Amanani e-insulin: Ibiza malini i-insulin?
Imininingwane YezidakamizwaIsifo sikashukela akuyona inkinga encane e-United States. Kunabantu abacishe babe yizigidi ezingama-30.3 abanesifo sikashukela e-U.S., Ngokusho kwe- Isikhungo Sokucwaninga Ngesifo Sikashukela . Amaphesenti amahlanu kubo — noma abantu abangaba yizigidi eziyi-1.5 — bane-type 1 yesifo sikashukela futhi badinga i-insulin ukuze baphile. Abanye abantu abanesifo sikashukela sohlobo lwesibili bangalawula ushukela wegazi ngokudla nangomsebenzi. Noma kunjalo, abaningi badinga i-insulin, ikakhulukazi njengoba isimo siqhubeka.
Futhi, ngeshwa, amanani entengo e-insulin akhuphuke kakhulu kule minyaka eyishumi edlule. Phakathi kuka-2012 no-2016, intengo icishe yaphindeka kabili, ngokusho kwe- Isikhungo Sezindleko Zokunakekelwa Kwezempilo . Ngo-2012, izindleko ezijwayelekile ze-insulin esigulini ngasinye sikashukela kwakungu- $ 2,864 ngonyaka. Ngo-2016, sase sikhuphuke safinyelela ku- $ 5,705. Namuhla, isitsha esisodwa se-insulin singabiza u- $ 250, kanti abanye abantu badinga izitsha eziyisithupha ngenyanga.
Ngaphezu kwalokhu, kunezinye izinto zesifo sikashukela, ezifana ne-glucose Monitor, imichilo yokuhlola, ama-lancet, nendawo ephephile yokugcina imijovo noma amapeni asetshenzisiwe. Kungabiza kalula umuntu ngaphandle komshuwalense $ 1,300 ngenyanga ukunakekela lesi simo. Ngisho nge umshwalense, ama-copayments nempahla kungadla kwisabelomali sakho sanyanga zonke. Ngenhlanhla, kukhona izinketho zokonga.
Yimalini ibhodlela le-insulin?
Izindleko zesitsha esisodwa se-insulin ziyahlukahluka kuye ngohlobo lwe-insulin oyisebenzisayo nokuthi uyikhokhela kanjani. Kepha, noma ngabe kubiza malini, kunezinye izindlela zokukhokha intengo yemali.
Uma ungenawo umshwalense, izinkampani ezithaka imithi ezenza imikhiqizo ye-insulin zinikela ngezinhlelo zosizo lweziguli, kuchaza UMichael Carnathan MD , udokotela womndeni oqinisekiswe yibhodi eBethlehem, ePennsylvania. Isikhathi esiningi, isiguli singathola i-insulini mahhala noma ngemali ephansi kakhulu.
Kulabo abangenawo umshuwalense wezempilo, ama-insulins amadala womuntu abiza kusuka ku- $ 25 kuya ku- $ 100 ngesitsha ngasinye; isibonelo, iWalmart ine-insulin yomuntu etholakala ku- $ 25 ngesitsha ngasinye. Ama-insulins amasha womuntu abiza phakathi kwe- $ 174 kuya ku- $ 300 nge-vial ngayinye, ngokusho kwe- Umbiko ushicilelwe ngo-2018 .
Kubiza malini ibhodlela le-insulin nomshuwalense?
Kunzima ukusho ukuthi isamba se-insulin sibiza malini uma ukhokha ngohlelo lwakho lwezempilo. Uhlelo ngalunye lomshuwalense luhlanganisa imikhiqizo ye-insulin ngokuhlukile.
Kungaleso sikhathi lapho uthola khona umshuwalense wezempilo lapho ukuthola i-insulin ngentengo enhle kuba yinkinga, kusho uDkt Carnathan. Kulezo zimo, iziguli kwesinye isikhathi ziphoqeleka ukuthi zishintshele kuhlobo olwehlukile nolungabizi kakhulu lwe-insulin ebizwa nge-NPH noma i-70/30 phakathi kwezinye ezimbalwa. Le insulins kade yaba khona futhi iyabiza. Isiguli sidinga udokotela wokunakekelwa okuyisisekelo noma i-endocrinologist okhululekile ukusebenzisa lawa ma-insulins amadala futhi awalungise ngokuphepha.
