Just as runaway costs have affected cancer drugs, sticker shock is jolting diabetics with price increases ranging from 93 percent to more than 300 percent in five years.
All told, the cost of diabetes medications is expected to continue rising over the next three years at a pace of 18.3 percent annually, a growth rate estimated to be 60 times greater than recent increases in family income of 0.3 percent, new research has found.
The growing costs are considered unsustainable, according to advocates for patients and the trade group representing Medicaid-centered health plans that analyzed years of pricing data. The findings dovetail with two studies released in June highlighting exorbitant and often unaffordable price tags on cancer drugs.
Highflying costs have not as seriously affected older pressed-pill drugs for type 2 diabetes, the form of the disease that usually, but not exclusively, begins in adulthood.However, the price of Januvia, an oral type 2 medication introduced in 2006, rose 93 percent between 2010 and 2015, the pricing analysis found.
As with cancer therapies, the highest rates of growth are on diabetes medications that are genetically engineered. But though these treatments come nowhere near the costs of so-called biologic cancer medications, diabetes is lifelong, which means people pay longer and experience more price increases, experts say.
"This is why I advocate for people with chronic diseases," said Sabrina Gardner, an Elmont mom of a 20-year-old daughter with type 1 diabetes. "I have uncles and aunts in my family who have a hard time buying their [diabetes] medications because their insurance carriers don't cover them."
Although her daughter is fully insured now, Gardner worries what will happen when the young woman enters the workforce and is starting out on her own. She takes an engineered insulin called Lantus, whose price has jumped 189 percent since 2010. Insulin was the first medication produced through recombinant DNA technology 35 years ago.
"When you have to come out of pocket to pay for these medications, it is very difficult for some people who can't afford them," said Gardner, founder of the Diabetes Health and Wellness Academy of New York City, a nonprofit in Richmond Hill.
Diabetes is a major health issue affecting nearly 30 million people nationwide. Many diabetics are low-income or elderly on fixed incomes, which makes diabetes a serious wallet issue, Gardner said. "People shouldn't have to choose between food or medicine," she said.
The metabolic disorder is typified by elevated levels of blood sugar and occurs in two forms. Type 1, characterized by failure of the pancreas to manufacture insulin, is an autoimmune condition. Beta cells in the organ are destroyed.The disease usually emerges in childhood and results in lifelong insulin dependency.
Type 2 is associated with obesity and is characterized by insufficient insulin to control blood glucose. This form also has a genetic component and tends to run in families. About 90 percent of all instances of diabetes are type 2.
The new pricing figures are from the Alliance for Community Health Plans, an association representing 57 Medicaid-centered insurers in 24 states, including New York.
Richard Bruzek, a spokesman for the alliance and vice president of pharmacy at HealthPartners in Minnesota, said he is not surprised by the price increases, and that they need to be controlled. "I have been a pharmacist for 40 years and there is no rhyme or reason for these prices," he said.
"People can't stop taking their medications," Bruzek said. "But the medical industry has to stand up and say we're not going to take this any more."
The pharmaceutical industry vigorously defends drug pricing despite ever-escalating costs that rarely plateau.
"It is disingenuous to discuss costs without acknowledging the tremendous value these medicines provide to patients," said Holly Campbell, spokeswoman for PhRMA, the pharmaceutical industry trade organization.
"Improved treatment options for patients are one of the reasons that death rates for people with diabetes have fallen 40 percent since 1997," she said.