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Diabetes and Insulin Impact on Health

The Dispensary of Hope team frequently hears from safety net providers across the country about the need for access to insulin.  Caregivers for vulnerable populations often struggle to meet all the medication needs for their diabetic patients.

Diabetes is one of the most prevalent chronic medical conditions in the United States.1,2 According to the 2017 National Diabetes Statistics Report, over 30.2 million Americans (9.4% of the total population) have diabetes. 1, Diabetes is the seventh leading cause of death, in addition to being the leading cause of kidney failure, lower limb amputations, and adult onset blindness. 1,2  The Centers for Disease Control and Prevention (CDC) estimates that $245 billion dollars can be attributed to total medical costs and lost wages for people diagnosed with diabetes.2  People from minority populations are more likely to be affected by type 2 diabetes (insulin resistance), and certain groups including African Americans, Hispanics, and American Indians are at an increased risk for the development of diabetes. 1,2  Often, these minority groups may have difficulty seeking and affording care to treat their diabetes. 

Insulin is a necessary treatment for type 1 diabetes (insulin dependence) and plays a large role in those with type 2 diabetes (insulin resistance), with an estimated 17.8% of diabetic patients using insulin only.  Insulin was first discovered in the 1920s and sourced from animals. After several improvements in the formulation, the older animal version of insulin disappeared and the newer, more costly insulin is currently available from only three manufacturers.3 Insulin costs can exceed $100 per vial, thus many patients living with diabetes cannot afford to take their medication as prescribed.  Some companies including Walmart and CVS are now introducing $25 vials from partnerships with Eli Lilly and Novo Nordisk.4

Due to this high cost, many patients still struggle to control their blood sugar levels and either skip doses or do without which ultimately leads to poor health outcomes.5  Offering the most vulnerable patients, those who couldn’t afford even a $25 vial, access to donated insulin can impact their health and reduce their risk of heart attack, blindness, and amputations.  Donated insulin for those patients most in need can save the patients’ communities and health systems that provide care billions of dollars in uncompensated medical care.3,5.  Diabetes can be controlled if managed properly.  Providing medication for those most in need can help those patients lead healthier lives and can change a diabetes diagnosis from a terminal one to a manageable disease. 

Here are some resources:

•          Preparing for Donated Insulin – this document could be used if you are planning to start an insulin program or looking for ideas to measure results. 

•          “CINCI” study – this study was published by one of our network members St. Vincent de Paul Charitable Pharmacy of Cincinnati after they followed patients switched from basal/bolus to twice daily dosed insulin. 

 

References:

  1. Centers for Disease Control and Prevention. National Diabetes Statistics Report: Estimates of Diabetes and Its Burden in the United States, 2017. Atlanta, GA: US Department of Health and Human Services; 2017. Available from: https://www.cdc.gov/diabetes/data/statistics/statistics-report.html
  2. Office of Disease Prevention and Health Promotion.  Healthy People 2020: Diabetes.  Washington, D.C.: US Department of Health and Human Services; 2014. Available from:https://www.healthypeople.gov/2020/topics-objectives/topic/diabetes
  3. National Public Radio.  Why Is Insulin So Expensive in the U.S.?  Accessed on March 27, 2017.  Available from: http://www.npr.org/sections/health-shots/2015/03/19/393856788/why-is-u-s-insulin-so-expensive
  4. Newsday.  Rising cost of insulin leads LI diabetics to take dangerous risks.  Available from: http://www.newsday.com/news/health/rising-cost-of-insulin-leads-li-diabetics-to-take-dangerous-risks-1.14196973 
  5. Business Insider.  Novo nordisk and cvs offer 25 per vial insulin.  Available from: http://www.businessinsider.com/novo-nordisk-and-cvs-offer-25-per-vial-insulin-savings-program-2017-3