By Ana Martinez-Ortiz
Over the past decade or so, the cost of prescription drugs has increased. As a result, patients with chronic illnesses who require medication to live healthy and normal lives are left in a predicament: to cover their basic needs or to choose their medication.
Chuck Rynearson, the Vice President of Health Analytics and Pharmaceutical Benefits at Network Health, said that people used to pay affordable prices for their prescription drugs. Now, given the high cost some people chose to either reduce the amount of medication they were taking or stop taking it all together.
For people living with chronic illnesses, this decision rarely ends well. For example, patients living with diabetes who choose to forgo their insulin or lower their dosage may end up worse off with the potential for heart disease, stroke, amputation, blindness, kidney disease or death.
Recently, Network Health, the Wisconsin-based health plan, announced that it wants to make the cost of insulin more affordable through its new Patient Assurance Program.
Through the program, members will be able to afford insulin at a more reasonable cost. The program will cap the cost of a copayment at $25 for a 30-day supply of preferred insulins, according to the press release. This change will become effective on Jan. 1, 2020.
Currently, the average copayment is about $42 a month while the average out-of-pocket cost reaches $6,000, according to the press release.
Rynearson explained that the cost of insulin began increasing when new insulin known as bio-tech was engineered. Instead of standard insulin, now there’s different strands of insulin such as long lasting or short term, which increased the price of insulin.
According to the American Diabetes Association (ADA), about 517,000 people in Wisconsin are living with diabetes and about 30,000 are diagnosed each year in the state. Furthermore, 1.5 million people in Wisconsin are at pre-diabetic levels.
In addition to making insulin affordable, Network Health is working on its pilot program “Prevent T2.” Rynearson said the program works with people who are pre-diabetic and over the course of year, the group meets to discuss lifestyle changes such as exercising and eating right.
The goal is to educate people with the added benefit of losing weight. The program, which began in April 2019, helped participants lost about eight percent of their bodyweight.
“It’s much better to prevent disease than to try to fix it when it’s already there,” Rynearson said.
Network Health plans to work with drug manufacturers to make the insulin more affordable. It will be examining its formulary to determine which ones are the most effective. The change will be effective immediately in January.
Commercial members and those under the Affordable Care Act who are using the preferred products will see the change in prices.
Rynearson said he hopes this becomes a trend among other chronic illness medications.