Uhlelo ngalunye lwezempilo lunama-copay ahlukahlukene nokudonswayo, nawo. Isibonelo, kubantu abanecebo elidonswa kakhulu, inani lemali le-insulin likhokhwa uze uhlangane nodonswayo. Amanye ama-copay angaphakama ngama-50% wezindleko zemithi.
Futhi kwesinye isikhathi kungaba nzima kubantu abakuMedicare ukuthi bakwazi ukukhokhela i-insulin. Iziguli eziningi ezibhekene nezindleko eziphezulu ze-insulin zizithola zibanjwe emgodini we-Medicare donut, kusho UGail Trauco, RN , umphathi omkhulu we I-PharmaKon LLC .
Njengamakhasimende angaqinisekisiwe, izinhlelo zosizo lweziguli zingaba usizo kumakhasimende e-Medicare. Kodwa-ke, lezi zinhlelo zidinga isicelo, esingathatha izinsuku ezingama-30 kuye kwezingu-60 ukubuyekezwa nokuvunywa, kanye nemibhalo enamarisidi ukuqinisekisa izindleko zakho zenyanga zokuphila.
Ngenxa yomsindo womphakathi ophathelene namanani aphezulu e-insulin, ezinye izinkampani zomshuwalense nezinkampani ezidayisa izidakamizwa zithatha izinyathelo zokwehlisa izindleko zenyanga. Ngokwesibonelo:
- Imibhalo yeCigna ne-Express babamba izindleko zanyanga zonke zokuphuma ephaketheni ngo- $ 25 ngenyanga. I-ExpressScripts ilinganisela ukuthi abantu ababalelwa ku-700,000 abanesifo sikashukela bazokwazi ukuthola le mali. Kodwa-ke, abaqashi kumele bangene kulolu hlelo.
- USanofi, ongomunye wabahlinzeki abakhulu be-insulin, wenza uhlelo lwabakhokhi bemali. Lolu hlelo lubiza u- $ 99 ngenyanga futhi luhlinzeka ngamabhodlela ayi-10, amabhokisi we-10 amapeni, noma inhlanganisela yalokhu okubili. Abantu abane-Medicare, Medicaid, noma ezinye izinhlelo zikahulumeni nezikahulumeni abafanelekile ukuthola lolu hlelo. Noma ngubani omunye umuntu, noma ngabe unomshuwalense wezempilo, angabamba iqhaza uma ekhokha imali ye-insulin yakhe. I- $ 99 kungenzeka ingakhokhi zonke izindleko, futhi okuhlinzekwayo kungabiza okungeziwe.
- U-Eli Lilly usanda kuphuma nohlobo olujwayelekile lweHumalog oluthengisa uhhafu wentengo, ngo- $ 137.35 ngesitsha ngasinye.
Ufuna intengo engcono nge-insulin?
Bhalisela izexwayiso zentengo ye-insulin bese uthola ukuthi intengo ishintsha nini!
Thola izexwayiso zentengo
Ngabe izitsha ze-insulin zishibhile kunezibaya?
Kunomehluko ophawulekayo kumanani entengo e-insulin phakathi kwezingqimba ze-insulin (ngamasirinji) kanye nezibaya ze-insulin. Kusetshenziswa izingqayi kubiza kancane kunezibaya. Kodwa-ke, abanye abantu banomuzwa wokuthi ukusebenzisa amapeni njengohlelo lokuletha kuletha impilo esezingeni eliphakeme. Izibaya ziza kuqala, futhi lapho usebenzisa imithi ye-analogi, inani lamanani lingehla. Izibaya zenza kube lula ukuthatha i-insulin uhambe nayo, ikunikeze inkululeko ethe xaxa.
Sebenzisa amapeni kuphephe kakhulu, kulula kakhulu, futhi kunikeza ukulawula okungcono kwe-glycemic, ngokusho kwe- Ucwaningo olushicilelwe ku-2018 . Kodwa-ke, lolu cwaningo luphawule nokuthi abantu abasebenzisa amapeni basebenzisa imali ethe xaxa njalo ngenyanga ukulawula isifo sikashukela. Kwezinye izimo, kwakubiza ngokuphindwe kathathu ukusebenzisa amapeni.
