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Young adults with type 1 diabetes can not afford insulin when they reach 26 years without insurance




BuzzFeed News; Getty Images

On the day that Jiany Lavorty turned 26, he worked at Columbus, Ohio, and Freeland as a corporate event specialist, hoping to get to the door of the event planning industry. This birthday has made the search for a full-time job in something urgent.

Laverty has type 1

diabetes and from that day in 2017 he can no longer be covered by his parents' health insurance. He needed medication to live that he could not afford.

"It's a human necessity for me," said Lavrati, 28, now in the BuzzFeed News. "This is my life or death every time I do or do not take insulin." The price of insulin, the drug that keeps them alive, has tripled in the US from 2002 to 2013 – and one recent study found that from 2012 to 2016 its average annual price rose from $ 3200 to $ 5,900

This is an impossible price tag for a generation that still feels the effects of the financial crisis of 2008 and is burdened by the huge debt of student credit and rising housing costs. Studies show that US thousands are far less financial than previous generations, with an average net worth of less than $ 8,000. – incredibly risky and desperate measures that could cause long-term harm or death. About 1.25 million Americans have type 1 diabetes, a disorder where the immune system attacks the pancreas and prevents the body from absorbing energy from the food. People with type 1 diabetes are dependent on multiple types of insulin to survive because the disease disables the ability of the pancreas to produce a chemical that regulates the amount of sugar in the blood. Without insulin, cells can not absorb sugar and the body is forced to quickly break down fat cells to use them as a backup fuel source. This dehydrates the body, converts the blood acid into blood and leads to a life-threatening complication called diabetic ketoacidosis (DKA).

Most people with type 1 diabetes take at least two types of insulin: a long-acting type that is taken daily. constantly releases insulin and short-acting or fast-acting type taken before or after meals. The amount of insulin in need of type 1 diabetes varies dramatically depending on age, weight, food, exercise, illness, stress, and for women if they are menstrual or ovulatory. In fact, many endocrinologists will overestimate insulin so that patients have enough for emergency situations.

All this medicine is expensive. Lavrati said that in 2017 insulin costs about $ 950 a month without his parents' insurance coverage. So he started giving rations. He only gave himself what he could afford to buy, the minimum he needed to function.

"I took half the medication I had to take," he said. he should not use a dose of his fast-acting insulin and he has reduced the amount of insulin in every injection he gave himself. The effects were immediate. Its energy levels dropped, leaving it irritable and tired and in a constant state of discomfort. He could not sleep, he was always thirsty, and he had to urinate.

"This definitely affected my ability to function," he said. He lives for four months until he finds a full-time job in a company that offers full medical benefits.

This type of distribution may have serious long-term effects for people with type 1 diabetes, Simeon Taylor, University of Researcher and diabetes lecturer at the University of Maryland Medical School, told BuzzFeed News. "You may be able to avoid a quick death," he said. "But you open for long-term complications like blindness, kidney failure, amputations. If you do not treat yourself optimally, you are also at greater risk of short-term crises. "

For Alec, the son of Nicole Smith Holt, the situation was deadly. Alec died from DKA in 2017, one month after he was 26, and was expelled from his mother's insurance. He could not afford insulin and gave a ratio to the little he left.

In August, Smith-Holt testified before the US Senate about his son's history and what she calls the "price crisis of pharmaceutical drugs."

Nicole Smith-Holt holds a picture of his son Alec The news that she has heard from "too many" people with stories like Alec. A December study published in the Journal of the American Medical Association revealed that 1 out of 4 people with diabetes have reduced insulin due to their high costs

"I've always been connected with people every day," said Smith Holt. "From the two parents of young adults or the young people themselves. They are afraid of what will happen. They are afraid to be 26 years old. "

The aging of parental health insurance has always been a problem for young Americans with chronic health problems. But since the Accessibility Care Act for 2010 allowed young people to remain in parental insurance until the age of 26, there was a universal deadline.

Louis Phillips, director of the Diabetes Center at Chicago University, told BuzzFeed News that many young adult patients with type 1 diabetes live in fear of this deadline.

