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    Nancy Klobassa, R.N., and Peggy Moreland, R.N.

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  • April 18, 2009

    Tips for managing diabetes in tight economy

    By Nancy Klobassa, R.N., and Peggy Moreland, R.N.

6 comments posted

Another day, more layoffs. When in New York City just this week, I heard on the news that 600 city workers were laid off.

I wondered how those workers, most of them with families, were making it. Were they able to pay the rent/mortgage or buy groceries?

A job is more than just money, it's about health insurance. Even with good health and without any outstanding medical bills, monthly medical expenses add up — from co-pays for medication and birth control pills to non-prescription medication items such as vitamins and healthy food.

These issues are affecting families all across the nation. A recent article in the "New York Daily News" reports that people with diabetes are cutting back on — or even going without — doctor visits, insulin, medicines and blood-sugar testing as they lose income and health insurance in the recession.

Doctors and diabetes educators have seen a drop in regular diabetes appointments. Sales for top-selling diabetes medications and supplies used to treat and monitor diabetes have dropped since the economy took a downturn last fall.

Looking for ways to spend less money may be difficult if you have diabetes. The American Diabetes Association reports that the typical monthly cost to treat diabetes runs from $350-$900 for those who do not have insurance. Emergency care and short term hospitalization can cost $10,000 or more.

Long-term complications of diabetes can cost far more. The economy affects people with other health problems, but people with diabetes who do not closely monitor and control their disease dramatically increase their risk for diabetes complications. The cost of treating the complications can be much greater than what might be spent on medications and supplies.

The American Diabetes Association offers several guidelines for those who consider themselves having a problem paying for:

Diabetes medications

  • Do not stop or reduce medications without first discussing it with your doctor.
  • Discuss medication costs with your healthcare provider. Ask for equivalent generic medications whenever possible. Shop around for the best prices.
  • If you are on more than one medicine for diabetes, discuss with your healthcare provider the possibility of taking a combination diabetes drug.
  • Check your local and state government for medication and diabetes supplies prescription assistance. Many state governments have programs to help people who do not qualify for Medicaid cover the cost of diabetes prescriptions and supplies.
  • Certain drug companies offer assistance to those without drug coverage.

Diabetes supplies

  • Buy test strips in bulk. A 100-count box of test strips is cheaper than 50-count boxes. Ask your healthcare provider to order bulk sizes.
  • Look for generic brand meters and supplies.
  • If you can't afford to test as much as you would like, talk to your healthcare provider or diabetes educator about a testing schedule that is feasible for you.
  • Know what your health insurance policy covers.
  • Research ordering strips through the mail such as in 90-day quantities as many insurance plans charge a lower co-pay for this.
  • Free monitors are easy to come by. Do not get the first free glucose meter that you see as the long-term cost is in the strips.
  • No need for alcohol swabs. Cleaning well with soap and water is all you need.

Insulin and related supplies

  • If you buy insulin in bulk, make sure to check the expiration date and use the insulin before it expires.
  • Buy syringes in bulk.
  • Check with your diabetes healthcare provider or educator as to how long you can use your insulin once opened. It differs by type of insulin. Write the start date on your insulin vial or pen.
  • Compare the cost of insulin pen compared to the cost of a vial. If you are on small doses of insulin, an insulin pen may be cheaper in the long run because you throw less insulin away at the end of the month.
  • If you use a pump, explore all options for covering the cost of the pump and supplies.

The price of good diabetes control is high, but long-term the cost of not staying healthy is higher. In what ways are you managing cost of care?

6 comments posted

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  • June 5, 2009 12:45 p.m.

    Diabetes1.org recently developed a new care tool for diabetics. http://www.diabetes1.org/caretools/ The cost savings tool provides a comprehensive overview of the yearly cost to manage diabetes and a list of suggestion for reducing this cost.The tool is free to use. I hope you enjoy the tool!

    - CScott

  • April 22, 2009 7:27 p.m.

    i was diagnosed to have cerebellar peduncle damage & globus pallidus damage. I also have DKA.My problem is that i have many erratic episodes of hypoglycemia & other times hyperglycemia (levels are either too high or too low)..why is this so? what can i do to prevent my hypoglcemic episodes.pls help.thanks a lot

    - raven

  • April 22, 2009 7:39 a.m.

    Ask your doctor for generic drugs where it's appropriate. My doctor is very sensitive to costs and whenever possible he writes generic scripts. Shop everywhere for the best prices! Even WITH medical insurance, it's cheaper for me to get most of my prescriptions filled at K-Mart. Their prices are less than I'd pay by using my insurance. Walgreens, WalMart and many other retailers offer very low prices for 90 generic prescriptions. I also changed the glucose meters that my wife and I use because of the cost of strips through the insurance. I had been using a Bayer Contour with a co-pay of $45.00 for 50 strips! I now use OneTouch UltraMini with a co-pay of $75.00 for a 90 day supply. Amazon.com is also an incredible source of inexpensive supplies. I get syringes for my wife for $12.00 per box of 100.

    - Phil

  • April 22, 2009 3:07 a.m.

    Fortunately for my type 2 diabetes I am living in Australia and most costs are covered by my own insurance and Medicare as I have retired and am on a pension. Nonetheless it is important for all of us to do what we can to remain healthy by following tips such as you have given, keeping in touch with health providers, exercising and trying to keep the weight off by eating low GI foods and as many fruits and vegetables as budgets permit. We are thinking of growing at least a few vegetables in our small patio garden.

    - Ellen

  • April 20, 2009 1:53 p.m.

    Dear blogger, thanks so much for the great tips on economizing with diabetes. Diabetes is an expensive disease, but if not managed well , diabetes will cost more in the long run in terms of future health and potential complications.

    - Nancy and Peggy

  • April 17, 2009 11:36 p.m.

    Hi! Great Topic, and sooo important to many families. My child and husband are both diabetic and we are lucky enough to have good health care coverage. I work at a retail pharmacy and can give any of you a few pointers to help save money. 1. Ask for coupons at the pharmacy counter. They may not always have them available, but it never hurts to ask. We usually have free meter coupons, and occasionally coupons from drug reps for pills. 2. Get store brand meters. The strips are usually about half the price of name brand meters. 3. Ask your doctor about generic pills, or less expensive insulins. If you have insurance, get your doctor to write your prescription for the max amount you may use on your sliding scale for the month so you will only pay one co-pay per 30 days. 4. Ask your doctor to write your Rxs for 90 day supply. You may get better discounts buying in bulk if you don't have insurance, or some insurance plans let you mail order for additional discounts when done 3 months at a time. 5. Check at you local department of human sevices to see if there are any programs you qualify for. They aren't all income based. 6. Last and maybe most important... don't skip checking your sugar. You will always save more by staying healthy in the long run. 7. Call the company your medicine is made by, several of our customers have vouchers for type 2 meds as well as vouchers for insulins. If you don't see contact info on the bottles, ask your pharmacist to help you get their # :)

    - Jennifer

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