Ibiza malini inyanga ye-insulin?
Wonke umuntu unezidingo ezihlukile ze-insulin. Abukho ubukhulu obulingana nayo yonke indlela yokunquma ukuthi udinga i-insulin engakanani. Labo abathatha i-insulin ye-analog bathatha isizinda noma umthamo we-basal kanye noma kabili ngosuku. Ngokuphambene nalokho, labo abathatha i-insulin ejwayelekile yomuntu bayithatha kathathu noma kane ngosuku.
Le cadence ukuphela kwe-insulin abanye abantu abanesifo sikashukela sohlobo lwesibili. Kodwa ngohlobo lwesifo sikashukela sohlobo 1, kanti ezinye zinohlobo 2, kudingeka i-insulin eyengeziwe ngesikhathi sokudla. Kuya ngokuthi usebenzisa yiphi i-insulin, kufanele kuthathwe imizuzu eyi-10 kuye kwengama-30 ngaphambi kokudla kwakho. Inani le-insulin lincike kulokho ohlela ukukudla. Isibonelo, ungadinga amayunithi ama-1-3 ngesabelo ngasinye se-carbohydrate (amagremu ayi-15).
Abantu abanesifo sikashukela sohlobo 1 ngokuvamile basebenzisa izinhlobo ezimbili ezihlukene ze-insulin ngosuku. Baqala ngemijovo emibili ngosuku bese badlulela emithamo emithathu kuya kwemine ngosuku, ngokusho kwe- I-American Diabetes Association (ADA). Abantu abanesifo sikashukela sohlobo lwesibili bangaqala ngamayunithi angu-0.5-0.8 ngekhilogremu lesisindo somzimba ngosuku futhi ekugcineni bathathe amayunithi angu-1-2 ngekhilogremu yesisindo. Kumuntu onesisindo esingamakhilogremu ayi-150, lokhu kungaba amayunithi angama-68 kuye kwayi-136 ngosuku. Kumuntu onesisindo esingamakhilogremu ayi-175, lokhu kungaba amayunithi angama-80-160 ngosuku.
Isitsha esisodwa se-insulin siqukethe amayunithi ayi-1000, namapeni aqukethe amayunithi angama-300.
Ithebula elilandelayo liqhathanisa izintengo zemithi yezinhlobo ezahlukahlukene ze-insulin yokulethwa kwezinsuku ezingama-30 ngokususelwa ezitsheni ezintathu noma amapeni ayi-10 ngenyanga. Ithebula lifaka phakathi amanani entengo e-insulin; noma kunjalo, ungakhokha inani elihlukile ngokususelwa endaweni yakho nasekhemisi lakho. Lungisa izindleko ziye phezulu noma ezansi, kuya ngokuthi udinga ini.
| Amanani we-insulin Ibiza malini inyanga ye-insulin? | ||
|---|---|---|
| Igama Lesidakamizwa | Intengo Emaphakathi Ngephakheji | Intengo Emaphakathi Ngenyanga * |
| I-Novolog (i-insulin aspart) Ipeni le-Novolog Flex | $ 333.99 / isitsha $ 123.99 / ipeni | $ 1,001.97 $ 1,239.90 |
| I-Humalog (lispro) | $ 316.22 / isitsha | $ 948.66 |
| I-Lantus (i-insulin glargine) ILantus Solostar (ipeni) | $ 314.99 / isitsha $ 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 / isitsha | $ 500.97 |
| I-Levemir (i-detemir) ILevemir Flextouch (ipeni) | $ 446.99 / isitsha $ 112.98 / ipeni | $ 1340.97 $ 1129.80 |
| I-Novolin R (i-insulin ejwayelekile) | $ 161.00 / isitsha | $ 483.00 |
| I-Toujeo Solostar (i-insulin glargine) | $ 115.18 / ipeni | $ 1151.80 |
| I-Tresiba (i-insulin degludec) UTresiba Flextouch (ipeni) | $ 351.38 / isitsha $ 123.18 / ipeni | $ 1054.14 $ 1231.80 |
* Ngokususelwa kwizitsha ezintathu noma amapeni ayi-10
Ngokungeziwe kuzindleko ezingenhla, ungahle udinge izinto ezingeziwe, ezinjenge:
- Amasirinji: $ 15- $ 20 ebhokisini le-100
- Imichilo yokuhlola: $ 25- $ 60 yemichilo yokuhlola engu-50 (ingadinga noma yikuphi ukusuka ku-1 kuye ku-10 ngosuku)
- Amaphampu: Kungabiza u- $ 6,000 ukuthenga ipompo kanye ne- $ 3,00 yezinto ezifana namabhethri
Yini ebhebhethekisa ukwanda okusheshayo kwamanani e-insulin?
