Affording insulin... and syringes!

This may be the most important post I ever write: ReliOn insulin at Wal-Mart costs $25 per vial.

No matter how many times I see conversations about insulin prices and I mention that, no one ever seems to know. It is a life-saving thing.

Better yet, it is not prescription. I don't know why that is, and I don't recommend random experimentation, but that does mean that if you have not seen a doctor for over a year and do not have a current prescription, you can still get it.

In my case, as I was losing my health insurance and worrying, my endocrinologist suggested it. She had been giving me free samples of Lantus and Humilog to help out, but availability was always going to be a concern. Yes, when money is tight coming up with $50 a month might be hard, but it is way easier than coming up with $1000 or more.

That was our last visit, so she suggested some doses. There are no pens, but you can mix the N and the R (the cloudy and the clear), and she offered to show me that. I thought it sounded overly complicated so I declined, but then I looked it up on the internet and it was in fact very easy. I do it without thinking about it now.

It is better with a doctor's care. Once I was insured again my new primary care physician had me work with a pharmacist to adjust the dosing, and that has helped. Guessing on your own is probably not a great idea, but it is still so much cheaper.

The N (also sometimes referenced as NPH) is not a direct substitute for Lantus. It is more of a medium-acting than a long-acting. I take it twice a day. The R is fast-acting, though you might not take it with meals like Humilog and Novolog. I was initially taking it twice a day, but we added a midday dose and that has been good. Experimenting could be dangerous, but so is rationing the regular insulin you can't afford.

There are no pens; it is all vials and syringes. That is another expense.

Generally syringes come in boxes of 100 with bags of 10 inside. I use three a day, so need about one box a month. If the pharmacist doesn't know you, it is common to be reminded that they are not sold individually, and once I was even asked for ID, because you could be an IV drug user. 

Before transferring to the Wal-Mart pharmacy, I was at Fred Meyer. If they had Kroger syringes a box was about $15, but they usually only had BD for around $30 (which actually were nicer, but not twice the price nicer). Of course pen needles were always around $50 a box after they took down all the eBay auctions, so even the $30 didn't seem terrible, but Wal-Mart has them for around $13. It made sense to just get the syringes with my prescriptions now, plus they recognize me and aren't eyeing me for signs of drug abuse.

I mention this because I was out of syringes one night when none of my prescriptions were due. The Wal-Mart isn't close to home, so I was just going to run in to Rite-Aid. $50! No other options.

I walked out, and got a $30 pack at Walgreens. I really try and plan ahead better now, only getting them at Wal-Mart or Costco. I know $15 isn't a lot of money for many people, but it is for me. It would also be very easy to not even realize the price range out there.

I have written before about avoiding shopping at Wal-Mart for a long time because of their business practices, and giving in because it means I get to live. My current insurance would let me go back to Lantus and Humilog, but in thinking about that I felt so much panic; what if I lose insurance again? I want to stay with something I can afford. I can easily avoid Chik-Fil-A and Home Depot, and there will probably be some pain in not getting New Balance if I can ever afford new shoes again but I will do it, but at this time my efforts require me staying alive. That means insulin at Wal-Mart.

Do what you need to do to stay alive too.

Recently I saw tweets about mortality coming up that were all related but with key differences. One was about how a lot of young people start dying after 26 because they lose their parents' insurance coverage, and another was about approaching 40 and all of the conditions that you have had to put off treating becoming issues, and one was about elderly people no longer being able to afford the care they need when they are on fixed incomes.

That last one may be the worst, because time was when if you could make it to 65 and Medicare you would have the best health care of your life, and probably be good into your 80s. We talk about average lifespans, but within that set there are clusters and danger areas. We just keep adding minefields.

I also recently saw a very eugenics-heavy tweet that called out diabetes specifically. Fine, I am not reproducing anyway, clearly, but that kind of hostility will pop up in other areas. I have health coverage for now.

Sometimes the most radical thing you can do is live. Do what you can.

Edited to add: I should have mentioned that ReliOn insulin is not meant for Type 1 diabetes. Obviously I am more familiar with Type 2 issues, and I don't know of any better options for Type 1. Better health care coverage and better price controls for life saving medications would be huge, and help everyone.