Price hike takes patients to Craigslist for insulin

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By Serena Gordon
HealthDay Reporter

TUESDAY, February 18, 2020 (HealthDay News) – You may have gone to Craigslist to find a used car or a second-hand sofa, but imagine having to go online to pay for life-saving medicines.

It is already happening: a new study found that hundreds of ads were placed on Craigslist for insulin and asthma inhalers over a period of 12 days in June 2019.

"This study sheds a light on how deeply some patients are struggling to pay for life-saving medications. Patients should not have to go to Craigslist to try to find affordable insulin and inhalers," said lead study author Dr. Jennifer. Goldstein, research scientist at The Value Institute at ChristianaCare, in Newark, Del.

People with type 1 diabetes cannot survive without a constant supply of insulin, which must be injected. People with type 2 diabetes who need insulin face an increased risk of serious complications of diabetes if they cannot get the insulin they need. But it is increasingly difficult to pay. The American Diabetes Association says that the average cost of insulin in the United States almost tripled between 2002 and 2013.

The cost of asthma medications has also increased significantly over a similar period of time, according to published reports. People with asthma need "rescue" inhalers such as albuterol when they have symptoms such as wheezing and shortness of breath.

The idea for the study initially came from a news article that Goldstein saw that detailed how someone bought drugs on Craigslist. When he did a quick search on the Internet, he was surprised to see enough drug listings.

"It is illegal to sell prescription drugs without a license and buy non-prescription drugs," Goldstein explained.

For the study, researchers analyzed Craigslist ads across the country over a period of 12 days. They included all 50 states in their searches.

The researchers found ads for insulin and albuterol inhalers in 240 cities in 31 states.

Insulin was often offered at a very high discount. For example, a vial of Humalog insulin sells for almost $ 300, but it was for sale on Craigslist for $ 37.

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Altruism was one of the reasons why people sold insulin online. "I have been blessed with an excess of insulin and I know what it is to need it and not have a couple of hundred dollars to pay out of my pocket," said one vendor.

Not everyone had such altruistic motives. Some sold older supplies to make money to buy new medications after their doctor changed their prescriptions.

A major concern with insulin is that it needs to be refrigerated. Once at room temperature, it should be used within a month. And you can't know by looking at insulin if it has ever been left out of the refrigerator.

Another problem is whether insulin is sterile or not. A vendor was offering a vial filled with three-quarter insulin that had been used on a pet. While the seller claimed to have always used new needles in the vial, there is no way to verify that information.

"This is not a safe way to get medication," Goldstein said.

Interestingly, asthma inhalers seemed to be more expensive to buy on Craigslist than through a retail store. The retail price of an albuterol inhaler was $ 25, but the average retail price on Craigslist was $ 44.

Goldstein said researchers don't know why asthma inhalers were for sale at a higher price than the retailer.

He noted that the researchers could not verify the sale of any of these products. They only knew that they were being offered for sale.

Goldstein said Craigslist is probably not the only online forum where these sales are made. The researchers tried to contact Craigslist through their online contact link, but did not get a response from them.

Craigslist also did not respond to the request for comments from HealthDay.

Dr. Kasia Lipska, an assistant professor in the department of internal medicine at the Yale School of Medicine, said: "This adds to the growing body of literature that suggests patients are desperate. They need a life-saving medicine and they are forced to do it or ration their insulin. "

Lipska did not participate in this study. But she published an investigation in 2018 in the magazine JAMA Internal Medicine In a group of 200 people with diabetes, more than one in four had rationed their insulin.

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Lipska said that buying drugs from strangers on the Internet is risky. If patients have trouble paying for their medications, she said they should talk to their doctor. She said it is also important that doctors try to help by addressing the issue. "Patients may not mention this unless the doctor asks," Lipska said.

"The finding of this study, that people may be receiving medication in unregulated places, is a symptom of a defective system. It is a symptom of a system that does not work for patients. Insulin and other drugs should be more affordable for the patients, "said Lipska.

Goldstein's study was published online on February 17 in JAMA Internal Medicine.

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Sources

SOURCES: Jennifer Goldstein, M.D., scientific researcher, The Value Institute, ChristianaCare, and hospitalist, ChristianaCare Hospitalist Partners, Newark, Del .; Kasia Lipska, M.D., M.H.S., assistant professor of medicine, department of internal medicine, Yale School of Medicine, New Haven, Conn .; February 17, 2020JAMA Internal Medicineonline



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