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Young adults with type 1 diabetes can not afford insulin at the age of 26 without insurance




BuzzFeed News; Getty Images

The day Jathan Laverty turned 26, he worked in a coffee shop in Columbus, Ohio, and freelance as an event technician, hoping to get a foot in the door of the event planning industry. That birthday turned the search for a full-time job into something urgent.

Laverty suffers from type 1

diabetes, and as of this date in 2017, he was no longer eligible for his parent's health coverage. He needed medicines to live that he could not afford.

"It's a human need for me," Laverty, now 28, told Buzzfeed News. "Every time I take insulin or not, it's my life or death."

Laverty has a health problem that only occurs with many Millennials with type 1 diabetes who have been cut by their parents' health insurance. The price of insulin, the drug that keeps it alive, tripled in the US from 2002 to 2013, and a recent study found that the average annual cost of $ 6,200 to $ 5,900 between 2012 and 2016 has increased.

That's an Impossible Price A sign of a generation still feeling the effects of the 2008 financial crisis, plagued by massive student loan debt and rising housing costs. Studies show that US millennia are financially worse off than previous generations, with an average net worth of less than $ 8,000.

The result is that these young adults are rationing, stocking, and turning to the black market for the medicines they need to stay alive – unbelievably risky and desperate measures that can lead to long-term injury or death.

About 1.25 million Americans have type 1 diabetes, a disorder in which the immune system attacks the pancreas and impairs the body's ability to absorb energy from food.

People with type 1 diabetes rely on multiple types of insulin to survive, as the disease affects the ability of the pancreas to produce the chemical that regulates the amount of sugar in the blood. Without insulin, cells can not absorb sugar and the body is forced to rapidly break down fat cells to use as a substitute fuel source. This drains the body, makes the blood acid and leads to a life-threatening complication called diabetic ketoacidosis (DKA).

Most people with type 1 diabetes take at least two types of insulin: a long-acting, daily-onset type that constantly releases insulin and acts quickly or quickly, either before or after a meal. The amount of insulin needed by a person with type 1 diabetes varies dramatically depending on age, weight, food intake, exercise, illness, stress, and in women who have menstruation or ovulation.

In fact, many endocrinologists will over-prescribe insulin so patients have enough for emergencies.

All these medicines are expensive. According to Laverty, his insulin will cost approximately $ 950 a month in 2017 without his parent's coverage. So he started rationing. He only gave himself what he could afford, the bare minimum he needed to work.

"I took half of my medications I needed to take," he said. He did not have to take a dose of his fast-acting insulin and lowered the amount of insulin given every injection he gave himself. The effects were immediate. His energy level dropped, leaving him irritated and tired and in a constant state of discomfort. He could not sleep, was always thirsty and constantly urinating.

"It has definitely compromised my ability to function," he said. He lived this way for four months until he found a full-time job in a company that provided all medical services.

This type of rationing may have serious long-term consequences for people with type 1 diabetes, Simeon Taylor, a University of The Diabetes Researcher and a professor at the Maryland School of Medicine told Buzzfeed News, "You can probably avoid a quick death," he said. "But you open up to long-term complications like blindness, kidney failure, amputations, and if you're not optimally treated, you're at greater risk for short-term crises."

Nicole Smith-Holt's son Alec was deadly, and Alec died in 2017 DKA, one month after the age of 26 and after being exempted from his mother's insurance, could not afford insulin and had rationed what he had left.


Courtesy of International

Nicole Smith-Holt holds a photo of her son Alec in hand

In August, Smith-Holt testified before the US Senate what her son's story was and what she called the "drug price crisis". Smith-Holt told Buzzfeed News that she has heard of "far too many" people with stories like Alec's. A study published in December in the Journal of the American Medical Association found that one in four diabetics rationed its insulin due to high costs.

"People contact me every day," Smith-Holt said. "From both parents of young adults or young adults themselves. They are afraid of what will happen. They are afraid of becoming 26 years old.

Aging from parental insurance has always been a problem for young Americans with chronic conditions. However, since the 2010 Act on Affordable Care, young adults can stay in their parents' insurance until the age of 26.

Louis Philipson, director of the University of Chicago's Kovler Diabetes Center, told Buzzfeed News that he sees many young adult patients with type 1 diabetes living out of fear of the deadline.

