“Joshua Andrew Wilkerson, 27, of Berryville, Virginia, died Saturday, June 15, 2019 in Inova Loudoun Hospital, Leesburg, Virginia of complications due to Type 1 Diabetes.”
This is part of the obituary for a young man who lost his life to being priced out of the life-saving prescription he needed.
On his 26th birthday, Wilkerson received an unwanted present: notice that he had aged out of his stepfather’s health insurance plan. As a person with Type 1 diabetes, it was crucial to continue receiving the right prescription.
But when his analogue insulin prescription cost him almost $1,200 every month, his work as a supervisor in a dog kennel forced him to switch to an over-the-counter human insulin – just months after losing his insurance coverage. (1)
“We figured: Hey, it’s $25. We can do that. And we’ll just work with it and try to do the best we can,” said Rose Walters, who was Wilkerson’s fiancee and also a Type 1 diabetic. “But, the fact that it takes so long to kick in? It scared me a little bit.” (1)
Over the next few months, Wilkerson began to experience side effects. He struggled with stomach problems and dramatic mood swings, both telltale signs that his blood sugar levels were not under control.
“Something in him, you could just tell, was different,” she said. “I would tell him, ‘Check your blood sugar,’ and he would check it, and it would be high,” said Walters. (1)
Then, while working an extended shift, Wilkerson fell into a diabetic coma, with blood sugar levels 17 times higher than normal ranges.
Concerned about not hearing from him when she expected, his fiancee rushed to the dog kennel, where she also worked, and found him unconscious on the floor.
“I just remember smacking him on the face, saying, ‘Babe, wake up. You have to wake up,’ ” Walters recalled. (1)
Doctors determined that Wilkerson had suffered a series of strokes and was in a vegetative state. After five days supported by a hospital ventilator, Wilkerson died.
“It’s very hard. How many more young Type 1 diabetes patients have to die before something finally changes?” said Walters. (1)
Wilkerson’s mother, Erin Weaver has become an advocate for people with Type 1 diabetes.
“It’s pretty much a death sentence,” she said. “They have no health insurance or good jobs to afford what they need, so they’re left with the pittance that is left.” (1)
Analogue vs. Human Insulin
Analogue insulin is a type of human insulin. Both are produced in a lab using human insulin, but analogue insulin undergoes recombinant DNA technology to work faster or more uniformly. By modifying the order of amino acids, analogue insulin becomes a more effective option for many people with Type 1 diabetes. (2)
Rapid acting insulins act as soon as they’re injected. They peak within the first hour of injection and last up to 4 hours. Examples of rapid acting insulins include Humalog and NovoRapid. (2)
Long acting insulins take around 2 hours to act after they’re injected. They don’t spike or peak, and will last up to 24 hours. Examples of long acting insulins include Lantus, Levemir, and Tresiba. (2)
Pre-mixed analogue insulins are a combination of rapid acting and long acting insulins for fast and longer action. Examples of pre-mixed analogue insulins include Humalog Mix 25, Humalog Mix 50, and NovoMix 30. (2)
The Right Prescription… The Wrong Price
The trouble is, analogue insulin prices have almost tripled in just 7 years. (1).
The American Diabetes Association released a white paper in 2018, recommending that human insulin be used as a temporary alternative for some diabetics who can’t afford their usual prescription. (3)
At the very least, it can be a better option than attempting to ration insulin injections, which is extremely dangerous.
Allison Bailey, U.S. advocacy manager for T1International, a nonprofit organization for people with Type 1 diabetes, explained to the Washington Post, “For the estimated 1.25 million people with Type 1 diabetes in the United States, using human insulin is riskier. Their bodies typically are unable to produce any natural insulin, leaving them more vulnerable to fluctuations in blood sugar levels without careful monitoring.” (3)
“There is a lot of room for error,” she said. “You need to have one-on-one communication with a health provider who is going to be able to guide you through some of this, which isn’t always available to someone who is on a lower income.” (3)
Recently, the federal government announced that steps would be taken to begin to allow states to import more affordable medication, including insulin, from across the Canadian border. (Unfortunately, this is what many families are already resorting to of their own accord).
The human cost of insulin in the USA has been a growing concern for some years now. And while there are some steps being taken towards more affordable healthcare, uninsured and underinsured patients living with diabetes now are still in danger with each passing day.
Disclaimer: This information is not intended to be a substitute for professional medical advice, diagnosis or treatment and is for information only. Always seek the advice of your physician or another qualified health provider with any questions about your medical condition and/or current medication. Do not disregard professional medical advice or delay seeking advice or treatment because of something you have read here.
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