Mitengo ya insulini: Kodi insulin imawononga ndalama zingati?

Zambiri Zamankhwala

Matenda a shuga si nkhani yaying'ono ku United States. Pali anthu pafupifupi 30.3 miliyoni omwe ali ndi matenda ashuga ku US, malinga ndi Bungwe Lofufuza Za shuga . Asanu mwa anthu 100 aliwonse — kapena pafupifupi anthu 1.5 miliyoni — ali ndi matenda a shuga a mtundu woyamba ndipo amafuna kuti insulin ipulumuke. Anthu ena omwe ali ndi matenda a shuga amtundu wa 2 amatha kuwongolera shuga wamagazi ndi zakudya ndi zochita. Komabe, ambiri amafunikira insulini, makamaka matendawa akamakula.

Ndipo, mwatsoka, mitengo ya insulin yakula modabwitsa pazaka 10 zapitazi. Pakati pa 2012 ndi 2016, mtengo udakwera kawiri, malinga ndi Chithandizo Cha Zaumoyo Institute of Health Care Institute . Mu 2012, mtengo wapakati wa insulin wodwala matenda ashuga unali $ 2,864 pachaka. Pofika 2016, idakwera mpaka $ 5,705. Masiku ano, botolo limodzi la insulini limatha kulipira $ 250, ndipo anthu ena amafunikira mbale ziwiri pamwezi.

Kuphatikiza pa izi, palinso zinthu zina za shuga, monga chowunikira shuga, timizere toyeserera, lancets, ndi malo abwino osungira ma syringe kapena zolembera. Itha kumulipira wina popanda inshuwaransi $ 1,300 pamwezi kuti asamalire vutoli. Ngakhale ndi inshuwaransi, zolipira ndi zinthu zina zitha kukuwonongerani ndalama zanu pamwezi. Mwamwayi, pali njira zosungira.

Kodi botolo la insulini ndi zingati?

Mtengo wa botolo limodzi la insulini umasiyana kutengera mtundu wa insulini yomwe mumagwiritsa ntchito komanso momwe mumalipirira. Koma, zilibe kanthu mtengo wake, pali njira zina zolipirira ndalama.

Ngati mulibe inshuwaransi, makampani opanga mankhwala omwe amapanga mankhwala a insulin amapereka mapulogalamu othandizira odwala, akufotokoza Michael Carnathan MD , dokotala wovomerezeka pabanja ku Bethlehem, Pennsylvania. Nthawi zambiri, wodwalayo amatha kupeza insulini kwaulere kapena pamtengo wotsika kwambiri.

Kwa iwo omwe alibe inshuwaransi yazaumoyo, ma insulini okalamba amunthu amawononga kulikonse kuyambira $ 25 mpaka $ 100 pa mbale; Mwachitsanzo, Walmart ili ndi insulin ya munthu yomwe imapezeka $ 25 pa vial. Ma insulini atsopano a anthu amawononga pakati pa $ 174 mpaka $ 300 pa botolo, malinga ndi a lipoti lofalitsidwa mu 2018 .

Kodi botolo la insulini limafuna ndalama zingati ndi inshuwaransi?

Ndizovuta kunena kuti botolo la insulin limawononga ndalama zingati mukamalipira kudzera muumoyo wanu. Dongosolo lililonse la inshuwaransi limakwirira zinthu za insulin mosiyanasiyana.

Carnathan akuti, ndipamene mumakhala ndi inshuwaransi yazaumoyo pomwe kupeza insulini pamtengo wabwino kumakhala kovuta. Pazochitikazi, odwala nthawi zina amakakamizidwa kusinthana ndi mtundu wina wotsika mtengo wa insulini wotchedwa NPH kapena 70/30 mwa ena ochepa. Ma insulini awa adakhalapo kwanthawi yayitali ndipo ndiokwera mtengo. Wodwala amafunikira dokotala woyang'anira wamkulu kapena endocrinologist yemwe amakhala womasuka kugwiritsa ntchito ma insulins achikulirewa ndikuwasintha bwino.

