I used to be an avid watcher of the ABC show “Once Upon A Time.” Within the show, the character Rumpelstiltskin could perform wonderful acts of magic, but never without first warning the person whose wish is being granted, “Don’t forget, magic always comes with a price.”
As I look back at my meetings with Novo Nordisk and Medtronic last spring, I can’t help but feel conflicted. They are good people, trying to do good things. I promise you they aren’t virtual Ebenezer Scrooges. They are people who genuinely want to make a difference in the world.
But…(you knew that was coming,)
Their magic always comes with a price.
The fact is, you can’t serve three masters. These companies feel like they can serve the patient community, their shareholders, and the insurance industry, without conflict…but the truth is, it’s impossible.
The greater master will always be the bottom line, and because of this, when it comes down to the wire the patient will always be the one to get the short end of the stick.
We have a couple insulin companies monopolizing the market on the medication that keeps my boys alive. Choices within the confines of this disease are severely limited, yet they are being taken away from us more and more day by day.
Insurance companies tell me what insulin my children must use if I want them to pay for any of it. They negotiate prices and who loses? My children. Everyone is touting the words, “Better outcomes,” yet they aren’t giving my doctor and myself freedom to choose what would produce those “better outcomes” for my children.
People are choosing medications not because they are the best for their health, but because it’s the cheapest, and because it's the medication their insurance company is telling them to use.
It makes me throw up in my mouth thinking about it.
I don’t care how many times anyone in the free world says it, Humalog and Novolog are not the same. Novolog produces better outomes for my children, but my insurance company’s preferred insulin is Humalog…so we pay A LOT more money because my doctor and I both know what is best for my boys, and we are acting on that knowledge.
And now it doesn’t stop with insulin. Now one very large insurance company is only covering one kind of insulin pump.
And this kind of pump only links to one kind of meter.
And this one kind of meter uses only one kind of test strips.
Choice? We have no choice.
When it comes to Type One Diabetes we are already strapped with very limited choices.
Three kinds of fast acting insulin.
Four different pump companies.
Just a few major blood sugar monitor companies.
And still, no one at our pharmacy even knows what a Blood Ketone Meter is. (Which might be for the best, because many insurance companies don't cover Blood Ketone Strips as they retail for $10 a strip.)
We’re shoved into a corner, paying three times the dollars we did before, and the people doing the shoving are shrugging their shoulders and saying, “Not our fault.”
So what can we do? We can’t fight back and say, “I’m not buying insulin anymore!” (Because, death.) Sure, we can stop using insulin pumps and move to MDI, but I know in my childrens’ situation that would totally suck.
And pharma knows that too.
They know they can do whatever the hell they want, and play these games within the United States Healthcare system because WE CAN’T DO ANYTHING ABOUT IT.
Die or infuse insulin.
God help us.
All the good these big companies are doing in the world is awesome. Seriously, they do a lot of good. But my boys are the ones paying the price for that good….to the tune of $400 a vial of insulin, $7000-$10,000 for an insulin pump, and $1 plus for every blood sugar test strip that they use.
The Healthcare System in the United States is broken.
It’s not going to be fixed without a fight. Insurance companies won’t fight it. Pharma won’t fight it. Only we can fight it.
It’s time our community packed a bigger punch.
Tomorrow: more information to come. We will be introduced to real life stories, and make some real life decisions regarding what we are going to do about it.
We, meaning you. Meaning, all of us.
Let's face it, if you have a butter compartment full of insulin right now, you are blessed. There are some who do not. There are some who make choices between food on the table or insulin, rent or insulin, paying the electric bill or insulin. I promise you, if it were you considering rationing insulin, or if it were your child's life that you couldn't afford to save every day...you would stand up.