Akungabazeki ukuthi amanani entengo e-insulin afinyelele eqophelweni lapho abanye abantu bengakwazi ukukhokhela imithi yabo. Phakathi ku isethulo se-ADA , U-Irl B. Hirsch, MD, uchaza ukuthi kusuka ngo-2013 kuya ku-2016, isitsha se-glargine insulin sanyuka ngo-593%, kwathi ibhokisi lamapeni amahlanu e-insulin lispro lenyuka ngama-522%. Ngaleso sikhathi, ukwehla kwamandla emali kukhuphuke ngo-8.3% kuphela. Ngo-2014, abenzi bezidakamizwa bakhuphule intengo ye-insulin kabili, isikhathi ngasinye cishe ngama-16%. Lokho kusho ukuthi amanani e-insulin akhuphuke ngaphezu kwama-30% ngonyaka owodwa.
Asikho isizathu esisodwa kuphela sezindleko eziphezulu ze-insulin. Izinkampani ezithaka imithi zikhala ngokuthi abaphathi bezinzuzo zekhemisi (PBM) abasebenzisa izinzuzo zemithi kadokotela bezinkampani zomshuwalense wezentengiselwano bakhokhela izindleko ngokufuna ukuthi izaphulelo zifakwe kuhlobo lwazo lwe-insulini ku-formulary yomshuwalense. Bathi inani labo lentengo liphansi kunentengo yohlu. Kodwa ama-PBM athi yizinkampani ezithaka imithi ezibeka intengo yohlu.
Izici eziningana zigcina amanani entengo e-insulin ephezulu:
- Kukhona abenzi be-insulin abathathu kuphela emhlabeni jikelele. Ngokuncintisana okuncane, bangabeka noma yiziphi izintengo abazifunayo.
- Kunzima futhi kubiza izindleko ukwenza inguqulo ejwayelekile. Emkhakheni wezidakamizwa, abenzi bezidakamizwa bangahambisa ucwaningo ku-FDA ngeminye imishanguzo uma bengafakazela ukuthi le mithi emibili iyafana ngokwamakhemikhali. Kepha i-FDA ayikuvumeli ukuthi usebenzise ucwaningo olufanayo ngemikhiqizo ye-biologic insulin. Lokho kusho ukuthi ukuletha i-insulin ejwayelekile emakethe kuba yinto ebiza kakhulu, kusale kuphela izidakamizwa zamagama.
- Njengezinkampani ezenza imithi, kunokushoda komncintiswano kuma-PBM, okunika izinkampani, njengeCVS Caremark ne-Express Script, amandla okuzenzela imithetho yazo. UHirsch ukhombisa ukuthi ngo-2013, iCVS Caremark ibinemali engenayo engama- $ 123 billion, kanti i-Express Script ibikuma- $ 94 billion.
Izinga eliphakeme lokuncintisana lizokwehlisa amanani, kwenyuse ukutholakala kwe-insulin.
Izindleko ezikhulayo ze-insulin zinemiphumela yangempela emhlabeni. Iqembu eMinneapolis kubikwa thatha ibhasi eliya eCanada uyothenga i-insulin ngentengo engaphansi kwentengo njengoba ithengiswa e-United States.
Abanye abantu baphinde balinganise i-insulin yabo ngokuhlukanisa noma ukweqa amanani. Kokubili kunemiphumela emibi kwezempilo. Ngemuva kokuguga emshwalense wezempilo kanina, indoda eneminyaka engu-26 waziswa ngusokhemisi wakhe ukuthi i-insulin nempahla yakhe kuzoba ngama- $ 1,300 ngenyanga. Kwakungaphezu kwamandla akhe kumholo womphathi wezindawo zokudlela. Kungakapheli nenyanga elahlekelwe ngumshwalense wakhe, washona. Umndeni wakhe ukholelwa ukuthi waqala ukulinganisa i-insulin yakhe, futhi yilokho okwambulala.