Dongosolo lililonse laumoyo limakhala ndi ma copay osiyanasiyana komanso deductibles, nawonso. Mwachitsanzo, kwa anthu omwe ali ndi mapulani odula kwambiri, mtengo wa insulini umalipira mpaka mutakumana ndi deductible. Ma copay ena amatha kukhala okwera 50% ya mtengo wamankhwala.

Nthawi zina zimakhala zovuta kwa anthu omwe ali pa Medicare kuti athe kupeza insulini. Odwala ambiri omwe akukumana ndi mtengo wokwera kwambiri wa insulini amapezeka kuti agwidwa mu dzenje la Medicare donut, akuti Gail Trauco, RN , Mtsogoleri wamkulu wa PharmaKon LLC .

Monga makasitomala osalimbikitsidwa, mapulogalamu othandizira odwala atha kukhala othandizira makasitomala a Medicare. Komabe, mapulogalamuwa amafunika kufunsira, komwe kumatha kutenga masiku 30 mpaka 60 kuti muwunikenso ndikuvomerezedwa, ndi zolembedwa ndi ma risiti kuti mutsimikizire ndalama zomwe mumawononga mwezi uliwonse.

Chifukwa cha chipwirikiti cha anthu chokhudzana ndi kukwera mtengo kwa insulini, makampani ena a inshuwaransi ndi makampani azamankhwala akuchitapo kanthu pochepetsa mtengo wapamwezi. Mwachitsanzo:

• Cigna ndi Express Scripts akulipira zolipirira mthumba pamwezi $ 25 pamwezi. ExpressScript ikuyerekeza kuti anthu pafupifupi 700,000 omwe ali ndi matenda ashuga atha kulandira ndalama izi. Komabe, olemba anzawo ntchito ayenera kulowa nawo pulogalamuyi.
• Sanofi, m'modzi mwa omwe amapereka chithandizo chachikulu cha insulin, akupanga pulogalamu ya omwe amapereka ndalama. Pulogalamuyi imawononga $ 99 pamwezi ndipo imapereka mbale 10, mabokosi 10 a zolembera, kapena kuphatikiza ziwirizi. Anthu omwe ali ndi Medicare, Medicaid, kapena madongosolo ena aboma sioyenera pulogalamuyi. Wina aliyense, mosasamala kanthu kuti ali ndi inshuwaransi yazaumoyo, atha kutenga nawo mbali ngati atalipira ndalama za insulin. $ 99 sizingakwaniritse zonse zomwe zawonongeka, ndipo zoperekazo zingawonjeze zina.
• A Eli Lilly posachedwa adatulutsa mtundu wa Humalog womwe umagulitsa theka la mtengo, pa $ 137.35 pa vial.

Mukufuna mtengo wabwino kwambiri pa insulini?

Lowani zidziwitso zamitengo ya insulini ndikupeza kuti mitengo isintha liti!

Pezani zidziwitso zamitengo

Kodi mbale za insulin ndizotsika mtengo kuposa zolembera?

Pali kusiyana kwakukulu pamitengo ya insulin pakati pa mbale za insulin (kudzera m'masingano) ndi zolembera za insulin. Kugwiritsa ntchito mbale ndizotsika mtengo kuposa zolembera. Komabe, anthu ena amaganiza kuti kugwiritsa ntchito zolembera ngati njira yoberekera kumapereka moyo wabwino kwambiri. Zolembera zimabwera kale, ndipo mukamagwiritsa ntchito mankhwala a analog, kuchuluka kwake kumatha kutsika. Zolembera zimakupangitsani kukhala kosavuta kutenga insulini nanu, ndikupatseni ufulu wochulukirapo.

Kugwiritsa ntchito zolembera ndi kotetezeka, kosavuta, ndipo kumawongolera kuyendetsa bwino kwa glycemic, malinga ndi a kafukufuku wofalitsidwa mu 2018 . Komabe, kafukufukuyu adanenanso kuti anthu omwe amagwiritsa ntchito zolembera anali kuwononga ndalama zambiri mwezi uliwonse pothana ndi matenda ashuga. Nthawi zina kugwiritsa ntchito zolembera kunali kodula katatu.

