Amaxabiso e-insulin: Ixabisa malini i-insulin?

Ulwazi lweziyobisi

Isifo seswekile ayisiyonto incinci eMelika. Kukho malunga ne-30.3 yezigidi zabantu abanesifo seswekile e-US, ngokwe IZiko loPhando ngeSwekile . Iipesenti ezintlanu kubo-okanye malunga ne-1.5 yezigidi zabantu-bane-1 yeswekile kwaye bafuna i-insulin ukuze baphile. Abanye abantu abanesifo seswekile sesi-2 banokulawula iswekile yegazi ngokutya kunye nomsebenzi. Okwangoku, uninzi lufuna i-insulin, ngakumbi njengoko imeko iqhubeka.

Kwaye, ngelishwa, amaxabiso e-insulin anyuke kakhulu kule minyaka ili-10 idlulileyo. Phakathi kuka-2012 no-2016, ixabiso liphantse laphindeka kabini, ngokwe ICandelo leNdleko yeNkathalelo yezeMpilo . Ngo-2012, ixabiso eliphakathi le-insulin kwisifo seswekile laliyi- $ 2,864 ngonyaka. Ngo-2016, yayinyuke yaya kwi-5, 705 yeedola. Namhlanje, ibhotile enye ye-insulin inokubiza i-250 yeedola, kwaye abanye abantu bafuna iibhotile ezintandathu ngenyanga.

Ukongeza koku, kukho ezinye izinto zeswekile, ezinje ngeglucose esweni, imicu yovavanyo, iilancets, kunye nendawo ekhuselekileyo yokugcina iisirinji okanye iipeni. Inokuhlawula lula umntu ngaphandle kwe-inshurensi eyi-1,300 ngenyanga ukukhathalela imeko. Nkqu nge i-inshurensi, iintlawulo ezikhutshelweyo kunye nokubonelelwa kunokutya kuhlahlo-lwabiwo mali lwakho lwenyanga. Ngethamsanqa, kukho iindlela zokonga.

Yimalini ibhotile ye-insulin?

Iindleko zentsimbi enye ye-insulin iyahluka ngokuxhomekeka kuhlobo lwe-insulin oyisebenzisayo kunye nendlela oyihlawula ngayo. Kodwa, ngaphandle kwendleko, kukho ezinye iindlela zokuhlawula ixabiso lemali.

Ukuba awunayo i-inshurensi, iinkampani ezixuba amayeza ezenza iimveliso ze-insulin zibonelela ngeenkqubo zoncedo lwesigulana, uyacacisa UMichael Carnathan MD Ugqirha wosapho oqinisekisiweyo eBhetelehem, ePennsylvania. Uninzi lwexesha, isiguli sinokufumana i-insulin simahla okanye ngexabiso eliphantsi kakhulu.

Kulabo bangenayo i-inshurensi yezempilo, ii-insulins zabantu ezindala zibiza naphi na ukusuka kwi- $ 25 ukuya kwi- $ 100 ngebhotile; umzekelo, iWalmart ine-insulin yomntu efumaneka kwi- $ 25 ngebhotile. Ii-insulins ezintsha zomntu zibiza phakathi kwe- $ 174 ukuya kwi- $ 300 nge-vial, ngokwe-a ingxelo epapashwe kwi2018 .

Yimalini ibhotile ye-insulin nge-inshurensi?

Kunzima ukusho ukuba ingakanani ibhotile ye-insulin ebiza iindleko xa uhlawula ngesicwangciso sakho sempilo. Isicwangciso seinshurensi nganye sigubungela iimveliso ze-insulin ngokwahlukileyo.

Kulapho ke une inshurensi yezempilo ethi ukufumana i-insulin ngexabiso elifanelekileyo kube yingxaki, utshilo uGqirha Carnathan. Kwezo meko, abaguli ngamanye amaxesha banyanzelwa ukuba batshintshele kuhlobo olwahlukileyo nolungabizi kakhulu lwe-insulin ebizwa ngokuba yi-NPH okanye i-70/30 phakathi kwezinye ezimbalwa. Ezi insulini kudala zikho kwaye ziyafikeleleka. Isigulana sidinga ugqirha wokhathalelo oluphambili okanye ugqirha we-endocrinologist okhululekile ukusebenzisa ezi insulin zindala kwaye azilungelelanise ngokukhuselekileyo.

