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Why are Diabetes Medications so Expensive?

December 11, 2020

high drug prices

The exorbitant cost of diabetes medication is a major source of anxiety and financial distress for many Americans. Unless you can afford excellent health insurance, or your employer provided health insurance plan is top notch (a rarity, at this point), then your diabetes medication(s) aren't exactly cheap.

Diabetes is a significant problem in the United States, with an estimated 34.2 million diabetics, which amounts to just over 10% of the population. Furthermore, the American Diabetes Association estimates that about 1.5 million new cases are diagnosed every year. It's safe to assume that these numbers will only increase in the coming years, as 88 million people were estimated to have prediabetes according to 2015 data.

There are a lot of popular prescriptions that have proven to be very helpful for diabetics. We covered some of them in a previous blog post, but here, we'll discuss three others, in addition to the complicated cost of insulin, and how health insurance doesn't always help reduce your out-of-pocket costs.

The Shocking Cost of Diabetes

According to the American Diabetes Association, the total cost of diagnosed diabetes in the U.S. for the year 2017 was a whopping $327 billion. Of that cost, $237 billion was direct medical costs, including visits to the doctor, hospital stays, and medication. The remainder ($90 billion) is attributed to lost productivity, which includes missed work days because employees needed medical care, or slower productivity because they weren't feeling well while they were at work.

A study conducted by the American Diabetes Association found that for every four dollars spent on healthcare, one of them (or 25%) is for the care of a person diagnosed with diabetes. Of that expense, it's estimated that half is a direct result of diabetes, and not a different ailment that a diabetic is seeking treatment for.

As if all of this weren't shocking (and frankly, horrifying) enough, the cost of diabetes isn't likely to decrease anytime soon. The same study found that "economic costs of diabetes increased by 26% from 2012 to 2017 due to the increased prevalence of diabetes and the increased cost per person with diabetes." Furthermore, researchers expressed concern that this burden would be felt heavily by senior citizens and the Medicare system. Senior citizens are more likely to be retired and living on a fixed income, which can make their situations more dire, more quickly.

3 Popular Diabetes Drugs and What They Cost

There are many medications approved to treat various aspects of diabetes. We've discussed other drugs in the past, but here, we'll focus on three common medications, plus insulin. All diabetes medications are recommended to be used as part of a holistic health plan that includes diet and exercise (as first discussed and approved by a doctor).

Jardiance

Jardiance includes the active ingredient empagliflozin, which is in a drug class called sodium-glucose co-transporter 2 (SGLT2) inhibitors. Empagliflozin helps the kidneys get rid of glucose, which lowers your blood sugar.

Jardiance was approved in 2014 to improve glycemic control in patients with type 2 diabetes. Because it's still under patent protection, there is no generic available at this time. In the United States, people can expect to pay about $585.00 for a 30-day supply of the lowest dose (10 mg), which comes out to nearly $20.00 per pill.

At NorthWestPharmacy.com, we have Jardiance for a fraction of the price — about $120.00 for a 28-day supply, which comes out to about $4.29 per pill.

Januvia

Januvia contains the active ingredient sitagliptin, which is a DPP-4 (dipeptidyl peptidase 4) inhibitor. Sitagliptin helps the body release incretins, which are natural substances that help increase insulin release, in addition to decreasing the liver's sugar production.

Januvia was approved in 2006, and there is only a brand version in the USA. Therefore, in the United States, it's quite expensive — though not as expensive as Jardiance. For a 30-day supply at the 50 mg dose, Americans can expect to pay about $537.00, which is about $18 per pill.

At NorthWestPharmacy.com, you can get the same dose of the brand name medication for about $3.00 per pill. For 56 pills, you can expect to pay about $170.00. We also have access to a generic version of the drug, which is even more affordable. The generic is also sold in 56-pill quantities and costs about $110.00, or just under $2.00 per pill.

Ozempic

Ozempic contains the active ingredient semaglutide and was approved in 2017. Semaglutide works similarly to sitagliptin, in that it assists in incretin production to moderate blood sugar levels. Because it's so new, there is no generic available at this time.

Unlike Jardiance and Januvia, Ozempic comes in a prefilled injectable pen meant to be administered once per week as opposed to once daily. Between the frequency difference and the method in which it's delivered, the price is very noticeably affected.

Ozempic is intended to start on a smaller dose before being increased according to the patient's needs. In the United States, you can expect to spend about $900.00 for one pen in the lowest dose — and as a reminder, this covers you for one week.

While still expensive, we offer Ozempic at a much lower price at NorthWestPharmacy.com. The lowest dose pen is about $300.00. Again, that's not a small sum, but it's one-third of what you'd pay in America.

The Complicated Cost of Insulin

Most diabetics require some dose of insulin throughout the course of a day. Afterall, this is a condition in which the pancreas isn't making enough insulin to support the body. Because it's such a common need for diabetics, the cost of it is a frequent topic in the news — and there have been a lot of headlines in the past few years about the rising cost of insulin.