Kodi mwezi wa insulini umawononga ndalama zingati?

Aliyense ali ndi zosowa zosiyanasiyana za insulin. Palibe kukula kwake komwe kumagwirizana ndi njira zonse zodziwira kuchuluka kwa insulini yomwe mukufuna. Omwe amatenga insulin ya analog amatenga maziko kapena mlingo woyambira kamodzi kapena kawiri patsiku. Mosiyana ndi izi, omwe amatenga insulin wamunthu nthawi zonse amatenga katatu kapena kanayi patsiku.

Cadence iyi ndi insulin yokhayo yomwe anthu ena omwe ali ndi matenda a shuga a mtundu wa 2 amafunikira. Koma chifukwa cha matenda a shuga amtundu woyamba, ndipo ena omwe ali ndi mtundu wachiwiri, pamafunika insulini yowonjezera nthawi yakudya. Kutengera ndi insulin yomwe mukugwiritsa ntchito, imayenera kumwa 10 mpaka 30 mphindi musanadye. Kuchuluka kwa insulin kumadalira zomwe mukufuna kudya. Mwachitsanzo, mungafunike mayunitsi 1-3 pagawo lazakabohydrate (15 magalamu).

Anthu omwe ali ndi matenda a shuga amtundu wa 1 amagwiritsa ntchito mitundu iwiri ya insulin patsiku. Amayamba ndi jakisoni awiri patsiku ndikupita patsogolo mpaka katatu kapena anayi patsiku, malinga ndi Bungwe la American Diabetes Association (ADA). Anthu omwe ali ndi matenda a shuga amtundu wa 2 amatha kuyamba ndi magawo 0,5-0.8 a kilogalamu ya kulemera kwa thupi patsiku ndipo pamapeto pake amatenga mayunitsi 1-2 pa kilogalamu yolemera. Kwa munthu wolemera mapaundi 150, izi zitha kukhala mayunitsi 68 mpaka 136 patsiku. Kwa munthu wolemera mapaundi 175, izi zitha kukhala mayunitsi 80-160 patsiku.

Mbale imodzi ya insulin imakhala ndi mayunitsi 1000, ndipo zolembera zimakhala ndi mayunitsi 300.

Tebulo lotsatirali likufanizira mitengo yamankhwala amitundu yosiyanasiyana ya insulini pamasiku 30 popereka mbale zitatu kapena zolembera 10 pamwezi. Gome limaphatikizaponso mitengo ya insulin; komabe, mutha kulipira ndalama zosiyana kutengera dera lanu komanso mankhwala anu. Sinthani mtengo wokwera kapena wotsika, kutengera zomwe mukufuna.

Mitengo ya Insulin Kodi mwezi wa insulini umawononga ndalama zingati?
Dzina la Mankhwala	Mtengo Wapakati Phukusi	Mtengo Wapakati pamwezi *
Novolog (gawo la insulini) Cholembera cha Novolog Flex	$ 333.99 / botolo $ 123.99 / cholembera	$ 1,001.97 $ 1,239.90
Chizindikiro (lispro)	$ 316.22 / botolo	$ 948.66
Lantus (insulini glargine) Lantus Solostar (cholembera)	$ 314.99 / botolo $ 101.73 / cholembera	$ 944.97 $ 1,017.30
Humulin N (insulini isophane)	$ 122.67 / cholembera	$ 1,226.70
Novolin N (insulini isophane)	$ 166.99 / botolo	$ 500.97
Levemir (kusokoneza) Levemir Flextouch (cholembera)	$ 446.99 / botolo $ 112.98 / cholembera	$ 1340.97 $ 1129.80
Novolin R (insulini pafupipafupi)	$ 161.00 / botolo	$ 483.00
Toujeo Solostar (insulini glargine)	$ 115.18 / cholembera	$ 1151.80
Tresiba (insulini degludec) Tresiba Flextouch (cholembera)	$ 351.38 / botolo $ 123.18 / cholembera	$ 1054.14 $ 1231.80