Isicwangciso ngasinye sezempilo sineekopi ezihlukeneyo kunye nokuncitshiswa, nazo. Umzekelo, kubantu abanesicwangciso esitsalwe ngaphezulu, ixabiso lemali le-insulin lihlawulwa ude uhlangane nokutsalwa. Ezinye ii-copays zinokuphakama njenge-50% yeendleko zonyango.

Ngamanye amaxesha kunokuba nzima kubantu abakwiMedicare ukuba bafumane i-insulin. Izigulana ezininzi ezijamelene neendleko eziphezulu ze-insulin zizifumana zibanjiwe kumngxunya we-Medicare donut, utsho UGail Trauco, RN Umphathi oyintloko we IFarmaKon LLC .

Njengabathengi abangaqinisekiswanga, iinkqubo zoncedo lwesigulana zinokuba luncedo kubathengi beMedare. Nangona kunjalo, ezi nkqubo zifuna isicelo, esinokuthatha iintsuku ezingama-30 ukuya kuma-60 ukuphononongwa kunye nokwamkelwa, kunye namaxwebhu aneerisithi zokuqinisekisa iindleko zakho zenyanga zokuphila.

Ngenxa yengxolo yoluntu malunga namaxabiso aphezulu e-insulin, ezinye iinkampani zeinshurensi kunye neenkampani zamachiza zithatha amanyathelo okwehlisa iindleko zenyanga. Umzekelo:

• ICigna kunye neZikripthi zokuBonisa bafaka iindleko zenyanga eziphuma epokothweni nge- $ 25 ngenyanga. Uqikelelo lwe-ExpressScript malunga ne-700,000 yabantu abanesifo seswekile baya kufaneleka kolu londolozo. Nangona kunjalo, abaqeshi kufuneka bangene kule nkqubo.
• USanofi, ongomnye wabathengisi abakhulu be-insulin, wenza inkqubo yababhatala imali. Le nkqubo ixabisa i-99 yeedola ngenyanga kwaye ibonelela ngeebhotile ezili-10, iibhokisi ezili-10 zeepeni, okanye ukudityaniswa kwezi zimbini. Abantu abane-Medicare, Medicaid, okanye ezinye iinkqubo zombuso kunye nelizwe abafanelekanga kule nkqubo. Nabani na ongomnye, nokuba unayo i-inshurensi yezempilo, unokuthatha inxaxheba ukuba uhlawula imali kwi-insulin yabo. I-99 yeedola ayinakho ukuhlawula zonke iindleko, kwaye ukubonelela kungabiza ngaphezulu.
• Kutshanje u-Eli Lilly uphume nohlobo oluqhelekileyo lweHumalog ethengisa ngesiqingatha sexabiso, nge $ 137.35 ngebhotile.

Ngaba ufuna elona xabiso lilungileyo kwi-insulin?

Bhalisela izilumkiso zexabiso le-insulin kwaye ufumane ukuba amaxabiso atshintsha nini!

Fumana izilumkiso zamaxabiso

Ngaba izitya ze-insulin zitshiphu kuneepeni?

Kukho umahluko obonakalayo kumaxabiso e-insulin phakathi kweentsimbi ze-insulin (ngeesirinji) kunye neepeni ze-insulin. Ukusebenzisa iibhotile kubiza ngaphantsi kuneepeni. Nangona kunjalo, abanye abantu baziva ngathi ukusebenzisa iipeni njengenkqubo yokuhambisa kunika umgangatho wobomi ophezulu. Iipeni ziza kuqala, kwaye xa usebenzisa amayeza e-analog, inani leedosi linokuba sezantsi. Iipeni zenza kube lula ukuthatha i-insulin kunye nawe, ikunike inkululeko engakumbi.

Sebenzisa iipeni kukhuselekile, kulula ngakumbi, kwaye kubonelela ngolawulo lwe-glycemic olungcono, ngokwe Uphando lupapashwe kwi-2018 . Nangona kunjalo, olu phononongo luye lwaqaphela ukuba abantu abasebenzisa iipeni bachitha inkcitho eninzi inyanga nenyanga kulawulo lweswekile. Ngamanye amaxesha, kwakudla ngokuphindwe kathathu ukusebenzisa iipeni.

Ixabisa malini inyanga ye-insulin?

