An estimated 12.4 percent or 281,355 Nevadans suffer from diabetes and the cost of insulin to the patient in some cases has risen by 17 to 27 percent in the last two years, a preliminary state report shows
The state Department of Health and Human Service released its findings earlier this month as required by the 2017 Legislature which adopted the transparency law.
There was testimony at the session that the cost of insulin to manufacture may be $1 but the consumer ends paying $20. And kickbacks may range from 50-70 percent to the middle man who sells the drug to the pharmacy. Both allegations were denied.
The department said the direct and indirect costs for diabetes is $2.4 billion annually in Nevada.
Of that, $1.9 billion is direct costs which includes the price of the drugs, hospital care, visits to doctors and supplies. The rest of the cost is due to reduced productivity at work and chronic disability.
In an instant case, a woman who suffers from type 1 Diabetes purchased five vials of insulin and paid $110 as her co-pay. The individual, who asked not to be identified, was told by the pharmacist that without her Medicare and health insurance the price would be $660.
The new law limited the cost to the consumer price index over a two-year period. The report said 17 percent of the manufacturers increased the drug price above the threshold. But the state said it would not take enforcement action until more information is submitted by mid-January.
The department said 21 or 17 percent of the manufacturers raised their prices above the limit. The companies are required to present a justification for exceeding the consumer price index. It said five of the 17 accounted for 59 percent of the total increases in prices above the limit in the law.
There were 125 manufacturers that produced the medications and only 6 percent boosted the price above the consumer price index. The companies were not identified. And the department cautioned this was a preliminary report and did not have the justification from the companies to justify the increases.
In addition to the 281,385 persons with diabetes, there are an estimated 75,000 Nevadans that have diabetes but are undiagnosed.
“There are an estimated 780,000 people in Nevada that have prediabetes with blood glucose levels higher than normal but not high enough to be diagnosed as diabetic,” said the report.
National figures show the average total individual medical costs for people with diabetes is $16,750 a year.
The agency found that 269,510 claims for diabetes drugs were submitted by persons receiving Medicaid.
Medicaid, which is supported by the federal government and the state, paid $55.2 million to buy the insulin.
The report can be viewed at http://dhhs.nv.gov/HCPWD/DRUG_TRANSPARENCY/.