Impatient

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#PriceCheck: When diabetes test strips are too expensive

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94108 full

Through our #PriceCheck project, we're crowdsourcing the cost of common medical procedures and devices. This time around, we're asking about the cost of diabetes test strips.

Mark's story

Mark Winters, 66, answered our call. A longtime tennis player and writer, Winters has had Type 1 diabetes for more than 60 years.

He told me it would be best if he checked his blood sugar four times a day. Instead, he says, he generally tests once in the morning and once at night. He's had diabetes for so long, he says, that he's very good at maintaining his blood sugar through nutrition and exercise.

Still, he concedes, "I should test more – but I don't, because I can't afford it."

'Immoral' costs

Diabetics can't necessarily just choose the cheapest strip on the market; there are a variety of glucose meters, and each one requires its own specific test strip.

Winters buys the Accu-Chek brand of test strips for his Accu-Chek Aviva meter. He's uninsured, and has paid for them out of pocket for years. (That will finally change at the start of 2015, when he'll go on Medicare.)

But in recent years, he's struggled to afford his test strips, as the cost has jumped - from roughly 33 cents a strip at Target, to more than a dollar, he says. So he took to the Internet to find a better deal: Boxes of 50 strips for about $31.50 per box, including shipping - a little more than 60 cents per strip.

"The situation with the pricing of diabetic necessities has become more than worrisome; gouging for a profit is immoral," Winters wrote in an email to Impatient. He wonders what happens to other people who can't afford to test as often as necessary, and don't manage their condition as meticulously as he does.

A larger problem

Winters has reason to wonder.

I spoke with Kathleen Wall, who was a certified diabetes educator for nine years, and recently became the director of the Los Angeles Diabetes Alliance. She says the majority of her clients were insured. Still, she estimates that about 40 percent of the people she worked with didn't test their blood sugar as often as they should – or didn't test it at all - because they couldn't afford the test strips.

She explains that while California law requires insurance plans to cover test strips, some charge high co-pays. Co-pays can range from $5 to $75, or more, for a box of 50 or 100 strips, she says. And, she says, a doctor might recommend that someone test, say, four times a day, but insurance might not cover that many boxes of strips.

This situation has serious ramifications for people's health, Wall says. If people with Type 1 diabetes don't test their blood sugar regularly, it can result in "shooting insulin blindly," she says – and that can be dangerous.  People with Type 2 diabetes have more difficulty self-monitoring their condition when they don't test their blood sugar frequently, adds Wall.

All of this, she says, can result in other chronic health conditions – like peripheral neuropathy, for example – and that can lead to more medical care, and missed days of work.

Solutions?

Wall says she encourages her clients to call their insurance company and be their own advocate. An important question to ask, she says, is whether they're using the company's preferred - and oftentimes, cheaper - meter. If not, patients should call their medical provider, and ask to get a prescription for the preferred meter. They should also ask how many test strips their insurance company will cover within a certain period.

For the uninsured, she recommends the more inexpensive, retail-brand glucose meters, sold at stores like Walmart and Ralph's.

Has the cost of diabetes test strips affected your ability to manage your condition? Tell us about it in the comment section below, or e-mail us at Impatient@scpr.org.

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