* Kutengera mbale zitatu kapena zolembera 10

Kuphatikiza pa mtengo wapamwambawu, mungafunenso zinthu zina, monga:

• Masirinji: $ 15- $ 20 pa bokosi la 100
• Zolemba zoyesa: $ 25- $ 60 pamayeso 50 oyeserera (angafunike kulikonse kuyambira 1 mpaka 10 patsiku)
• Mapampu: Zitha kutenga $ 6,000 kugula pampu kuphatikiza $ 3,00 pazinthu monga mabatire

Nchiyani chikuwonjezera kuwonjezeka kwaposachedwa kwamitengo ya insulin?

Palibe kukayika kuti mitengo ya insulini yafika poti anthu ena sangakwanitse kugula mankhwala awo. Mu chiwonetsero cha ADA , Irl B. Hirsch, MD, akufotokoza kuti kuyambira 2013 mpaka 2016, botolo la glargine insulin lidakwera ndi 593%, ndipo bokosi la zolembera zisanu za insulin lispro lidakwera 522%. Munthawi imeneyo, inflation idakwera ndi 8.3% yokha. Mu 2014, opanga mankhwalawa adakulitsa mtengo wa insulini kawiri, nthawi iliyonse pafupifupi 16%. Izi zikutanthauza kuti mitengo ya insulin idakwera ndi 30% mchaka chimodzi.

Palibe chifukwa chimodzi chokha chokwera mtengo kwa insulini. Makampani azamankhwala amadandaula kuti oyang'anira omwe amapindula ndi ma pharmacy (PBM) omwe amapereka chithandizo chamankhwala kumakampani ogulitsa inshuwaransi amawononga mtengo wake pofunafuna kuti omwe abweza ngongole azikhala ndi insulini mu fomu ya inshuwaransi. Amati mtengo wawo wotsika ndi wotsika kuposa mtengo wamndandanda. Koma ma PBM akuti ndi makampani opanga mankhwala omwe amaika mtengo pamndandanda.

Zinthu zingapo zimapangitsa mitengo ya insulini kukwera:

• Pali mitundu itatu yokha yopanga insulin padziko lonse lapansi. Ndi mpikisano pang'ono, amatha kukhazikitsa mitengo iliyonse yomwe angafune.
• Ndizovuta komanso zotsika mtengo kupanga mtundu wa generic. M'makampani opanga mankhwala osokoneza bongo, opanga mankhwala amatha kupereka kafukufuku ku FDA kuti amupatse mankhwala ena ngati angatsimikizire kuti mankhwalawa ndi ofanana. Koma a FDA samakulolani kuti mugwiritse ntchito kafukufuku womwewo pazinthu zamagulu a insulin. Izi zikutanthauza kuti kubweretsa insulini pamsika kumakhala chinthu chodula, kusiya mankhwala omwe ali ndi dzina lokha.
• Monga momwe zimakhalira ndi makampani azachipatala, mpikisano umasowa mu PBM, zopatsa makampani, monga CVS Caremark ndi Express Script, kuthekera kodzipangira malamulo. Hirsch akuwonetsa kuti mu 2013, CVS Caremark inali ndi ndalama zokwana $ 123 biliyoni, ndipo Express Script inali $ 94 biliyoni.

Mpikisano wapamwamba ungatsitse mitengo, ndikuwonjezera kuthekera kwa insulin.

Kukwera mtengo kwa insulini kuli ndi zotsatira zenizeni padziko lapansi. Gulu ku Minneapolis akuti kukwera basi yopita ku Canada kukagula insulini pamtengo wochepa kuposa momwe imagulitsira ku United States.

Anthu ena amagawananso insulini yawo pogawa kapena kudumpha mlingo. Onsewa ali ndi zovuta zoyipa. Atakalamba kuchokera ku inshuwaransi ya amayi ake, bambo wazaka 26 adadziwitsidwa ndi wamankhwala wake kuti insulini ndi katundu wake azikhala $ 1,300 pamwezi. Zinali zoposa zomwe amatha pamalipiro a woyang'anira malo ake odyera. Pasanathe mwezi umodzi atataya inshuwaransi, adamwalira. Banja lake limakhulupirira kuti adayamba kugawa insulin, ndipo ndizomwe zidamupha.