Wonke umntu uneemfuno ezahlukeneyo ze-insulin. Akukho sayizi enye elingana nayo yonke indlela yokumisela ukuba ingakanani na i-insulin oyifunayo. Abo bathabatha i-insulin ye-analog bathatha imvelaphi okanye idosi esisiseko kanye okanye kabini ngemini. Ngokwahlukileyo koko, abo bathatha i-insulin yomntu rhoqo bayithatha kathathu okanye kane ngosuku.

Le cadence kuphela kwe-insulin yabantu abathile abanesifo seswekile sesi-2 abafuna. Kodwa kuhlobo 1 lweswekile, kwaye ezinye zinohlobo 2, ukongezwa kwe-insulin ngexesha lokutya. Kuxhomekeke ekubeni usebenzisa yiphi na insulin, kufuneka kuthathwe imizuzu eli-10 ukuya kwengama-30 ngaphambi kokutya kwakho. Ubungakanani be-insulin buxhomekeke kwinto oceba ukuyitya. Umzekelo, unokufuna iiyunithi ezi-1-3 ngesahlulo sekhabhohayidrethi (iigram ezili-15).

Abantu abanesifo seswekile sokuqala basebenzisa iintlobo ezimbini ezahlukeneyo ze-insulin ngemini. Baqala ngenaliti ezimbini ngosuku kunye nenkqubela phambili ukuya kwiidosi ezintathu ukuya kwezine ngosuku, ngokwe Umbutho weSwekile yaseMelika (ADA). Abantu abanesifo seswekile sesi-2 bangaqala ngeeyunithi eziyi-0.5-0.8 ngeekhilogram yesisindo somzimba ngosuku kwaye ekugqibeleni bathathe iiyunithi ezi-1-2 ngekhilogram yesisindo. Kumntu onobunzima beepawundi ezili-150, oku kunokuba ziiyunithi ezingama-68 ukuya kwezi-136 ngosuku. Kumntu onobunzima beepawundi ezili-175, oku kunokuba ziiyunithi ezingama-80-160 ngosuku.

Ibhotile enye ye-insulin ineeyunithi ezingama-1000, kwaye iipeni zineeyunithi ezingama-300.

Le theyibhile ilandelayo ithelekisa amaxabiso eziyobisi kwiindidi ezahlukeneyo ze-insulin yokubonelela ngeentsuku ezingama-30 ngokusekwe kwiibhotile ezintathu okanye kwiipeni ezili-10 ngenyanga. Itheyibhile ibandakanya amaxabiso aphakathi e-insulin; Nangona kunjalo, unokuhlawula imali eyahlukileyo ngokusekwe kwindawo yakho nakwikhemesti yakho. Lungisa iindleko phezulu okanye ezantsi, kuxhomekeke kwinto oyifunayo.

Amaxabiso e-insulin Ixabisa malini inyanga ye-insulin?
Igama leziyobisi	Ixabiso eliPhakathi ngePakeji nganye	Ixabiso eliPhakathi ngenyanga nganye *
I-Novolog (i-insulin aspart) Ipeni yeNovolog Flex	$ 333.99 / igutyana $ 123.99 / ipeni	$ 1,001.97 $ 1,239.90 yeedola
Uhlobo (lispro)	$ 316.22 / igutyana	$ 948.66
ILantus (insulin glargine) ILantus Solostar (usiba)	$ 314.99 / igutyana $ 101.73 / ipeni	$ 944.97 $ 1,017.30
I-Humulin N (i-insulin isophane)	$ 122.67 / ipeni	$ 1,226.70
I-Novolin N (i-insulin isophane)	$ 166.99 / igutyana	$ 500.97
ILevemir (intsholongwane) ILevemir Flextouch (usiba)	$ 446.99 / igutyana $ 112.98 / ipeni	$ 1340.97 $ 1129.80
U-Novolin R (i-insulin rhoqo)	$ 161.00 / igutyana	$ 483.00
UToujeo Solostar (insulin glargine)	$ 115.18 / ipeni	$ 1151.80
UTresiba (i-insulin degludec) UTresiba Flextouch (usiba)	$ 351.38 / ibhotile $ 123.18 / ipeni	$ 1054.14 $ 1231.80

* Ngokusekwe kwiibhotile ezintathu okanye kwiipeni ezili-10

Ukongeza kwezi ndleko zingasentla, unokufuna ukongezwa kwezinto, ezinje:

• Isirinji: $ 15- $ 20 kwibhokisi ye-100
• Imigca yovavanyo: $ 25- $ 60 yemigca yovavanyo engama-50 (inokufuna naphi na ukusuka kwi-1 ukuya kwi-10 ngosuku)
• Iimpompo: Ngaba zinokubiza i-6,000 yeedola ukuthenga impompo kunye ne-3,00 yeedola kwizinto ezifana neebhetri

Yintoni ebangela ukunyuka okukhawulezayo kumaxabiso e-insulin?

