Article in the New York Times today about Diabetes

Today the New York Times wrote an article about the cost of medical advancements and the impact on Americans pockets, and it features a woman who wears an insulin pump.

Very curious as to what you guys think about this article.

@Gina

Great read! Thank you for sharing.

This is by far one of the biggest issues with treating diabetes; the cost of it. It’s no secret anymore how expensive it is for one to take care of themselves (as sad as that sounds).

One thing I find that these articles fail to mention, however, is the cost that healthcare/individuals end up paying when they DON’T control themselves with the proper equipment. This is what I never understand. It’s proven that when complications arise like kidney failure, heart disease, eye problems, etc… the cost is so much more expensive than it would be for just the supplies. I never understood why insurers are still reluctant to insure people with the proper equipment. This is just some food for thought though. There’s more behind these pharmaceutical/insurance companies than we know.

Hopefully as new technology comes out, some of the older stuff (like an insulin pump) will be more affordable.

@Caddy makes a great point.

And as expensive as an insulin pump is, the quality of life it’s given me and my family is priceless. I had such bad hypoglycemia unawareness with shots, doubt I’d still be alive if that had been my only treatment option.

Yes this was a great article. The expenses I incur on a daily basis is just phenomenal. I’m always having to do special requirements to get my supplies. (ie). Having my PCP fill out extra paperwork just get Test Strips. I pay a good premiums for my Health Insurance. What amazes me it cheaper to pay out pocket for certain supplies. What scares me when these Drug Companies decide when they will eliminate certain Insulins. My expenses start even higher .I’m lucky to have a PCP that helps me out with this with samples from the Drug Companies. In which I’m so grateful for. We still need more Reform. I’m here today. And my voice in this Reform will not silence me. I will continue to Learn , Teach and Advocate.

While this article makes some good points about the high cost of care, it gets a lot of information wrong as well. I can only speak from experience with Minimed (as this article focuses on), but my last 3 pumps (that’s about 10 years worth of pumping) have used the exact same supplies–they are not all proprietary to each new upgraded pump. I am grateful that Minimed does this so that I can just keep ordering the same supplies. And you do not HAVE to use the meter that comes with your Minimed pump. Minimed is currently using Bayer meters with their pumps, but I just kept using my One Touch Mini that I’ve had for years. And might I add that those same One Touch test strips work with the majority of their meters (except the new Verio line). Most lancets in my experience can fit most of the lancing devices out there. So, I don’t feel the manufacturers are trying to gouge us in every way possible. I do not feel they innovate for the sake of innovation–the improvements they make are for good reasons (including patient comfort!). This article makes the technological advances in pumps and sensors sound frivolous when they are really amazing tools that I feel lucky to have access to.

I agree that the cost of diabetes is ridiculous, especially if you don’t have good insurance or any at all. I like that that point came across, but this article also makes it sound like we are a burden on the health care system because we’re no longer using pig insulin, syringes, and test strips that change color to reveal the “range” of your BG.

@KSmerk12

Wow do I enjoy good criticism of an article.

I agree with you on so many levels. I use the One Touch Ping insulin pump which comes a glucometer that interacts with the pump (really optional though). When I go out, I don’t take this glucometer because it’s bulky, so I take my One Touch Ultra Mini which uses, like you said, the exact same test strips, and I use the same pricker with the same lancets. Even when my Animas 2020 was upgraded to the Animas/One Touch Ping, the supplies stayed the same like you said.

They really are amazing tools that have proven effectiveness with improved control.

Thank you for your input and insight.

Thank you to everyone for sharing your responses on TypeOneNation regarding the New York Times story.
Share them directly on the article on the New York Times website and use the hashtag #NotJustAGadget
Please take a moment to read JDRF’s official response to this article. http://jdrf.org/blog/2014/notjustagadget/

The JDRF’s response annoyed me, honestly. The focus of the issue, and the topic that I think deserves real advocacy, is the cost of caring for chronic illness. The bigger point of Rosenthal’s article, to me, was that chronically ill people are reliant/dependent on such medical care, and are beholden to companies looking for a profit. I really did not view it as a critique of the devices we use today; but rather, a delving into the costs of those items. I mean, the fact that brand name test strips cost around $50-$60 for a one-to-two week supply is INSANE. I use Wal-Mart brand strips, which cost $9 for a bottle of 50, and I can’t help but wonder why there aren’t more generics like that. Isn’t that something JDRF could support?

