Diabetes costs money. Medicines, equipment, health-care visits, and healthy foods can all be expensive. How do you keep from going broke with diabetes?
According to a survey by Consumer Reports Health, diabetes patients spend an average of $6,000 annually on treatment costs. That’s their own money, not insurance payments. According to The New York Times, “that figure includes monitoring supplies, medicines, doctor visits, annual eye exams, and other routine costs.”
Six thousand dollars is a lot of money, and that amount does not include the costs of treating complications. These costs can seriously impact people’s lives and interfere with treatment. One commenter wrote on TuDiabetes, “Sometimes I have to choose to live without heat in the winter or electricity in order to afford my insulin and test strips.”
Writing on Diabetes Health, blogger with Type 1 Amy Mercer said, “Many people with diabetes are making the choice to pay the mortgage instead of their medical bills. Many people are choosing to skip doctor appointments and not refill certain prescriptions.”
Writing in The New York Times in 2010, Walecia Konrad explained that, “The inability [to pay costs of treatment] is part of the reason only 25% of diabetics are getting the care they need.”
A study from the University of Michigan and Stanford University in 2004 found that people with Type 2 diabetes often “underuse their medications because of out-of-pocket costs. A total of 19% of respondents reported cutting back on medication use in the prior year due to cost.”
They did this because they had to, not to buy luxuries. According to Health.com, “Of the participants, 28% said they cut back on food, heat, or other basic needs so that they would have enough money to pay for their prescriptions.”
Medication cost problems were especially common among younger people and those who had worse health insurance or no coverage.
Doctors are not helping with cost issues as much as they could, the study reported. “Few respondents, including those reporting medication cost problems, reported that their health-care providers had given them information or other assistance to address medication cost pressures.”
People with Type 1 also reduce their treatment or change their lives to pay. In Type 1, it’s usually paying for pumps, monitors, and supplies.
Amy Mercer quoted a person with Type 1: “I am no longer pumping…the supplies are too expensive. Since I am starting my first semester of college. I just can’t afford it…which makes me really sad.” Using syringes and frequent injections is usually cheaper (around $900 annually) than pumping (around $2,500 annually), although clearly much less comfortable and reliable.
The costs of medical appointments can be another budget buster. Some have had to give up their personal physicians and wait in long lines at free clinics, where they’ll see a GP or a nurse practitioner, never an endocrinologist.
Mercer herself has had to make tough choices: “I had to [pay] for test strips, insulin, and syringes instead of new clothes and shoes like my friends.”
A lot depends on your treatment and what’s covered by insurance, if you have insurance. Supposedly, under Obamacare you cannot be denied insurance because of having diabetes, but there are still barriers in many states. The ADA has good information on insurance at this page.
Managing medical costs
• If you don’t have good prescription drug coverage, see if you can manage with generic drugs. Newer drugs such as incretin mimetics and the SGLT-2 inhibitors can be good, but they are not available in generics yet. Older generic drugs are very cheap, almost free, at large retailers like Costco.
• Ask your doctor to write prescriptions for larger quantities of insulin, pills, and test strips. Larger prescriptions will cost less per dose.
• Ask for help. Ask your doctor for samples at each visit. If you are taking a brand name drug, see if you qualify for a patient assistance program. You can interact with these programs at the drug industry site www.PPARx.org. There are hundreds of such programs. You can also call the industry referral program at (888) 4PPA-NOW (888-477-2669).
• Shop around. The Perfect D website says “Prices can fluctuate wildly,” for drugs and equipment, so you have to shop for the best deals. The same applies to doctors — you don’t necessarily need or want the most expensive. A good nurse practitioner might be better in some cases.
• Reuse lancets for self-testing.
• Some endocrinologists, such as Dr. Marvin Lipman, advise people with Type 2 to get their blood sugar under control so they can test less often. Test only when you need the information for something, like if you’re sick or trying a new food. Don’t test routinely; it’s not worth it.
• Be your best self-manager. Keeping good control will avoid the costs of complications. Healthy food costs more than mass-produced refined carbs that spike your blood sugar, but it’s worth it if it saves you one trip to the ER or one day in the hospital.
How is the cost of diabetes affecting your treatment? How do those costs affect your life? What is diabetes doing to your bank account, and what ways have you found to stay afloat? More next week.