Maboma angapo aboma akuyesanso kutsitsa mitengo ya insulin. Colorado idalemba insulini copay pa $ 100 pamwezi kwa anthu omwe ali ndi inshuwaransi. Nevada adakhazikitsa lamulo lowonjezera kuwonekera pamitengo ya mankhwala osokoneza bongo, osayang'ana kuthana ndi kukwera mtengo kwa insulini kokha komanso kukwera mtengo kwa mankhwala onse akuchipatala. Maiko ena makumi awiri mphambu atatu apereka lingaliro lamalamulo olimbana ndi kukwera mtengo kwa mankhwala osokoneza bongo.

Zimawononga ndalama zingati kupanga insulin?

KU Phunziro la 2018 akuganiza kuti botolo limodzi la insulin yaumunthu limawononga $ 2.28- $ 3.42 kuti apange, ndipo botolo limodzi la insulin ya analog imawononga $ 3.69- $ 6.16 kutulutsa. Kafukufukuyu adawonetsa kuti kupezeka kwa insulin yamunthu pachaka kumatha kutenga $ 48- $ 71 pa wodwala, ndipo insulin ya analog imatha kutenga $ 78- $ 133 pa wodwala pachaka.

Kafukufukuyu adayesa mtengo wopangira kokha. Sizinaphatikizepo ndalama zoyendetsera, kugulitsa, ndi kufufuza ndi chitukuko chakuwongolera mankhwala. Komabe, opanga insulin sanapereke tanthauzo lokwanira la kusiyana kwakukulu pakati pamitengo yopanga ndi kugulitsa.

Momwe mungasungire pamitengo ya insulini

Lumikizanani ndi kampani yanu ya inshuwaransi (kwa iwo omwe ali ndi inshuwaransi) ndikupeza momwe malingaliro anu amalipirira insulini. Kodi amalipira kwambiri mitundu ina ya insulini? Kodi amapatula mitundu ina? Ngati malipiro awo kapena kuchotsedwa sikugwirizana ndi zomwe mukutenga, lankhulani ndi omwe amakuthandizani pazachipatala. Makampani ena a inshuwaransi amavomereza chomwe chimatchedwa chilolezo choyambirira, zomwe zikutanthauza kuti dokotala amakulemberani kalata pofotokozera chifukwa chomwe mukufunira mtundu wina wa insulini. Pezani zomwe deductible yanu ndi momwe mudzafunikire kulipira mthumba. Funsani ngati ali ndi mapulogalamu apadera a insulini, monga omwe amaperekedwa ndi Cigna.

Ngati mulipira ndalama, Gwiritsani ntchito mapulogalamu omwe amaperekedwa ndi makampani azachipatala , monga yomwe Sanofi adapereka. Onjezerani ndalama zowonjezera kuti muwone zomwe muyenera kulipira mwezi uliwonse.

Yang'anani m'mapulogalamu othandizira odwala omwe amaperekedwa ndi makampani akuluakulu azachipatala, monga Eli Lilly ndi Novo Nordisk, ndi mapulogalamu ena osapindulitsa, monga Rx Hope, omwe amapereka mankhwala aulere kapena otsika mtengo kwa omwe amapeza ndalama zochepa komanso osalimbikitsidwa.

Gwiritsani ntchito mwayi wa Khadi losungitsa mankhwala kuchokera ku Singlecare . Ma pharmacies opitilira 35,000 amalandira makuponi a SingleCare. Mutha kuyika zip code yanu pa intaneti kapena pa pulogalamu yathu yam'manja kuti mupeze mankhwala omwe ali ndi mtengo wotsika kwambiri wa insulini yanu. Kenako, tengani mankhwala anu ndi khadi lanu la SingleCare kuti mulandire kuchotsera. Kulowa mu SingleCare ndi kwaulere.