Equal Protection And Non
The International Covenant on Civil and Political Rights , which the United States has ratified, and the ICESCR guarantee the right to equal treatment and protection under law, without discrimination on the basis of race, ethnicity, national origin, gender, property, or other status, including economic status. The International Convention on the Elimination of All Forms of Racial Discrimination , which the United States has ratified, spells out in more detail protections against discrimination on the basis of race, ethnicity, and national origin, among others.
US constitutional law requires a finding of discriminatory intent before courts will rule unconstitutional discriminatory practices that disproportionately burden a racial group. But ICERD goes further, prohibiting policies and practices that have either the purpose or effect of restricting rights because of race. It proscribes apparently race-neutral practices that affect fundamental rights, regardless of racist intent, if those practices create unwarranted racial disparities.
Under the ICERD, governments may not ignore the need to secure equal treatment of all racial and ethnic groups, but rather must act affirmatively to prevent or end policies with unjustified discriminatory impacts. Governments are obligated to undertake to prohibit and to eliminate racial discrimination … notably in the enjoyment of the right to public health medical care.
Options For Uninsured Patients
First, remember to check for coupons like those at Goodrx.com and patient assistance programs offered by insulin manufacturers. Major insulin manufacturers in the US offer patient assistance programs to uninsured patients and patients on Medicare Part D, so they can get their insulin for free. These programs have certain eligibility restrictions, requirements and limitations, so be sure to read the fine print before using them. More information is available below.
Then, patients sometimes ask if they can switch to an insulin that may be cheaper out of pocket. Insulins come in certain classes, like rapid-acting or long-acting insulins. But even within these classes, individual insulins may have different peak times and durations of effectiveness. While there are standard conversion recommendations when changing from one insulin to another, this process requires close observation from a physician, especially if the patient has type 1 diabetes. It may also involve the use of a continuous glucose monitorlike Dexcom, Libre, and Eversense sensorswhich are relatively new to the field of diabetes treatment.
Check Discount Pharmacy Cards And Options
Health insurance is a nightmare, right? Fortunately, there are discount savings cards and other programs that can help.
For example, Blink Health is working with Eli Lilly to offer a 40% discount on Lilly insulin. The discount is honored at 67,000 local pharmacies nationwide. Anyone can participate because there are no monthly fees or premiums. Blink Health also has a Roche Diabetes Patient Care program that offers a free Accu-Chek Guide meter, discounted test strips and more.
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Iii Why Are Us Insulin Prices So High
The list price of insulin, independently set by pharmaceutical manufacturers, is too high for a 100-year-old drug that has seen no significant innovations for decades. For years, insulin manufacturers have used loopholes in the patent system to stifle competition and increase prices.
Heather Cianfrocco, CEO, OptumRx, Letter to Human Rights Watch, September 20, 2021
Human Rights Watch found three structural causes that drive up insulin prices in the US and contribute to the high prices of other essential medicines: government failure to regulate drug prices before they enter the market the lack of regulation over manufacturers post-approval drug pricing practices and the role of rebates in fueling list price increases and policy gaps related to patents and market exclusivity that delay generics and extend manufacturers market monopolies over prices.
Sanofi Me Continuing Need Program
ME Continuing Safety Net Program throughSanofi Patient Connection, a patient assistance program that helps patients get access to their medications.
- Download the Sanofi Patient Assistance Application for Maine and completely fill out Page 2 and sign Page 3 . The download link is here:
- You can also have an application mailed to you by calling 855-937-7765 between the hours of 9am and 8pm Eastern.
- You will need to provide your insurance information on the application.
- Contact your healthcare provider and let them know you need them to fill out Page 4 and submit the completed form. This form cannot be sent in without your healthcare providers signature and information.
- Assuming the application has been completed in full, once the application is sent in by your healthcare provider, it takes approximately 5 to 7 business days to make a decision, which is sent by mail to you and your healthcare provider.
- If you do not receive a decision after 7 business days, you can call 866-489-5957 between the hours of 9am and 8pm Eastern to ask for an update.
- If your application is approved, a 90-day supply of insulin will be shipped to your home within 5 to 7 business days from approval.
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Diabetes Community Paying It Forward
The reality is that members of our D-Community are not afraid and increasingly motivated to help each other, myself included.
As noted in my human cost post last year, in order to be sure I was giving away prescription medications to strangers safely and responsibly, I chose to help by donating my excess insulin vials and pens to my endos office and nearby clinics, to let them distribute to patients as they see fit.
If you Google pay it forward diabetes, you will find a lot of forum discussion about this, where people are connecting individually to help each other.