"Now they are insured by their parents, but some are in the gambling economy, moving from one job to another when they start their lives, they may not have insurance coverage covering their insulin, or their work may have zero insurance, or it is a job that is under-insured with a high deductible amount, "he said.

The rising cost of deduction – The annual amount the patient has to pay out of his pocket before their insurance plan starts paying – is a problem for all Americans. A comprehensive national analysis, published in May, showed that the deductibles in workplace-sponsored insurance plans increased fourfold in the past 12 years and averaged over $ 1,300. High deduction plans are also commonplace for those who choose to be insured through state exchanges created under the ACS and these franchises can be even higher than those with job-sponsored plans. In 2018, the average deduction for the most popular stock exchange plan was nearly $ 4,000.

As your parents' insurance is considered a "qualified event for life", young adults receive a 60-day special enrollment period after their stay. birthday to sign up for new insurance. But some young people with type 1 diabetes can hardly afford medication, even with government-provided insurance.

"I looked at it," said Laverts on state insurance. "But it would have been so expensive that it was not worth it. "He said the plans he was able to find on the stock exchange were so big he thought he would probably find full time. work with benefits before meeting your deduction. Meanwhile, he will pay a price list for insulin during this period between or without state insurance.

"The first month [of medication] could be $ 1,000 or even more," said Philippe. "He breaks budgets, forces people into unacceptable situations: you have to choose between rent and insulin."

"Going to 26 – is afraid that you will spend $ 500 a month, from $ 5,000 to $ 6,000 a year alive," Philippe said. "This is not an option Type 1 diabetes is a fatal illness if you do not have insulin. 19659004] Margotta, a 25-year-old living in Brooklyn, has no insurance there, "said Marotta for BuzzFeed News

Marotta plans to find a job with good health insurance or buy insurance from the government, she "prepares to be insured for a certain period of time as both of these things take time." So with by using its endocrinologist, she has begun storing insulin samples from the endocrinology offices' supplies for urgent cases and training newly diagnosed patients on how to dispense. "Marotta said her endocrinologist also prescribes her extra insulin [19659004] "She's like," Let's load you as well as you can for now, so you can wait a little better, "Marato said. 19659019] Courtesy Marotta

Marotta also tries to get his current insurance provider to approve it as a continuous glucose monitor, a device implanted under the skin that constantly reads the blood glucose levels of a person. I had one in college and it really is great, "she said. "I do not like to have anything attached to me all the time, but I want to go back to one so I can be really perfect, knowing as much as I can about my tendencies to be more prepared for that period.

Although there is currently insurance, Marotta is still giving regular insulin. She regularly buys only one of the two types she needs because she can not afford to pay for her multiple medication, medical appointments, and a battery of tests that accompany each visit to her endocrinologist. Until my brief actions before I take long action, because at least you can do urgent coverage, "she said. – If you only have one, it makes sense to do the short one. This is simply not perfect because you do not have this baseline [of insulin] so the slightest thing can affect you and your blood sugar rises.

This is risky, but Marotta says she spends almost half of her income on student loans. and rent. She has no choice.

"For me, rationalization is literally just because I do not have 20 dollars to take it today," she said.

The price list for the monthly delivery of long insulin, according to a receipt provided to BuzzFeed News, is $ 740.99. Its current payout is $ 10.

People with type 1 diabetes also have to pay for many expensive supplies to help control their illness. Patients who can not afford reduce the corners by regularly not testing their blood sugar levels instead of relying on their body response to determine how much insulin they need. They also reuse disposable medical supplies, such as lancets, that prick their fingers to test blood sugar and needles to inject insulin despite the risk of infection. and many people do it, "Marato said.

Lavirtti said that although he is no longer forced to divide insulin, he regularly supplies food to reduce costs. He says he often uses lancet "for weeks or months" until he becomes so dull that he does not break the skin anymore. "It gets worse and leaves a bigger hole, but it saves me a lot of money.


Courtesy Laverty

Laurti syringe with needle broken by excessive use.