Alithandabuzeki elokuba amaxabiso e-insulin afikelele kwinqanaba apho abanye abantu bengenako ukuhlawulela amayeza abo. Kwi ntetho ye-ADA U-Irl B. Hirsch, MD, ucacisa ukuba ukusukela ngo-2013 ukuya ku-2016, igutyana ye-glargine insulin inyuke ngexabiso elingama-593%, kwaye iibhokisi ezintlanu ze-insulin lispro pens zanyuka ngama-522%. Ngelo xesha, ukunyuka kwamaxabiso kwenyuka ngama-8.3 ​​ekhulwini kuphela. Ngo-2014, abenzi beziyobisi bonyusa ixabiso le-insulin kabini, ixesha ngalinye malunga ne-16%. Oko kuthetha ukuba amaxabiso e-insulin anyuke ngaphezulu kwama-30% kunyaka omnye.

Akukho sizathu esinye seendleko eziphezulu ze-insulin. Iinkampani ezixuba amayeza zikhalaza ukuba abaphathi benzuzo yekhemesti (PBM) abalawula izibonelelo zeenkampani zeinshurensi zorhwebo baqhuba iindleko ngokufuna izaphulelo ukuba uphawu lwe-insulin lubandakanywe kwifomula yeinshurensi. Babanga ukuba ixabiso labo lilonke liphantsi kunexabiso loluhlu. Kodwa ii-PBM zithi ziinkampani ezixuba amayeza eziseta uluhlu lwamaxabiso.

Izinto ezininzi zigcina amaxabiso e-insulin ephezulu:

• Kukho abathathu kuphela abenzi be-insulin kwihlabathi liphela. Ngokhuphiswano oluncinci, banokuseta nawaphi na amaxabiso abawifunayo.
• Kunzima kwaye kuthintela iindleko ukuphuhlisa uhlobo oluqhelekileyo. Kwishishini leziyobisi, abenzi beziyobisi banokungenisa uphando kwi-FDA ngamanye amayeza ukuba banokubonisa ukuba la machiza mabini ayafana. Kodwa i-FDA ayikuvumeli ukuba usebenzise uphando olufanayo kwiimveliso ze-insulin ye-biologic. Oko kuthetha ukuba ukuzisa i-insulin ejwayelekile kwintengiso iba yinto ebiza kakhulu, ishiya kuphela iziyobisi ezinamagama.
• Njengakwiinkampani ezixuba amayeza, kukho ukunqongophala kokhuphiswano kwii-PBMs, zinika iinkampani, ezinje ngeCVS Caremark kunye ne-Express Script, amandla okwenza ezazo imithetho. I-Hirsch ibonisa ukuba ngo-2013, i-CVS Caremark yayinemali eyi-123 yezigidigidi, kwaye i-Express Script yayingama-94 billion.

Amanqanaba aphezulu okhuphiswano aya kunciphisa amaxabiso, anyuse ukufikeleleka kwe-insulin.

Ixabiso elinyukayo le-insulin lineziphumo zokwenyani zehlabathi. Iqela eMinneapolis ixelwe thatha ibhasi uye eCanada uyokuthenga i-insulin ngeqhezu lexabiso njengoko ithengiswa eMelika.

Abanye abantu bakwabela i-insulin yabo ngokwahlulahlula okanye ngokudlula kwiidosi. Zombini zineziphumo ezibi kwezempilo. Emva kokuguga kwi-inshurensi yezempilo kanina, indoda eneminyaka engama-26 ubudala waxelelwa ngusokhemesti ukuba i-insulin kunye nezinto azibonisayo ziya kuba yi- $ 1,300 ngenyanga. Yayininzi ngaphezu kokuba wayenokukufikelela kumvuzo womlawuli wakhe werestyu. Kwisithuba esingaphantsi kwenyanga emva kokuphulukana neinshurensi yakhe, wasweleka. Usapho lwakhe lukholelwa ekubeni waqala ukulinganisa i-insulin yakhe, kwaye yile nto yambulalayo.

