- Associated Press - Sunday, July 26, 2015

JACKSON, Miss. (AP) - For the past 18 years, Barney Shepherd, an 87-year-old World War II veteran from Philadelphia, has purchased a box of 22 glucose test strips to check his Type 2 diabetes for $25.

When he wanted to increase the count to 50, the cost was $90.

“That’s too high. And I don’t understand how they can do that,” Shepherd said. “A box of 50 should have been less than $50. I’m disabled. I can’t go to Meridian. I can’t go to Carthage. I can’t go anywhere else.”

But where in Mississippi he buys those strips doesn’t really matter.

In the state with the second highest incidence of diabetes in the country, the cost of diabetes-related medication is the same from the Tennessee line to the Gulf Coast. And it’s true across the country.

A box of 50 Accu Check Aviva Glucose Test Strips is $90 at the Wal-Mart Shepherd goes to in Philadelphia. It is $97 at Fred’s Pharmacy in Carthage; $90 at Wal-Mart in Meridian; $95 at Wal-Mart in Jackson; $88 at Walgreen’s in Jackson; $97 at Fred’s in Greenville and $100 at Walgreens in Cleveland.

In Colorado, the state with the lowest diabetes rate, those same strips were: $99 at Walgreens in Denver and $89 at Cornell Pharmacy, also in Denver. In West Virginia, the state with the highest diabetes rate in the nation, the prices were $93 at Rite Aid and $88 at CVS.

“I have enough to survive on,” Shepherd said. “But with Social Security, I’m maxed out. I don’t have any income.”

Many individuals on a fixed income, like Shepherd, have no choice but to pay what the retailer wants.

“We have people that make too much for Medicaid and others who can’t afford the Affordable Care Act,” said Irena McClain, associate director of the Diabetes Foundation of Mississippi. “Between the rapid increase in some of the insulin analogs . and some of the newer oral medicines . people are really struggling to make ends meet and take good care of themselves.”

In its 2012 statistics, the Centers for Disease Control and Prevention said Mississippi had the second highest rate of diabetes in the nation with 11.7 percent. The Diabetes Foundation said that’s about 280,000 people who know they have the disease and 93,000 others who don’t.

And yet, with a staggering number of residents on meds for some form of diabetic or renal disorder, the costs of diabetic supplies seem higher in Mississippi than in many other states.

McClain said in the last 30 years, genetic engineering has taken over and insulin is no longer taken from cows and pigs but is genetically engineered “human” insulin.

“These engineered insulins are the ones that we’ve seen a dramatic increase in the cost,” she said. “And I can’t figure that out. They work really well. And we’re creating these in yeast and bacteria. So it’s not like it takes some special animal to create these insulin analogs. But why the cost has increased so rapidly, I’m at an absolute loss to say.”

When these rapid-acting insulin analogs were first introduced in the late 1990s, the cost was $45 a vial, McClain said, and that was considered extreme. Today, those same analogs are nearly $300 a vial.

“Medicaid will cover those analogs,” she said. “And so will Medicare, provided you’re not already in the ‘doughnut hole’ or beyond your coverage limit.”

Individual pharmaceutical companies set the cost of prescription meds. The Food and Drug Administration and the Federal Trade Commission regulate those costs.

For decades, the cost of prescription drugs has long been the fuel in many ethical, moral and political conflicts.

While the pharmaceutical companies argue their prices help fund research and product development, naysayers insist the majority of their capital is being spent on self-promotion (marketing) and administrative costs, according to the Professional Staff Congress, the union that represents more than 25,000 faculty and staff at the City University of New York.

However, the Bureau of Competition, a division of the FTC that protects consumer interests, said it has examined the issue several times and found the reason for the increase or decrease of a drug is often the result of “normal market forces.”

“One common cause of a sudden spike in the price of a drug is the development of a supply problem, such as an ingredient shortage,” Alan Friedman of the FTC said in a blog. “It’s a normal market event for prices to rise after a fall in supply.”

Friedman said when there is no supply shortage, costs may be affected by a new company acquiring the drug manufacturer and independently increasing the price, the pharmacy benefit manager changing coverage, or the price simply varying from retailer to retailer.


Information from: The Clarion-Ledger, https://www.clarionledger.com

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