Youll also quickly run into the Type 1 Diabetics Pay It Forward group on Facebook founded about eight years ago by Bill Patterson in North Carolina. Bill was diagnosed almost 30 years ago with a rare form of T1 known as type 1b idiopathic diabetes, and hes personally been without insurance for years and struggled to obtain healthcare and insulin. Before getting needed coverage through the Affordable Care Act , Bill says he obtained insulin from his doctors office as well as generous pay it forward gestures from others in the D-Community.
There are long-term resources out there, but they take time to obtain possibly weeks to months, he says. But there were no short-term options at the time. So I created my group to bridge that gap.
Ask Your Physician For Samples
If you are struggling to afford insulin, be sure to tell your health care provider. Your primary care provider or endocrinologist may have insulin samples available in their office. They also can help you find ways to reduce your costs by writing a larger quantity prescription, changing brands or formulas or documenting your medical needs for other assistance programs.
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One Final Word Of Advice On Managing Diabetes During The Pandemic
Finally, as you search for ways to afford your diabetes treatments and other living costs, remember to be patient with yourself, advises Isaacs. The pandemic has left millions of people in the same predicament, on top of those who were already feeling the strain. Its important for a person not to be hard on themselves, she says. This is a really stressful situation for everyone.
Government And Corporate Human Rights Responsibilities
Unregulated pharmaceutical pricing in the US and market practices that incentivize price increases can result in out-of-pocket costs for essential medicines that are so expensive as to undermine their equal and affordable access, a cornerstone of the human right to health. This dynamic disproportionately impacts people based on their economic status and within that group further disadvantages particular racial and ethnic groups in violation of domestic and international law prohibiting discrimination.
The Universal Declaration of Human Rights and the International Covenant on Economic, Social and Cultural Rights , which the US has signed but not ratified, affirm that governments are obligated to ensure that health care, including the provision of essential drugs as determined by the World Health Organization, is accessible to everyone without discrimination and affordable for all. This duty extends to preventing and protecting against human rights harms caused by businesses and other non-state actors, and may include or require effective regulation of their activities.
This responsibility extends to all actors in the supply chain between drug manufacturers and consumers, which should address policies and practices that contribute to out-of-pocket costs for insulin that undermine equal and affordable access to the drug.
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The United States Does Not Have Price Controls
However, one of the main reasons that insulin is so expensive in the United States is simply because we do not have any price controls. Only 7% of the worlds diabetics live in North America, and yet North America is responsible for 52% of global insulin revenue.
There is a raging debate in the United States about how health care should be paid for. Some favor universal health care others prefer our current system. Either way, we need cheap diabetic supplies and more reasonable insulin prices.
I, personally, agree with Dr. Ira B. Hirsch:
is not a concierge drug that should be used by only those who can afford it. Insulin, in my view, is a right, not a privilege. And although I have no problems with the newest and greatest insulins receiving whatever cost the market can bear, older insulins yes, including the insulin analogs ideally should be made available for all Americans at a reasonable cost.
This concept may seem counter-intuitive for many in the United States and perhaps would make us look more like our neighbors and our friends in Europe. But to those who detest the thought of having our government involved in the distribution of insulin, I would say that I detest more the pain, suffering, cost, and potential death from diabetic ketoacidosis resulting from patients inability to afford insulin. Insulin should be readily available to anyone who needs it.
Medicare Part D Senior Savings Program
- If you use an insulin pump, your insulin is covered under Part B. You pay 20% of the amount approved by Medicare after you meet your Part B deductible.
- If you inject via syringe or pen needle, your insulin is covered under Part D. How much you pay will depend on the type of Medicare Part D plan you choose.
no more than $35 per month for a thirty-day prescription, with no deductible
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Request A Fax Or Electronic Submittal Confirmation From Your Healthcare Provider
Get proof that your application was submitted. It can be helpful when following up with the manufacturer for example, if they say they didn’t receive the application, says Evans. I’ve had a few where things have gone wrong. Once the manufacturer was switching contracted companies and telephone hold times were five-plus hours, so we definitely didn’t want to have to call them.
Welcome To Lantus Savings And Support*
Whether you have commercial insurance or not, we have an offer for you. Its easy to sign up to receive information emails about Lantus and living with diabetes powered by TeamingUp. Check the boxes below to select the level of support and savings that may be right for you. You may want to check more than one!
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Warning Signs Of Low Blood Sugar
Bell, the retired sales account manager living with type 2 diabetes, says he has switched from rapid-acting Humalog to an over-the-counter fast-acting human insulin to help save money, but because his Medicare insurance doesnt cover the $50 cost for two bottles every month, it still takes a bite out of his wallet.