He added that he should use a new needle tip for his insulin pen every time, but it is limited to one per day because it is "expensive". calculates that it is dosed between five and eight times a day, with each dose becoming more painful. Before going to pens, he would again use syringes and needles to inject insulin. He shared a photo with BuzzFeed News about a used needle that bent and broke inside his body during a regular injection. Sometimes, due to circumstances beyond their control, people with type 1 diabetes are forced to turn to risky options. In 2017, Julia Wirzouk, 24, from Linden, New Jersey, was allowed to climb after a clerical mistake left her family uninsured for five months. She had a small surplus of stored insulin and could also get samples from a friend of the family who worked in an office for endocrinology. However, as it became clear that solving the insurance problem would take months, not weeks, she had to find a more durable solution. In July 2017, she turned to the black market.

She bought 10 insulin vials for $ 1,000 from a person who had really good insurance, she said. It was not a "terrible" price and it was cheaper than what Wyrzuc would have paid without a prescription. She uses insulin from this stock when she enters a "heavy DKA" a few months later.

"I've never felt so terrible in my life," says Wirzouk. "I'm thrown for 12 hours, I can not even drink water."

Wyrzuc was hospitalized, spending five days in the intensive ward. Her doctors assumed that she had taken a "bad batch" of insulin, which eventually overheated. Fortunately, her parents have solved the insurance problem "literally two weeks" before it happened, and Wyrzuc managed to resume her.

Even when young diabetic patients provide their own health insurance, they may face problems.

Hannah Samner, 26, from Sopperton, Georgia, has voluntarily excluded her parents' insurance before she is required, which she describes as "the biggest mistake in her life."

"I have a job that offers insurance and I wanted to do it myself," she told BuzzFeed News. "I have a 6-year-old daughter. I was trying to be older. "

Her plan through the bank she's working on has a great deal of coverage for everything except for diabetes. Her insurance company also recently stopped covering her insulin brand, forcing her to move on to a brand she thinks is equivalent. The new insulin causes her to get sick, but she can not afford to go back to her old one and have to cope with the symptoms. Samner said that her pharmacist allows her to put most of the deduction she said. is about $ 225- $ 250, on a billing account early in the year to be able to afford insulin. She pays her bill monthly, but there are times when her finances are so stretched that she can not even afford to pay.

"There are times in the month I can not have 50 dollars," she said. In those months, her pharmacist, an "incredible" family friend who knows her even from her baby, lets her add to her bill.

Even with this "incredibly lucky" deal with her pharmacist, that she has used her money for financial reasons in the past and is currently being distributed, so she can go to work without feeling sick with her new insulin. "I will not be able to work one day because of this disease and I want to work now," she said.

Samner's disease weighs heavily on her, especially as a mother.

"Of course, you have that fear not to get sick and die," she said. "I learned my daughter how to deal with how to call 911."

Many of those who spoke with BuzzFeed News said that because of the insulin price they were forced to pursue a career they offer security at work. and extensive health benefits, such as nurses. A teenager, Brooke Rapper of Houston, told BuzzFeed News that his type 1 diabetes is a factor he is forced to take into account when deciding what he wants to do with his life. She feels very pressurized to be financially successful. "Ideally, I would like to pursue a creative career, but this may not be a stable insurance – I have to have a steady income," she said. "Every time the price [of insulin] will affect me, I know it will be a heavy burden."

Lavirtti said that learning that he had Type 1 diabetes at age 21 forced him to change his whole life. He went to school for theater lighting and dreamed of a day work on a Broadway tour. But he changed his plan and is now working in corporate events for permanent insurance coverage.

"I understand I have to have health insurance to stay alive, that I have to change my career to have health insurance. He will not have it always, "he said.

Without insurance, Laverty would have paid nearly $ 8,900 for his insulin in 2018, according to the revenue he provided to BuzzFeed News." Including the deduction of 1 $ 200,000, pocket insulin price is $ 1,654.96

People with type 1 diabetes BuzzFeed News said it does not matter how much they are trying to be smart about managing their illness Planning can ease the rising feeling of insecurity comes with the aging of their parents' insurance. "" It's obvious he's sucks, "he said. Marotta. "Being a postgraduate student, understanding your career – all this is madness, then adding the layer of worry about medical things and having a life or death situation, literally a life or death situation, it's not that difficult You see that other countries do it and it's not that difficult, and there's no reason this is the way it is. "


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