Oorhulumente abambalwa bazama ukunciphisa amaxabiso e-insulin. IColorado ithathe ikopi ye-insulin kwi-100 yeedola ngenyanga kubantu abane-inshurensi. INevada ipasise umthetho wokwandisa ukungafihli kumaxabiso eziyobisi, ijonge ukulwa kungekuphela nje iindleko ezinyukayo ze-insulin kodwa iindleko ezonyukayo zawo onke amayeza amiselweyo. Amanye amazwe angamashumi amabini anesithathu acebise umthetho ojolise ekujonganeni neendleko eziphezulu zamachiza amiselweyo.

Kubiza malini ukuvelisa i-insulin?

UKUYA Ufundo lwe-2018 kuqikelelwa ukuba ibhotile enye ye-insulin yomntu ixabisa i-2.28- $ 3.42 yeedola ukuvelisa, kunye ne-vial enye ye-analog insulin ixabisa i-3.69- $ 6.16 yokuvelisa. Olu phononongo luveze ukuba ukubonelelwa nge-insulin yomntu ngonyaka kungaxabisa i-48- $ 71 yezigulana kwisigulana ngasinye, kwaye i-analog insulin ingabiza i- $ 78- $ 133 ngesigulana ngonyaka.

Uphononongo lilinganise iindleko zokuvelisa kuphela. Ayibandakanyi iifizi zolawulo, ukuthengisa, kunye nophando kunye nophuhliso lokuphucula amayeza. Nangona kunjalo, abavelisi be-insulin khange banike nkcazo yaneleyo malunga nokungangqinelani okukhulu phakathi kweendleko zemveliso kunye neendleko zentengiso.

Ungonga njani kumaxabiso e-insulin

Nxibelelana nenkampani yakho yeinshurensi (kwabo ba-inshurensi) kwaye ufumanise ukuba umgaqo-nkqubo wakho uyihlawula njani na i-insulin. Ngaba bahlawula ngakumbi iintlobo ezithile ze-insulin? Ngaba azibandakanyi iintlobo ezithile? Ukuba iintlawulo zabo okanye ukungafakwanga akusebenzi nento oyithathayo, thetha nomboneleli wakho wezempilo malunga nokhetho. Ezinye iinkampani zeinshurensi ziyakwamkela oko kubizwa ngokuba kukugunyazwa kwangaphambili, oko kuthetha ukuba ugqirha wakho ubhala ileta echaza ukuba kutheni ufuna uhlobo oluthile lwe-insulin. Fumanisa ukuba yeyiphi na into oyitsalayo kwaye uza kuyifuna njani ukuhlawula epokothweni. Buza ukuba banazo na iinkqubo ezizodwa ze-insulin, ezinje ngeCigna.

Ukuba uhlawula imali, Thatha ithuba leenkqubo ezibonelelwa ziinkampani ezixuba amayeza , njengaleyo ibonelelwe nguSanofi. Yongeza kwiindleko ezongezelelweyo zonikezelo ukubona ukuba yintoni oza kuyidinga ukuyihlawula inyanga nenyanga.

Jonga iinkqubo zoncedo lwesigulana ezinikezelwa ziinkampani ezinkulu zamayeza, ezinje nge-Eli Lilly kunye noNovo Nordisk, kunye neenkqubo zoncedo ezingenzi nzuzo, ezinje ngeRx Hope, enikezela ngemiyalelo yasimahla okanye yexabiso eliphantsi kumvuzo ophantsi kwaye ungakhuselwanga.

Thatha ithuba Ikhadi lokugcina imali elivela kwi-singlecare . Ngaphezulu kweekhemesti ezingama-35,000 zamkela amakhuphoni e-SingleCare. Ungafaka ikhowudi yakho ye-zip kwi-intanethi okanye kwiapps yethu yeselfowuni ukuze ufumane ikhemesti ngexabiso eliphantsi le-insulin yakho. Emva koko, ngenisa amayeza akho kunye nekhadi lakho le-SingleCare ukuze ufumane isaphulelo. Ukujoyina i-SingleCare simahla.