Prescription Management is Critical for Diabetes Patients

Burden on Patients: Prescription Management is Critical for Diabetes Patients

07.10.14 | By Allyson Funk

Patients, especially those suffering from chronic conditions, deserve access to the medicines they need to live longer, healthier lives. The Affordable Care Act’s health insurance exchanges and the Essential Health Benefits they’re meant to provide were supposed to ensure patients have access to the treatments they need. But for many, high out-of-pocket costs create a sometimes insurmountable barrier to access. Over the coming weeks, The Catalyst will highlight how barriers to access in health insurance exchanges are burdening patients with debilitating diseases including HIV/AIDS, arthritis, multiple sclerosis and more. Today, we’re talking about diabetes. Check back next week for the next post in our the Burden on Patients series. In the meantime, check out our fact sheets, and share your story with us in the comments section below.


With nearly more than 29 million people affected by diabetes, it is critical that Americans have access to innovative new medicines to help patients better manage the disease and reduce death rates. Diabetes is among the top 10 causes of death in the United States, and while it’s reassuring that death rates are declining, the number of Americans diagnosed with diabetes has more than tripled since 1980, making the need for such innovative medicines greater.

Many patients with Type 2 Diabetes need oral medicines, or antidiabetics, to stabilize their blood sugar, and many over time add insulin to their treatment regimen. These treatments allow individuals to manage their disease and live healthier lives. However, medicines only benefit patients if they have access to them.  For patients with coverage through the Affordable Care Act’s health insurance exchange plans, oral or injectable antidiabetics, insulin, or combinations of the two, for managing their diabetes may be difficult to obtain due to high cost sharing, prior authorization or exclusion of certain medicines from plans.

In Silver health insurance exchange plans, the average deductible is about $2,500 dollars. And even if that is met, patients with diabetes may still face out-of-pocket costs of up to 40 percent for their prescriptions. The lack of coverage and high cost-sharing can be detrimental for most diabetes patients who rely on these medicines to live productive lives. When cost-sharing puts medicines out of reach, patients may go without and risk even more costly complications.

For patients like Andrew Harris, who was diagnosed with diabetes in 2000, limited or no access to insulin is not an option. While diet and exercise are extremely important to the management of his symptoms, his body still cannot produce insulin on its own without the help of these needed medications. For patients with diabetes, adhering to their treatment regimens is critical. Without suitable insulin levels, diabetes patients could suffer from kidney failure, non-traumatic lower limb amputations, or blindness. 

America’s biopharmaceutical companies have 180 medicines in development to help patients with either Type 1 or Type 2 diabetes. These treatments offer individuals the opportunity to live healthier, more productive lives. Limited access to needed medicines shouldn’t get in the way. We’re continuing to explore what exchange coverage means for patients suffering from chronic conditions, so be sure to follow us on The Catalyst, Twitter and Facebook for more and check out our new fact sheets


Burden on Patients for Other Diseases 

Asthma

HIV/AIDS 

Mental Health Disorders

Multiple Sclerosis

Oncology

Rheumatoid Arthritis

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