June 9, 2019

The High Price of Diabetes Medication: A Dichotomy of High Costs & Interchangables

Have you ever wondered why diabetes medication is so expensive? There are many concerns such as exorbitant pricing, alternative products such as generics, and out of pocket copays. With the influx of the biosimilar and generics, which are often referred to as the interchangeables, or substituted medications, there is still no evidence of price relief! Now, the high price of medications create a struggle on those who are marginalized or near the poverty line. The copays and the out of pocket costs can be staggering. One has to wonder, why are these diabetic medications not subject to some sort of price-caps?

Some experts will mention that many diabetic medications are not on a formulary, therefore; their cost is not regulated. Furthermore, the FDA approved fewer diabetes medications in the last decade. Another problematic observation is diabetes medication has actually increased in cost anywhere from 10 to 14 per cent every year through 2016. When will it ever level off? Sadly, it has been reported that it is not unusual for a patient with type 2 diabetes to have copays in excess of 500 dollars per month!

One has to wonder ,what other hidden problems exist that affect the price of diabetes medications? What is of extreme importance, could be the lack of negotiation insofar as the purchase of insulin products are concerned. Should state Medicaid programs sit at the negotiating table to haggle pricing? Should they in effect play hard ball and get tough on price gouging? Greed? After all, insulin products are so vital to the Medicaid program when it comes to promoting the general welfare! Many patients take more than one diabetes medication at a time. That has caused a huge demand as well. How does the poor overlooked citizen stand in the battle of biologic greed?

Another key issue to consider is there are less manufacturers making specific medications, as there once was. This causes monopolistic pricing for diabetes medications. Some might call it supply and demand. Another interesting fact the public is not aware of - insulin products are being mixed with other chemicals to increase their potency, and effectiveness within the body. This creates a need for other chemical enhancements. New innovations have caused price increases. For instance, insulin manufacturers have added protamine to insulin. Protamine extends the duration of time for molecular activity of the insulin.

Just to expound on the price of diabetes medications, let us not forget to mention the problem of patents! Patents are a wedge between fair market pricing, and effective global marketing of medications. Patent protection along with price regulations have a grip on what becomes commercially available to patients! Some of the high price costs for medication deal with the manufacturer's goal to recapture the money spent in drug approvals, research. clinical trials, and the cost of launching the product. Yes, diabetes medications are pricey. However, much can be done to assuage some of the cost to the consumer.

Another issue in diabetes medications is the use of alternative medications. They might not be what the doctor ordered or really wants for the patient; nevertheless; they are distributed. Many patients have an alternative checked off on their script. While it might not be the exact prescription; it is a pervasive solution at the pharmacy, for sure. Now, a biosimilar drug or commonly called a biologic, can be substituted for a patient. However, it is only similar up to a limit! Now, generics truly are the chemical equivalent of an established medication. The marketing of biologics and generics are the result of an expired patent on the branded drug. Pharmaceutical manufacturers then begin- to market medications as a cheaper but effective alternative! What is difficult is that a patent or monopoly on a medication can last for 20 years! That is an expensive score of time. Also, it is eye opening to note, that a biologic cannot be copied as easily as a synthetic branded drug. A biosimilar is a biologic medication made from complex molecules which are difficult to copy. Therefore, it can weigh heavily on the out of pocket expense. Many organizations are taking a stand for drug price control. One such organization is AARP which rallies for a more affordable pharmaceutical agenda. President Trump is looking into the pricing of medications in the U.S. The U.S. has one of the world's highest priced medication systems. Alas, write or call your congressman to introduce a bill that would address some of these issues. Let's not forget the wisdom of Montesquieu and create checks and balances within the health care system. That would be the Spirit of the Law! Communicate with your congressional representative, today!

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