Diabetes is a disorder in which the body either doesn't produce enough insulin or can't use its own insulin properly, causing glucose levels to rise. Treatment will depend on whether a patient has Type 1 of the condition, which requires insulin shots, or Type 2, which can be treated with oral or injectable medication in addition to insulin. Either way, it almost always entails monitoring blood sugar, weight and diet.
Typical costs:
For patients covered by insurance, typical out-of-pocket costs consist of a prescription drug copay ranging from $10 to $50, depending on the drug. If the patient takes multiple drugs, copays can total $200 a month or more.
For patients not covered by health insurance, it costs $4-$100 per month for metformin[1] , the most commonly prescribed first-line diabetes drug for Type 2 diabetics. Metformin decreases the amount of glucose absorbed from food and produced by the liver and heightens the body's response to insulin.
For patients without health insurance, it costs $8-$200 per month or more for metformin taken along with another diabetes drug, such as one of a class of medications called sulfonylureas[2] -- for example, brand name Glucotrol[3] or Diabinese[4] -- or one of a class of drugs called alpha-glucosidase inhibitors[5] , such as brand names Precose[6] and Glyset[7] .
For patients without health insurance, diabetes medication costs $200-$500 or more a month for a multi-drug regimen that could include other classes of oral medications.
Insulin pumps cost between $4,500-$6,500 for individuals without insurance. The price varies depending upon the features, brand and size of the pump. For example, the Accu-Chek Spirit Insulin Pump[8] costs about $4,600 when purchased without insurance coverage and includes only a few a features, such as software that allows readings to be downloaded to a personal digital assistant (PDA). The Minimed Paradigm Real Time Revel System[9] is more expensive, retailing for about $7,000 when purchased without insurance, but includes more features, like continuous glucose monitoring. Some insurance plans will cover the cost of the pump. Patients with insurance can expect typical copay and coinsurance rates ranging from $5 to half of the total cost of the pump.
Blood glucose meters can cost between $8.99-$1,150, but average $20 -$80. Individuals with insurance will pay typical copays and coinsurance rates, which can range from $5 to 50% of the cost for the device.
A registered dietitian, or RD, can provide consultations to clients who wish to eat more healthfully and lose weight. For patients not covered by health insurance, a one-hour initial consultation with a registered dietitian typically costs about $100-$200. If follow up visits are required, they typically cost $50-$150 each, depending on length of consultation and whether the dietitian comes to your home. For patients covered by health insurance, typical out-of-pocket costs would be about $10-$40 -- usually a copay or 10%-20% percent of the total cost of the visit.
Some Type 1 diabetics whose pancreas no longer functions normally, may qualify for a pancreas transplant. For those without insurance, the total cost of a pancreas transplant can range widely depending on the hospital, but typically falls between $125,000 and nearly $300,000 or more.
For patients covered by health insurance, out-of-pocket costs for a pancreas transplant typically consist of doctor visit, lab and prescription drug copays as well as coinsurance of 10%-50% for surgery and other procedures, which can easily reach the yearly out-of-pocket maximum.
Discounts:
To save money, the American Diabetes Association recommends asking the doctor to prescribe a higher-dose pill -- for example, 500 mg instead of 250 mg -- and using a pill splitter to get the correct dose; consult a pharmacist, though, since some extended-release medications are not suitable for splitting.
For patients without health insurance, many drug manufacturers provide free or discounted medications through patient assistance programs. Or, the Partnership for Prescription Assistance[10] can offer help to patients who qualify.
Shopping for diabetes treatment:
The American Academy of Family Physicians[11] provides guidelines for choosing a family doctor. Or, a board-certified internal medicine doctor can serve as the patient's primary care provider; the American Board of Internal Medicine[12] offers a doctor search feature.
Material on this page is for informational purposes only and should not be construed as medical advice. Always consult your physician or pharmacist regarding medications or medical procedures.
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