercise. Continue reading