As drug prices
continue to rise, patients who can’t afford their medicine
are taking some truly drastic steps.
across borders or order through international online
pharmacies, where medications commonly retail for much less.
Others try to ration or skip doses.
Christiana Care Health System in Delaware set out to learn
more about an option for people struggling to manage diabetes
amid rising insulin prices: Over-the-counter insulin.
insulin has been available over the counter, without a
prescription, since the 1950s and retails for a fraction of
the price of the newer, analog insulins that are now commonly
ReliOn human insulin is available without a prescription in
every state except Indiana and retails for a fraction of the
cost of brand-name versions, making it popular among patients
who can’t afford the pricer versions their doctors
prescribed, according to the researchers’ findings,
published in a research letter in JAMA Internal Medicine Feb.
surveyed 582 Walmart and chain pharmacies about their sales
Just over half
of the 557 pharmacies that completed the survey were Walmart
pharmacies. Among them, 87 percent said they sold
over-the-counter insulin daily. Non-Walmart pharmacies
reported infrequent over-the-counter insulin sales.
percent of the pharmacies surveyed said they were aware of
patients who purchased over-the-counter insulin because they
could not afford their prescription insulin.
A 10 milliliter
vial of ReliOn costs $24.88, compared to between $152 and $163
for a vial of Novolin or Humulin, according to the report.
patients with diabetes are struggling to afford their
medication. The availability of insulin over the counter is
potentially a solution for some patients, but doesn’t come
without potential consequences, especially for patients who do
not have access to a health care provider to help use that
medication safely,” said lead author Jennifer N. Goldstein,
a doctor and assistant program director of internal medicine
at Christiana Care System.
insulins predate federal drug prescribing regulations
established in 1951 and have continued to be available without
a prescription since then.
patients are more commonly prescribed a combination of newer,
analog insulins that help keep blood sugar levels even
throughout the day. They’re often considered easier to use
and more predictable, Goldstein said.
like ReliOn don’t last as long and must be taken more often.
But they are effective in managing diabetes for many patients
with careful attention to diet, meal times, and when insulin
pharmacy survey found that this type of insulin is popular,
it’s unclear whether the type of insulin a patient chose had
any effect on their health.
really unclear whether over-the-counter insulin is associated
with better or worse outcomes for patients because there’s
no data,” Goldstein said. “The next step is really to try
to examine use and outcomes.”