VERIFY: Rising cost of drugs; why many East Texans are paying more to stay alive

-

Diabetes affects more than 23 million Americans every year, and it is the seventh leading cause of death. Here in East Texas, doctors call it an epidemic.

The price of commonly used medications has increased between 70 and 1,200 percent in the last four years, so CBS19 verified the facts behind the price hikes.

Looking at insulin prices alone, the average price increase came out to 107 percent.

Families tell CBS19 they’ve had to make extreme sacrifices to make their lives livable.

"We’re a loud crazy fun family. We’re homeschool and diabetes 24/7,” said Sarah Wilson, the mother of three Type 1 diabetics living in Van, Texas.

Three of her children, Hope, Eli and Faith, were diagnosed young. Faith was diagnosed at just 9 months old, and Wilson said the doctors almost didn’t catch it.

"I had panic attacks all the time,” Wilson said. “I would run screaming to her bedside in the middle of the night. Hold my breath. Watching to make sure she was still alive. I would just wake up in a panic."

Wilson and her husband made the decision to apply for a service dog, scared for their daughter’s life, because they said her treatment was too demanding to keep up with on their own.

"The fact that they are going strong six years later is pretty remarkable," she said.

Wilson said faith is the youngest person in the country to have a service dog, and having this life-saving pup has been a gift from god.

The dog can sense when a child has a blood sugar spike, no matter when.

"She would take me and touch with her nose whichever girl's blood sugar was out of range,” Wilson said. “If both girls were out of range, she'd touch one then touch the other.”

The Wilsons said it’s not the burden of keeping her children healthy, it’s the toll on their wallet that’s keeping them up at night.

Mr. Wilson just returned to the oil field, only seeing his family one week every month, all to keep food on the table and insulin in full supply.

"The kind we have used successfully for seven years, they all of a sudden don't want to pay for," she said.

Faith is allergic to a certain type of insulin, the only one the Wilsons said they can easily get prescribed.

"We have to jump though fiery hoops every time we get an insulin prescription,” Wilson said. “Her doctors have written letters and we have documentation showing that she's been allergic since she was 15 months old."

Wilson said all they can do is pray and pay.

"Rather than not feeding the children this week, we chose to borrow from friends who we've shared with before," she said.

"Insane and obscene,” is how Dr. Christina Bratcher describes the rising cost of medicine – particularly insulin.

Working as an endocrinologist in Tyler, Bratcher said diabetes is an epidemic in East Texas.

"The problem in East Texas is that the burden of the disease is more, and you're going to have that anytime you have lower socioeconomic class, so poor people or less educated people," Bratcher said.

While bigger maybe better in the lone star state, not in terms of belt size.

"Where obesity goes, diabetes is going to follow," she said.

Here in East Texas, one in 10 have diabetes. Bratcher said what’s more alarming is one in 20 have diabetes, but don’t know it.

Looking at the demographics, she said race plays a role.

"It's much more common in Hispanics,” Bratcher said. “It's actually much more common in African Americans, and also of course Native Americans."

Overall, she said those getting diagnosed with the disease are getting younger and younger each year.

"Now it's very common for me to see patients in their 30's and 40's developing Type 2 diabetes, instead of in their 50's and 60's," Bratcher said.

Despite the closing age gap, she said it’s those over the age of 65 – specifically Medicare patients – forking the biggest bill.

"I watch now what I buy at the grocery store because I know I need this. This is lifesaving to me. Without this, I wouldn't be here,” said Gary Fletcher, a Type 2 diabetic living in Longview, Texas.

Like the Wilsons, Gary said he can only take a certain type of insulin without having an allergic reaction.

His wife Nancy Fletcher described a recent visit to the doctor, where they did not have Lantus – Gary’s insulin of choice.

“He said, 'I cannot take that.' They said, 'I'm sorry, this is what we have. You won't be allergic to this. It's the same thing as Lantus.' Well, guess what," she said.

He had an allergic reaction.

"He said if you ever have to go to the doctor, bring your Lantus with you,” Mrs. Fletcher said. “Now, isn't that ridiculous?"

The Fletcher, oftentimes couponing to make ends meet, said Medicare does not cover Lantus anymore – and they’re paying the price.

Lantus is just one of hundreds of brand name drugs to have a dramatic price hike since 2012.

WE HAVE VERIFIED THAT. 

The per unit price of Lantus today is $23.93, compared to $11.98 in 2012.

"I get two bottles of this a month,” Mr. Fletcher said. “Six years ago, I was paying less than $50 a month. I'm now paying over $250 a month for the same product, using the same units I've always used for the last 16 years."

"Medicare patients are most affected. They reach what we call the donut hole where it's no longer a co-pay,” Bratcher said. “They actually have to pay a cash price, which is about 50% of the cash price, and on average our diabetes medications and insulins are running about $400 cash price per month."

We verified prices did increase significantly for insulin.

Lantus went up 100 percent in four years. The highest spike was in Apidra, increasing 171 percent, and the lowest was Novolog, increasing 89 percent.

We verified how these prices are tracked.

First, by the center for Medicare and Medicaid services. The prices are then reported as the national average drug acquisition cost. Basically, what a pharmacy pays for the drugs.

"It's really difficult as a small business owner to manage these price fluctuations,” said Brad Martin, a pharmacist at Kinsey’s Pharmacy in Tyler, Texas.

As a local business owner, he said he takes a hit on these hikes because of insurance companies.

“There's usually a pretty good lag if the price goes up on a drug, the insurance companies can wait weeks to months raise what they pay, so we could actually be losing hundreds of dollars,” Martin said.

Dr. David Belk with real cost of truecostofhealthcare.net gained an interest in drug pricing after a pharmacy tech once explained that patients spend more than needed on drugs with their insurance than sometimes paying out of pocket.

“Since I’ve been looking at the prices every single year, nearly every brand name medication that I’ve tracked has gone up ten to percent on average, sometimes as much as 80 to 90 percent,” Belk said. “And remember, these drugs were expensive to begin with.”

For the 400 drugs he’s been tracking over the past four years, he’s seen an average rate of inflation of about 70 to 75 percent.

 “The three major players who are aware of this and who could do anything about this, the pharmaceutical companies, the FDA and congress are all far too happy with this arrangement than want to change it,” Belk said. “It’s a mess. It’s a complete mess.”

Bratcher said doctors are prescribing older insulin because newer ones are not affordable.

"It's devastating to not be able to use the newer drugs,” Bratcher said. “It would actually help people with weight loss and hunger, and we have to revert to the older drugs, which actually does the opposite. So, we're kind of fighting ourselves."

Regardless of who or what is to blame, Wilson said she sees the reality every single day.

“I think if they had to come here and look at my child and watch what she goes through daily, they'd have very different ideas about which decisions should be made,” Wilson said. "What they're really affecting in my world is the amount of times I have to pierce my daughter's flesh."

Right now, the American Diabetes Association has a petition you can sign to make insulin more affordable.

© 2017 KYTX-TV


JOIN THE CONVERSATION

To find out more about Facebook commenting please read the
Conversation Guidelines and FAQs

Leave a Comment