Scary New Obstacles to Getting the Diabetes Stuff You Need

Everywhere we turn these days, we’re seeing restricted access to the vital diabetes medications and supplies we depend on to keep us healthy.
From rationing test strips to restricting our choices of insulin to being told insurance will no longer cover the cost of a particular item we’ve been using for years, the roadblocks seem to be coming faster and harder than ever before.
It has me more than a little worried… I’m steaming mad, depressed, and just overall afraid of what the new “bottom line” will mean for those of us just trying to manage our diabetes the best we can.
The Oregon Fiasco
In Oregon, state health officials decided on Dec. 5 to dramatically reduce the number of test strips allotted to people with type 2 diabetes who are on Medicaid and don’t take insulin. They can now get only one vial of 50 test strips at the time of their diagnosis, and basically no strips beyond that — unless they can prove they’re at serious risk of hypoglycemia. Even then, the allotment is only “up to 50 test strips every 90 days.” WTF?!
The commission had actually been considering an even more drastic reduction in strips: type 2 PWDs with an A1c above 8.0% would have been entitled to only one test strip per week, while those an A1c below 8.0% wouldn’t get any strips at all!
As reported by our friends at diaTribe, who were able to attend the Oregon Health Evidence Review Commission (HERC) meeting and observe the vote:
While it’s encouraging that the commission responded to the public outcry against limiting test strips, we were shocked by the attitude of several commission members. We heard some say, “More knowledge for patients is not always better…”, “Lay people just don’t understand these issues…”, and “We make guidance based on evidence, not emotions…” Even though the revised proposal avoided the worst-case scenario, these quotes underscore a profound misunderstanding of the daily realities of diabetes management.
You’re darn right they do!
This is downright disturbing. And not just for those who are specifically affected by this change in Oregon. It’s only a matter of time (if it hasn’t already started) before other states look to what Oregon has done consider making similar cutbacks. And of course, what happens with Medicaid and Medicare is often seen as an instruction guide for the private insurance market, which we all know is heavily concerned with their short-term bottom line more than long-term health outcomes.
And what’s going on here isn’t limited to state health commissions. Not by a long shot.
Throughout the country, these same kind of restrictions are being felt by the D-Community from various insurance providers.
We’ve heard horror stories about PWDs being told they can no longer get their regular supplies and meds, both in federal programs and in the private insurance market. The Medicare reimbursement cuts have been forcing many to find new diabetes supply distributors and make changes in their management routines. We’ve even heard rumors that VA hospitals are telling veterans they can’t have any short-acting insulin but can only get long-acting insulin (we couldn’t substantiate this).
Express Scripts Tricks
And then there’s news that ricocheted through the Diabetes Online Community (DOC) a couple of months ago, that mail order meds distributor Express Scripts is making drastic changes for 2014 in terms of which diabetes meds and supplies are accessible to its members. Joining what CVS Pharmacy had already done in 2012, Express Scripts published a list of 48 medications and supply brands that will be “excluded” starting on Jan. 1.
On that list: key test strip brands like Abbott and Accu-chek, and insulins like Apidra and Novolog. We know a number of PWDs (people with diabetes) who’ve received letters from Express Scripts informing them of the change in coverage from Novolog to Humalog.
 Read more here:

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