My name is Dr. Julia Blanchette and I live in Cleveland, Ohio. I was diagnosed with type 1 diabetes over 20 years ago and need insulin to live. I was always aware of the widespread unaffordability of insulin, but the financial burden of insulin became real for me while I was working on my Ph.D. in Nursing Science. At the time, I was still on my parents’ insurance since I had not yet turned 26 years old. In January of 2016, my parents’ plan switched from a non-high deductible plan to a high deductible plan and my individual deductible on this plan suddenly increased to $4,000.
As we switched to this high deductible insurance plan, the real cost of my prescriptions became more apparent. For the first few months of the year, the cost of my insulin exceeded my monthly wages as a research fellow. I remember walking into the pharmacy the first time I purchased my insulin on this new plan and being shocked by the cost. At first, the pharmacist didn’t want to issue my prescription because she figured there had to have been some issue due to the astronomical price. During this period, I was spending about $800 per month just on insulin. With such high prices, I would cover my deductible in just a few months.
As a health care professional that moment was definitive for me, not only because of the economic impact it had on my life, but because of the way it opened my eyes to how severe the problem of unaffordable drugs can be. At that time, I was working on my dissertation, planning on studying self-management outcomes and psychological stress in young adults transitioning to adult diabetes care. At that moment in the pharmacy, I decided to refocus my research to include the effects of financial stress on such people with diabetes. I found little research on the topic at the time, particularly on type 1 diabetes, but through my research, I was able to provide evidence that diabetes-related financial stress can negatively impact psychological and physiological diabetes self-management outcomes.
I remain cognizant of that moment and my experience now as I work with patients as a diabetes care and education specialist. A common concern for my patients is how to afford necessary medications, especially in the first few months of the year, as more and more people have high deductible health plans or are in the Medicare donut hole. Additionally, many patients’ plans aren’t eligible for coupons or copay assistance, making it even more difficult for them to access their necessary prescriptions.
I have used an insulin pump for almost 20 years, but have had to change which brand of insulin I use over the years based on what my insurance covered at the time. The type of insulin I take should be a decision made by the person with diabetes and the health care team, not based on which one will be most affordable for health insurance plans. Drug companies lack an understanding of the effects the high prices have on patients’ lives. These days, it’s incredibly difficult for young adults to gain financial independence to begin with. When you have a chronic condition with expensive medications, it becomes nearly impossible. Pharmaceutical companies’ greed not only hurts patients through the inability to access care, but also through the stress caused by these unreasonable prices that impacts our health outcomes. We need changes that place patients’ needs first so that we can afford our prescription drugs.