I guess my bigger thought is that there are so many more meaningful and powerful ways for JDRF and T1Ds to advocate for better diabetes care, and taking issue with the “gadget” language just seems like a waste of time, at least to me. I could be alone here, but I’d love to see more advocacy for generic treatments, so that it’s easier for T1s to care for themselves and avoid those costly complications later on down the road.

As far as the updating of products, my research has shown me that for many products (like pumps and CGMs), the only ones available for purchase are the most up-to-date ones - in other words, the most expensive ones. I’m not even sure I want a pump or CGM, but it’s frustrating to me that I don’t even have the option of buying an older model for a cheaper rate.

Yes you are right. Just totally insane on the cost we incur with our Chronic Illness of T1D. I feel my life is somebody else’s control.but will not define me. I so glad that I have put a serious effort in my Diabetes Management. With the help of my caring Doctors. Everybody seems to say you need a Pump. I ask myself this everyday. Why do I need a Pump. I never seem to come to the answer of Yes I do.Not even the PCP answers yes to this question.As being a Small Business Owner I got No break in Insurance Costs. No Tax Credit for me. Over 8k out of pocket cost last year alone. I couldn’t even grasp the cost of this enormous expense. This T1D will being doing his Insulin Therapy the Old School way. Until there is more Reform and Regulation to improve our Health Care in America. We will always be in shadows of these for Profit Insurance Companies in our Country. So I continue writing lots of letters and Phone Calls to my Elected Members of Congress and The U.S. Senate.

I agree that the costs can be astronomical. I feel lucky to have always had insurance that kept my out of pocket costs minimal. I probably wouldn’t be on a pump and CGM if I personally had to pay thousands of dollars a year for it. But if the technology is within my grasp, I’m certainly going to use it to get the best diabetes management that I can.

One other good point about this article is that US consumers pay a LOT more than those in Europe because the government-funded healthcare over there negotiates pricing with the manufacturers. That is definitely something we could use here.

Again, the point they make about the cost of care was a good thing to bring to light in my book. I think what really got to me about this article was the part in the beginning where they said something to the effect of “worries about complications have faded away and been replaced by high costs”. Ummm–first, I still worry about complications occurring some day even though I don’t have any yet. And second, isn’t the cost of good care (whatever that cost) better than both the cost and physical/emotional stress of living with things like kidney failure, heart attacks, loss of vision, etc?

Are we supposed to just resign ourselves to having complications of diabetes because it’s cheaper? I don’t know the cost of dealing with complications but I doubt it’s any less expensive–which is the age-old argument with insurance companies. Preventative care is supposed to be cheaper in the long run than the consequences of not having preventative care.

I read this article in the paper on Sunday. I checked in over here to see if it was mentioned and to mention it if it wasn’t. Of course Gina beat me to it!

I see they did fix one of the errors in the online version. In the paper the caption next to the picture of the glucagon, was “emergency insulin kit”. :slight_smile:

The article said nothing earth shattering that any diabetic who keeps up at all already knows. But it did re enforce my opinion of how screwed up our health care delivery system is in America. Other countries can negotiate for drug prices and do to get much lower prices. Our system doesn’t allow it. Our members of congress with palms freshly greased by the Medical Industrial Complex put in the law that Medicare can’t.

Couple that with our inefficient insurance system and we get stuck paying the pharmaceutical companies a handsome profit on everything to make what more frugal consumer countries won’t pay. The article quotes 70% profit margin on insulin for example. With the mass production of test strips and the amount of time they’ve been making them, charging a $1 each is pure price gouging.

I may be speaking from ignorance here since I don’t have a pump or CGM nor do I want them. However, I do follow whats going on. Maybe someday?

But they seem to be over engineered with an emphasis on throw away supplies. Throw away sensors and wireless communication to pump controllers seems over the top to me. Surely there’s got to be a simpler cheaper way to do this. But if they’re not selling you a new sensor every week, that’s less profit. Oh, and if you do have a CGM, you still need a tester and strips too. They just want you to “need” more and more supplies to stay alive.

I admit I’m cynical, but this is a racket.

Hi All,

The NY Times Public Editor wrote up a response to the article written last wekeend:

http://www.diabetesdaily.com/voices/2014/04/a-response-to-the-new-york-times-public-editor/