Ohulumeni bezwe abambalwa nabo bazama ukwehlisa amanani entengo e-insulin. IColorado ifake i-insulin copay ngo- $ 100 ngenyanga kubantu abanomshwalense. INevada iphasise umthetho wokwandisa ukusobala emananini entengo yezidakamizwa, ibheke ukulwa hhayi kuphela izindleko ezikhulayo ze-insulin kepha nezindleko ezikhulayo zayo yonke imishanguzo kadokotela. Ezinye izifundazwe ezingama-23 ziphakamise umthetho ohlose ukubhekana nezindleko eziphezulu zemithi kadokotela.
Kubiza malini ukukhiqiza i-insulin?
TO Ucwaningo lwe-2018 kulinganiselwa ukuthi isitsha esisodwa se-insulin yomuntu sibiza u- $ 2.28- $ 3.42 ukukhiqiza, kanti isitsha esisodwa se-analog insulin sibiza u- $ 3.69- $ 6.16 ukukhiqiza. Ucwaningo luveze ukuthi ukutholakala konyaka kwe-insulin yomuntu kungabiza u- $ 48- $ 71 ngesiguli, kanti i-analog insulin ingabiza u- $ 78- $ 133 ngesiguli ngonyaka.
Ucwaningo lilinganise izindleko zokukhiqiza kuphela. Akufakwanga imali yokuphatha, ukuthengisa, nocwaningo nentuthuko yokuthuthukisa imishanguzo. Kodwa-ke, abakhiqizi be-insulin abanikanga incazelo eyanele yalokhu kungafani okukhulu phakathi kwezindleko zokukhiqiza nezindleko zokuthengisa.
Ungonga kanjani kuzintengo ze-insulin
Xhumana nenkampani yakho yomshuwalense (kulabo abanomshwalense) bese uthola ukuthi inqubomgomo yakho iyikhokhela kanjani i-insulin. Ngabe bakhokhela ngaphezulu izinhlobo ezithile ze-insulin? Ingabe azikhiphi izinhlobo ezithile? Uma izinkokhelo zabo noma ukukhishwa kungasebenzi nalokho okwenzayo, khuluma nomhlinzeki wakho wezokunakekelwa kwezempilo mayelana nezinketho. Ezinye izinkampani zomshuwalense zizokwamukela lokho okubizwa ngokuthi ukugunyazwa kwangaphambili, okusho ukuthi udokotela wakho ubhala incwadi echaza ukuthi kungani udinga uhlobo oluthile lwe-insulin. Thola ukuthi yini imali yakho ekhishwayo nokuthi uzodinga ukuyikhokha kanjani ephaketheni. Buza ukuthi ngabe banezinhlelo ezikhethekile ze-insulin, njengalezo ezinikezwa yiCigna.
Uma ukhokha imali, sisebenzise izinhlelo ezihlinzekwa yizinkampani ezithaka imithi , njengaleyo enikezwe uSanofi. Faka izindleko ezengeziwe zokuhlinzekwa ukuze ubone ukuthi yini oyodinga ukuyikhokha inyanga ngayinye.
Bheka ezinhlelweni zosizo lweziguli ezinikezwa izinkampani ezinkulu kakhulu ezenza imithi, njengo-Eli Lilly noNovo Nordisk, nezinye izinhlelo zosizo ezingenzi nzuzo, ezinjengeRx Hope, ezihlinzeka ngemiyalelo yezindleko zamahhala noma eziphansi kumholo ophansi nongaqinisekisiwe.
Sebenzisa ithuba le- ikhadi lokulondolozwa kadokotela kusuka ku-Singlecare . Amakhemisi angaphezu kwama-35,000 amukela amakhuphoni e-SingleCare. Ungafaka ikhodi yakho ye-zip ku-inthanethi noma kuhlelo lwethu lokusebenza lweselula ukuthola ikhemisi ngenani eliphansi kakhulu le-insulin yakho. Bese, uletha incwadi kadokotela kanye nekhadi lakho le-SingleCare ukuthola isaphulelo. Ukujoyina i-SingleCare kumahhala.
