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Diabetes “Insidious”

November 14, 2018
Posted by: Gerald “Pharmacist Jerry” Finken, RPh, MS; Contributor, Meghan Mosser

Diabetes InsidiousPhoto credit: Business Navigators Inc.

As a pharmacist and servant leader, when it comes to helping people with diabetes, I find the best approach is to advise on the problematic issues of this most insidious disease using plain honesty.

So…in honor of November being Diabetes Awareness Month, I’d like to share the ugly truth about the cost of branded insulin.

The prices of brand (versus generic) insulin continue to climb and patients are, more and more, finding themselves unable to afford it.

And, yet, for whatever their reason, patients continue to buy.

Manufacturers of brand insulin know they have something good here and they are taking full advantage, making profits, for better and for worse, and not always on the up and up.

An example: Business Insider reported that just a couple of weeks ago, Minnesota filed a lawsuit against three insulin making companies for deceptively raising prices.  Note: the combined revenues for 2017 of these three companies was a staggering $170 billion.

What’s most aggravating and disappointing here though is not what the Minnesota Attorney General did, but rather did NOT do.

He did NOT go after the PBM ExpressScripts, with the revenue of $100B in 2017, nor did he go after UnitedHealth Group, the fifth largest company in the entire US whose revenues were an astonishing $201 Billion in 2017.  It shouldn’t be lost on us either that UnitedHealth Group is headquartered in Minnetonka, MN.

My point here: since pharmaceutical companies can not sell their medications directly to patients, the real blame for deception of pricing should be put on the PBMs and the insurance industry.

Are they the only ones to blame? We should also consider the prescribers.

Bloomberg published an article reporting that part of the reason why patients are struggling to afford insulin is because physicians are continually prescribing high-tech insulin.

Why do they do that?  Is television that powerful of a tool that we, as healthcare providers, also believe it?

The original pioneers of insulin are probably rolling over in their graves.  Their vision was for insulin to be available to everyone who needed it, rich or poor, in developed or developing countries. They even gave away their rights to profit.

So, what can we, the pharmacist, do to change this? Here are four ideas:

  1. We need to help patients understand the difference between generic and brand medications and understand the cost of convenience, so they don’t end up spending more money than they need to or ration doses of expensive medicines.
  2. In the case of insulin pricing, pharmacists could change the trajectory of the price of insulin by using their trusted role as servant leaders to educate patients and to think outside the box and work directly with the pharmaceutical industry to find ways to reduce the direct and indirect costs patients pay for medication use and non-use.
  3. Pharmacists must join together and work with the press and their politicians and insist upon total pricing transparency.  Everyone should know the price the wholesalers, hospitals, the government, PBMs, insurance carriers and pharmacies pay and charge for medication.
  4. Pharmacists must also do a better job at helping the patient take more responsibility for their own health.   We all know that a better diet and a little exercise directly impacts our health.

In order to fight issues, like the high price of insulin, pharmacists must be looked at as the trusted healthcare professional AND as the medication expert AND not just a dispenser.

Pharmacists have a knowledge set that can not only lower prices of medications, but can also help patients receive better medical care.

Diabetes Awareness Month is the perfect time to start thinking about how we can go above and beyond for our patients living with diabetes.

What do you think?

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