Miller doesnt believe thats the answer. Yes, those insulins can keep people out of the hospital, but as far as quality of life, I am a strong believer that a switch to N and R is a switch backwards.
There are signs that people in search of additional savings on insulin are looking beyond chain pharmacies. A survey published in February 2019 in JAMA Internal Medicine suggests that some people with diabetes are turning to over-the-counter insulin, which Walmart sells. The authors wrote that this trend likely reflects the fact that the Walmart brand is considerably less expensive than other brands of insulin sold at chain pharmacies.
However, T1International, a UK-based advocacy group, released a statement in June 2018 that Walmart insulin can be less reliable than analogs, requiring the use of more blood glucose testing strips at additional cost. Suggesting that patients should switch back exacerbates a two-tiered system where the rich get the better insulin and the poor are forced to use the older, and often more problematic, insulin, the group says in its statement.
Find Free Insulin From Pharmaceutical Companies
There are three major insulin producers. Low income patients, those on Medicare, and the uninsured can get free insulin as noted below. There are also monthly subscription plans that charge a fixed rate per month, patient assistance programs, and other resources. Learn about .
Eli Lilly provides free or affordable assistance to low to moderate income families, the uninsured, people in high deductible plans, some patients with a disability and others who may be struggling. The Lilly Diabetes Solution Center will allow anyone in need of information to get insulin for free. Customer service representatives will review all of the insulin assistance programs that may be available to the patient.
There are community clinics which offer free insulin for type 1 diabetic patients as well as other health care services. Point of Sale savings and discounts are offered too. There is other forms of financial aid, and help is available in multiple languages too, including Spanish. The main phone number is 808-1234.
Low cost or free insulin can also be obtained from the patient assistance program known as Lilly Cares. It will focus assistance on patients without health insurance, those in Medicare Part D, and where insurance will not pay for any insulin or medications. There are other requirements as well in order to get insulin such as Humalog. Read more on .
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Pharmaceutical Company Patient Assistance Programs
You may be able to get help with the costs of insulin and medication through drug assistance programs from pharmaceutical companies, known as patient assistance programs . Each program has its own eligibility requirements for people with type 1 diabetes, so its important to check those details. Here are a few programs offering assistance for diabetes medications:
You can also find a program by searching on the medication name here.
If you need assistance with your pump supplies or CGM, directly contact the manufacturer via their customer service number.
- Medtronic: 1-800-646-4633
- Abbott Diabetes Care: 1-855-632-8658
More Grassroots Help Needed
In the end, for whatever reason, the resources that exist werent able to help Shane.
No, these programs and resources arent end-all-be-all fixes, and they dont ensure #Insulin4all. But they can help in an emergency for those facing a dire life or death choice.
Something more has to be done, without waiting for sweeping fixes in drug pricing structures and healthcare policy. NO ONE should be dying because they couldnt obtain a single vial of insulin, which is not in short supply in this country.
Here at the Mine, were big proponents of crowdsourcing innovative ideas so here is possibly the most important challenge ever put to our community:
What else can we do, at the local and grassroots level, to help people like Shane and Kevin and so many others who are falling through the cracks?
One idea is to set up roving donation centers, like those Recycle Your Electronics centers you often see in local parking lots, that would be manned by volunteer health professionals who can make sure that all the donated insulin and supplies are sealed and safe.
Another idea would be setting up a national hotline people can call for help if they are completely out of insulin and on the brink.
What else, Friends? What other emergency resources might we build, and how might we get the word out about them to those who need help the most?
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Free Insulin For A Year From Lilly Cares
Lilly Cares provides a patient assistance program for customers who use Eli Lilly products. You could receive up to a year of free medication from this program. Eligible medications include Basaglar, Glucagon, Humalog, Humulin and more!
In order to qualify, you will need to meet household income limits. You cannot have insurance in order to qualify.
Right To Health And The Right To An Adequate Standard Of Living
Health is a fundamental human right indispensable to the exercise of other human rights, and every human being is entitled to the enjoyment of the highest attainable standard of health conducive to living a life in dignity. Unregulated high prices of insulin products, especially insulin analogs, combined with inadequate cost mitigation or health insurance coverage, contribute to out-of-pocket costs that impact the livelihoods of patients and cause damaging and potentially lethal insulin rationing.
The Universal Declaration of Human Rights, which is widely accepted as reflecting customary international law, states that all people have the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.
Similarly, the International Covenant on Economic, Social and Cultural Rights guarantees the rights to an adequate standard of living and the enjoyment of the highest attainable standard of physical and mental health, including the prevention, treatment and control of epidemic, endemic, occupational and other diseases and the creation of conditions which would assure to all medical service and medical attention in the event of sickness.
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