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An Insulin Hurdle Out of The Way, Others Remain

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Tuesday, February 21, 2023   

Some older patients with diabetes are now getting easier access to insulin. But there is concern many younger ones are still navigating a difficult path in managing their situation, including an outspoken Wisconsin health care worker.

The average cost of insulin nearly tripled between 2002 and 2013, according to The American Diabetes Association. It prompted outrage following stories of patients being forced to ration their supply of the drug. Last year's federal Inflation Reduction Act capped monthly copays at $35 for Medicare recipients.

Saskia Hale, a registered nurse in Stevens Point, said she is relieved those individuals are less likely to need hospitalization for diabetes complications.

"Some of these complications include having limbs amputated, having sores, having chronic kidney problems, going into kidney failure," Hale said.

She said those often stem from patients not being able to cover out-of-pocket insulin costs. A new federal Health and Human Services report suggests the cap will save seniors $500 a year. But Hale, who is a diabetic herself, said non-Medicare patients still have insurance barriers, along with added expenses for supplies like needles and glucose monitors.

Hale said falling off a management plan because of skyrocketing insulin costs can result in being labeled "noncompliant" by your insurance coverage provider.

"When they're labeled that way, it makes it seem as though they are doing this simply because they don't want to take their insulin and that is usually not the case," she said. "It's usually because they cannot afford the medication."

She added being labeled noncompliant, even if it's not the patient's fault, can lead to the insurer dropping insulin coverage from the individual's plan. President Joe Biden recently called on Congress to extend the $35 cap to all Americans with diabetes. But political analysts predict it is unlikely, with a divided power structure right now. There is some bipartisan support, but some Republicans say it would be a mandate, hindering competition.


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