Feature Archive

Saving on the Cost of Diabetes Care

Some of the best cost-cutting strategies are free.

By Martin Downs
WebMD Feature

Reviewed By Brunilda Nazario

Carol Phillips has a problem -- a big one, but a common one. She is grappling with the cost of diabetes . At the end of May, her COBRA benefits from a former employer will run out, and she will join the ranks of more than 43 million Americans without health insurance. Because she was recently diagnosed with type 2 diabetes, it will be hard for her to afford a new policy.

"I have called a couple of places and inquired," she tells WebMD. "Either I am non-insurable, or the premiums that are quoted are ridiculous."

Phillips is too young for Medicare, and as a self-employed consultant in the travel industry, she makes too much annually to qualify for Medicaid. Nevertheless, her out-of-pocket diabetes costs will take a bite out of her income. "It's going to be very scary," she says.

Since her diagnosis in January, she says she has been able to get her blood sugar under control with the diabetes drug Avandamet and major lifestyle modification. "I'm a changed individual in terms of what I do and what I consume," she says. She exercises daily and has already lost 25 pounds.

She says she hopes to reduce her costs by getting off diabetes medication altogether, and managing her blood sugar by diet and exercise alone. For people who are diagnosed early in the course of the disease, that is sometimes possible.

Cost of Diabetes: Strategies for Saving Money

Even if she must stay on medication, Phillips is cutting her cost of diabetes by taking a combination diabetes drug. Many people with type 2 diabetes take more than one medicine. "Two or three is not uncommon," says Paul Jellinger, MD, president of the American College of Endocrinology.

Avandamet, which Phillips takes, combines the drugs metformin and rosiglitazone, which work by decreasing the amount of sugar the liver produces or by making the body more sensitive to insulin.

If someone with insurance were to take the two drugs individually, they would have to pay a co-payment for each one, doubling their cost. Those paying full retail prices out of pocket could benefit even more from a combination drug. For example, at one pharmacy, 60 tablets of Avandamet sell for $62, while 60 tablets each of the brand-name versions of metformin and rosiglitazone together cost $166.

Other examples of combination drugs are Metaglip (glipizide plus metformin) and Glucovance (glyburide plus metformin). "And there are more coming," Jellinger tells WebMD.

Considering generic drugs can cut your cost of diabetes care, sometimes significantly. Retail prices for generics are generally lower. Also, when a generic version of a drug becomes available, sometimes health plans will charge a higher co-pay for the name-brand version or may stop covering it altogether. The diabetes drugs available as generics are:

  • Chlorpropamide (Diabinese)
  • Glipizide (Glucotrol)
  • Glyburide (Diabeta)
  • Metformin (Glucophage).

"Wherever possible, go generic," James Gavin, MD, chairman of the National Diabetes Education Program, tells WebMD.

The cost of medications isn't the only cost involved in diabetes care, however. Phillips expects to pay $80 a month for test strips when her insurance runs out. She says she has seen test strips on eBay go for much less, and she says she would be willing to give that a try. "As long as it's a sealed, unexpired box, I'd buy it."

Gavin doesn't explicitly encourage buying on eBay, but he says people should bargain hunt and comparison shop like they would for anything else.

Diabetes Costs: Paying for the Insulin Pump

Diabetes is the sixth leading cause of death in the United States and is estimated to cost the nation $132 billion annually. Given the numbers, 46 states have mandated that insurers must cover not only diabetes medicines, but also supplies and equipment.

Some states have even written provisions into their laws that require insurers to pay for insulin pumps.

Many people who take insulin would love to try using a pump, but they are very expensive, costing as much as $6,000, plus monthly supplies. To get coverage often means jumping through a lot of hoops.

"Pumps are not for everybody, and they're not an easy fix," Martin Abrahamson, MD, acting chief medical officer of the Joslin Diabetes Center at Harvard University, tells WebMD.


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