"They are now insured with their parents, but some are in the gig economy and move from one job to the next as they begin. In their lifetime, they may not have work with insurance that covers their insulin, or theirs Work may not have insurance or it is a job that is underinsured with high deductibles. The annual amount a patient must pay out of pocket before his insurance plan starts is a problem for all Americans. A comprehensive nationwide analysis, released in May, showed that deductibles in workplace insurance plans have quadrupled in the last 12 years, averaging over $ 1,300 USD. High-deductible plans are also common for those who choose to be insured through the public stock exchanges set up under the ACA, and these deductibles may even be higher than those with work-related plans. In 2018, the average deductible for the most popular type of plan on the stock market was nearly $ 4,000. The cost of the deductible is added to the cost of the monthly premium payment.

Since the beginning of parental insurance is considered a "qualifying life event", young adults receive a special 60-day registration period after registering to sign up for a new insurance. However, some young adults with type 1 diabetes find it difficult to afford their medicines themselves with state-funded insurance.

"I took care of it," Laverty said about the conclusion of a state insurance. "But it would be so stupid that it was not worth it."

He said that the plans he found on the stock exchange had such high deductibles that he felt he would probably find a full-time job with services before he hit his deductible. In the meantime, he would pay the list price for insulin with or without state insurance.

"The first month [of medication] alone could be $ 1,000 or even more," Philipson said. "It breaks the budget, it forces people into unsustainable situations: they have to choose between rent and insulin."

"At age 26, you're worried that you'll spend $ 500 a month and stay between $ 5,000 and $ 6,000 a year alive, "said Philipson. "This is not an option – Type 1 diabetes is a deadly disease if you do not have insulin."

25-year-old Allie Marotta, who lives in Brooklyn, is nearing deadline.

"I'm one There is no insurance there, "said Marotta to Buzzfeed News.

Marotta plans to either get a health insurance job or to buy insurance from the government, but she's prepared to wait for a while uninsured, as both things take time, and with the help of her endocrinologist, she has begun to store insulin.

Marotta's doctor has given her insulin samples from the care department, the endocrine centers for emergencies and newly diagnosed patients Marotta said that her endocrinologist also prescribes her extra insulin.

"She says, 'Let us do you the best we can so that you can endure a bit better this time. ", Said Marotta. 19659019] Courtesy of Marotta

Allie Marotta's Prescription for Insulin

Marotta is also trying to get her current insurance approved for a continuous glucose monitor, a device that is implanted under the skin and constantly measures a person's blood sugar levels.

"I had one in college and it's really great," she said. "I do not like having anything on me all the time, but I want to go back to one, so that I have my [blood sugar] really perfect and know as well as I can, about my trends, to better this time to be prepared for the uncertainty.

Although she is currently insured, Marotta regularly rations insulin. She regularly buys only one of the two types she needs because she can not afford the back payments for her many times needed medications, medical appointments and a series of tests that accompany every visit to her endocrinologist.

"I choose Make my short game before I play my long game, because at least you can cover emergencies," she said. "If you have only one, it makes sense to make that short – it just is not ideal because you do not have that baseline [of insulin] so the slightest can affect you and your blood sugar."

It's tricky, but Marotta said she spends nearly half of her income on student loans and has no choice.

"For me, rationing is literally because I do not have the $ 20 to pick it up today," she said

List Price for a Monthly Delivery of Marotta's Long According to a receipt she provided to Buzzfeed News, the insulin she receives is $ 740.99 and her current premium is $ 10. [19659004] People with type 1 diabetes also have to pay for several expensive medicines to keep their illness under control – patients who can not afford to cut back by not raising their blood sugar levels Test your body's response to determine how much insulin you need. They also use disposable medical items, such as lancets, which prick fingers for testing blood sugar and needles to inject insulin, despite the risk of infection.

"This is a big part of the rationing that people do not talk about and many people do it," said Marotta.

Laverty said that although he is no longer forced to ration his insulin, Lavater regularly rations stocks to keep costs down. He said that he often reuses a lancet "for weeks or months" until it is so boring that it does not break the skin.

"This is getting more and more unpleasant and leaves a bigger hole, but it saves me a lot of money," he said.


Courtesy of Laverty

Laverty's syringe with a needle broken for overuse.

