Serious Health Consequences for People Who Cannot Afford Their Diabetes Medications
Part of a series of posts about common chronic illnesses and what happens when people cannot afford prescription medications to treat them.
According to the Centers for Disease Control and Prevention, an estimated 29.1 million people, or 9.3% of the U.S. population, have diabetes. Left untreated, diabetes can lead to unnecessary hospitalizations and death. While Diabetes ranks as the seventh leading cause of death in the U.S., many people with diabetes actually die from complications related to diabetes rather than the disease itself. In 2011, 85.3% of adults with diagnosed diabetes reported taking pills or insulin for their diabetes. But, the increasing cost of diabetes medications in the U.S. often leads patients to forgo or ration life-saving treatments.
There are two types of diabetes: Type 1, generally diagnosed in childhood, is an autoimmune disease wherein the pancreas ceases to produce insulin or produces too little insulin, a hormone allowing sugar (glucose) to enter cells to produce energy. Type 2, generally diagnosed after age 40, usually begins with an insulin resistance, occurring when fat, muscle, and liver cells do not use insulin to carry glucose into the body’s cells.
Common complications from diabetes include cardiovascular disease, hyperglycemic crises, diabetic ketoacidosis, end-stage renal disease, lower extremity conditions (peripheral arterial disease, ulcer/inflammation/infection, neuropathy), and visual impairment. In 2009, 2,417 people with diabetes died of hyperglycemic crises.
Patients diagnosed with Type 1 diabetes are prescribed insulin, which is marketed under several brand names, including Humalog, Novolog, Lantus, and Levamir. While some people with Type 2 diabetes can manage their diabetes with healthy eating and exercise, many with Type 2 diabetes also take medications, such as Actos, Metformin, and Januvia to help meet target blood glucose levels.
The price of insulin has become increasingly difficult and sometimes impossible for Americans with diabetes to afford. A recent study published in the Journal of the American Medical Association found that between 2002 -2013 the price of insulin tripled from $231 to $736 a year per patient. Additionally, patients diagnosed with diabetes face on average annual medical expenditures of about $13,700, which is 2.3 times higher than individuals without diabetes.
Without the proper medication, uncontrolled blood glucose can, over time, damages the body’s tiny and large blood vessels. Damage to tiny blood vessels causes microvascular complications and damage to large vessels causes macrovascular complications. Microvascular complications include eye disease (more than 4 million people with diabetes have some degree of retinopathy), kidney disease, and nerve damage (about half of people with Type 1 diabetes will develop neuropathy). Macrovascular complications involve the heart, and can result in heart attack.
If left untreated, Type 2 diabetes can also damage essential systems in the body: blood vessels, nerves, or both. The consequences include eye and vision problems, including blindness; kidney disease that can lead to kidney failure; nerve damage (neuropathy) that can cause tingling and pain the hands and feet; different types of infections; dental problems; and amputations due to infections in the feet.
The ever-increasing price of insulin and other prescription medications are presenting a real barrier for many Americans with diabetes. To learn more about how to afford diabetes medications, please consult Prescription Justice Action Group’s online resources on how to afford prescription medication.
By Stephanie Schroeder