According to data from the non-profit Health Care Cost Institute, the price of insulin nearly doubled between 2012 and 2016. There are many factors involved in the price increases, but one of the most impactful is the lack of competition. Three companies control the vast majority of the insulin on the market today (Novo Nordisk, Sanofi-Aventis, and Eli Lilly), which means they have a near-monopoly on insulin. Without competition, there isn't much incentive for the companies to lower their prices.

One of the major complications of the cost of insulin is that it needs to be refrigerated at all times — even during shipping. This makes finding more affordable insulin (like from online international pharmacies) much more difficult. We can't guarantee that the insulin will remain cold enough while it ships from, say Vancouver to New Jersey, or Germany to New York.

While we'd love to be able to offer more affordable insulin for diabetics struggling with the high (and climbing higher) costs, we can't do so in good conscience. If the temperature dips too low or rises too high during shipping, it could put you in danger.

This is why purchasing insulin from brick-and-mortar pharmacies is so common. They'll have bulk purchases brought in by special equipment or by companies that are built for transporting temperature-sensitive products. Unfortunately, that makes Americans more vulnerable to price gouging.

While an executive order was signed in 2020 in an attempt to alleviate the financial burden of insulin on senior citizens, time will tell as to whether or not it helps though we believe it almost surely won't. And with a new administration taking over, it's all up in the air as to which executive orders will stay and which ones will be replaced.

Why Insurance Doesn't Necessarily Reduce Out-of-Pocket Costs

Health insurance in the United States is drastically different than most other industrialized nations. According to the Kaiser Family Foundation, nearly half of all Americans get their health insurance through their employer. This means that their insurance plan is grouped with everyone else enrolled in their employer-sponsored plan.

The premium cost (the monthly payment for the plan) depends on the overall health of the employees enrolled in the plans, and the estimated cost of the population over the course of the upcoming year. Employees may get a couple different types of plans to choose from based on their unique needs, but these are their only options.

Generally speaking, the higher the premium, the lower the out-of-pocket costs. If you can afford to pay a more expensive premium, you may not have to worry so much about the cost of your diabetes medication. It may cost between $30 and $50 per month per prescription. But if you're looking to save money on monthly premiums, you'll be left with a higher prescription cost.

The highest out-of-pocket costs are associated with high deductible health plans (HDHPs), which mandate that enrollees pay for all medical expenses before the insurer will cover any costs at all. This includes doctor's visits, hospital stays, urgent care, and prescriptions. If you have diabetes and your individual deductible is $4,000, you can expect to pay every penny of that during the year — and after you've fulfilled that deductible, you still may owe coinsurance, which is a percentage of all costs after the fact.

If you're enrolled in a HDHP and your medication costs hundreds of dollars per month, there will not be a way to decrease your prescription costs without looking at international online pharmacies. The only alternative — not adhering to your prescribed medication plan as directed by your physician — is incredibly dangerous and puts your life at risk.

The Questionable Ethics of Drug Pricing

Knowing that people need these medications — particularly insulin — to literally survive, and they're still priced so exorbitantly high is unethical at best and seemingly extortionate at worst. Pharmaceutical companies know that people will pay whatever it costs in order to get the life-saving medication they need.

For whatever reason (there are many possibilities), the United States government has chosen to allow pharmaceutical companies to set their own prices without any kind of restriction. This is the opposite of what most countries do, which is to cap the price so they're accessible by the vast majority of people.

Pharmaceutical companies set their own prices for drugs sold all over the world. The packaging might look different from market to market, but the medication inside is typically the same. The major difference between Jardiance sold in the U.S. and Jardiance sold via an online international pharmacy is that the international price is regulated, and the U.S. price is not.

Finding More Affordable Diabetes Medication via International Online Pharmacies

At NorthWestPharmacy.com, we are committed to finding the lowest price possible for your medication, which is why we offer a lowest price guarantee — if you can find your prescription cheaper elsewhere, we'll beat it. We don't believe that anyone should be forced to choose between paying their bills and getting the medication they need to survive.

We also understand that circumstances surrounding healthcare and prescriptions (especially when you're ordering online for the first time) can be extraordinarily stressful, which is why we strive to provide the best customer service possible and make ordering incredibly simple.

But the best part about ordering from NorthWestPharmacy.com is that we'll deliver the medication your doctor prescribed straight to your door — you don't have to leave the comfort of your home to pick it up at the post office.

It might seem like a rarity in the days of texting and automated services, but we still love talking to our customers on the phone. In fact, we do so every single day. If you have questions about placing an order, what materials you need before you can order your medication, and how to pay for it, we're happy to walk you through that process. You can also check out our frequently asked questions, which may provide the answers you need.

We can't stress enough how much we enjoy talking to our customers, so if you've read through the FAQs and still have questions — or simply need to be reassured that you're placing your order correctly — please contact us today. For your convenience, we have a toll-free phone number: 1-866-539-5330. We're happy to walk you through the ordering process.

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