He added that he should use a new needle tip each time for his insulin pen, but limited to one per day, as this was "crazy expensive" estimates that he doses five to eight times a day, with every dose becomes more painful. Before switching to pencils, he used syringes and needles again to inject himself with insulin. He shared with BuzzFeed News a photo of a used needle that had bent and broken during a regular injection in his body.

Sometimes people with type 1 diabetes are forced to take risky options due to circumstances beyond their control. In 2017, Julia Wyrzuc, 24, of Linden, New Jersey, had to be uninsured for five months following a spelling mistake.

She had saved a small excess of insulin and was also able to obtain samples from a family friend who worked in an endocrinology office. However, when it became clear that solving the insurance problem would take months, not weeks, she needed to find a more permanent solution. In July 2017, she turned to the black market.

She bought 10 ampoules of insulin for $ 1,000 "from a man who was really well insured," she said. It was not a "terrible" price and cheaper than what Wyrzuc would have paid over the counter. She used insulin from this supply when she switched to "heavy DKA" several months later.

"I've never felt so terrible in my life," Wyrzuc said. "I vomited for 12 hours, I could not even drink water."

Wyrzuc was hospitalized and spent five days in intensive care. Her doctors speculated that she had taken a "bad batch" of insulin that might eventually have overheated. Fortunately, her parents had solved the insurance problem "literally two weeks" before this happened, and Wyrzuc was able to resume her regular treatment.

Even if young patients with diabetes take out their own health insurance, they can have problems.

Hannah Sumner, 26, of Soperton, Georgia, voluntarily turned off her parents' insurance before she was forced to do so. what she called "the biggest mistake of her life".

"I got a job offering insurance and I wanted to do it myself," she told Buzzfeed News. "I have a 6 year old daughter. I tried to be more mature. "

Her plan for the bank she works in has excellent coverage – for everything but diabetes. Her insurance company has also recently stopped insuring her insulin brand and forced her to switch to a brand she considers equivalent. The new insulin, she said, makes her ill, but she can not afford to return to her old one and has to deal with the symptoms.

Sumner said her pharmacist allowed her to spend most of her deductible, which she said is between $ 225 and $ 250, and will be charged at the beginning of the year so she can afford her insulin. She pays the account monthly, but there are times when her finances are so tight she can not even afford the supplement.

"There are times in the month when I may not have $ 50," she said.

Next In these months, her pharmacist, an "amazing" friend of the family, whom she knows since she was a child, has their co-payment transferred to her account.

Also with this "unbelievably happy" agreement with her pharmacist Sumner, she said that she had rationed for financial reasons in the past and is currently rationing so she can start her job without feeling ill from her new insulin.

"That's why I will not be able to work sickness one day and I want to work now," she said.

Sumner's disease weighs heavily on her, especially as a mother.

"Of course you are afraid to get sick and die," she said. "I've taught my daughter how to handle how to call 911."

Many of those who spoke to Buzz Feed News said they were forced to pursue careers that provide job security due to insulin costs Teenage boy, Brooke Raper from Houston, told Buzzfeed News that type 1 diabetes is a factor that has to be considered when deciding what to do with their lives. She feels under pressure to be financially successful.

"Ideally, I would aim for a creative career, but that may not have stable insurance – I need a stable income," she said. "Whenever the costs [of insulin] burden me, I know that this will be a heavy burden."

Laverty said he had type 1 diabetes at the age of 21 and had to change his entire life. He went to the theater lighting school and dreamed of one day working on a Broadway tour. But he changed his plan and now works at corporate events for permanent insurance coverage.

"I realized that I had to have health insurance to stay alive, that I had to change my career so I would have health insurance. A roadie does not always have that, "he said.

Without insurance, Laverty would have paid almost $ 8,900 for his insulin in 2018, including the receipts he had submitted to Buzzfeed News, including his $ 1,200 deductible his annual insulin expenses are $ 1,654.96.

The people with type 1 diabetes Buzzfeed News talked with, regardless of how they try to be smart about their illness, may be planning the impending sensation

"Obviously, it's shit," Marotta said. "After graduating, it's crazy at first, and then a little more concern for medical stuff and one Situation of life and death, in the truest sense of the word a life and death time situation.It should not be so difficult.You see how other countries do it, and it is not There is no reason that this is the way it is. "●


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