At a yearly cost of $237 billion to the healthcare industry, diabetes is ranked one of the most expensive conditions in America. From navigating skyrocketing insulin prices to monitoring blood pressure and taking medications as prescribed, living with diabetes requires complex self-management. And as a provider, it’s important to be mindful that your diabetic patients are often expending more than two times as much on medical care than those living without diabetes.
Learn the Basics of Diabetes Self-Management
When it comes to effective self-management, education is key, and providers play a crucial role in this, says spokesperson for the American Association of Diabetes Educators Christine Memering, RN, BSN, CDE, FAADE. If you work with any diabetes patients, you should learn as much as possible about medications, products and programs that will alleviate financial burdens.
“[Diabetes] is not just a financial cost — it’s also a very big mental health cost and physical cost on the body,” Memering tells Florence Health. “Nobody wants to say ‘I need help. This is too expensive and I can’t take care of my health.’ But it’s the single most important thing that people can say to [a provider].”
Diabetes education is a recognized part of diabetes care and covered by Medicare and most health insurance plans. For example, many patients don’t know that Medicare covers personal nutritional counseling for diabetes. Additionally, when a patient is first diagnosed with diabetes, Medicare covers 10 hours of self-management, education and support services, as well as two hours every year thereafter. The problem is, according to Memering, that patients are not being referred to these options enough.
“Part of it comes from practitioners not understanding or knowing that just because you send somebody to diabetes education, you’re not deterring from what you’re doing in the office,” Memering emphasizes. “It can actually help you as a practitioner and enhance your patient’s understanding.”
With Memering’s help, we’ve compiled a list of low-cost resources that you can share with your diabetic patients to proactively prioritize their needs.
Diabetes Education Programs
- Use this map to find low-cost diabetes education programs in your area.
- Offer these handouts, based in different subject areas, to your patients to help them manage their own diabetes.
Free and Low-Cost Apps
- One Drop. Patients can track and analyze blood sugar, medications, food and activity as well as set daily goals, view progress and connect with a worldwide diabetes community. The app also offers virtual coaching services.
- MySugr. MySugr specializes in all-around care for people with diabetes – made by people with diabetes. The app features a digital logbook, reminders and challenges and diabetes coaching services to ease the complexity of managing a daily diabetes routine.
- BD DiabetesCare. This mobile app enables people with diabetes to make smarter choices and provides personalized resources and expert content, empowering patients to have meaningful conversations with their providers. It can identify trends beyond blood glucose numbers, offering personalized insights and helpful tips to keep healthy behaviors on track.
- Dario. The Dario App provides users with a complete solution for personal diabetes management. It supports users by tracking all blood glucose levels in real-time and with actionable insights to allow for optimal self-management.
- Livongo. The Livongo app provides patients with tools, support and guidance to help understand and manage diabetes. It records every blood sugar and blood pressure reading, as well as daily step counts. It also provides real-time feedback after every reading to help patients learn and improve.
- For HCPs: Fingertip Formulary. This app maintains the highest quality and most comprehensive database of formulary information in the U.S., covering virtually all plans, in all segments: commercial, Medicare, Medicaid, PBM, Health Exchange, employers and more.
Patient Assistance Programs and Saving Cards
Most insulin companies have assistance or savings program that provides medication at a reduced cost for qualifying patients. Each program has its own eligibility requirements, so work with your patient to determine which one is best for them.
- Sanofi Savings Programs
- The Johnson & Johnson Patient Assistance Program
- Lilly Diabetes Solution Center
- The Novo Nordisk Diabetes Patient Assistance Program
- The Sanofi Patient Assistance Program
If your patient does not have prescription medication insurance and is paying cash, you can point them here:
John Hancock also offers a new solution to help people with diabetes manage their condition. The John Hancock Aspire program includes a life insurance plan and a tech feature that provides coaching, clinical support, education and rewards. Members have the potential to save up to 25 percent on premiums, according to the company.
Community-Specific Organizations and Programs
- Children with Diabetes
- College Diabetes Network
- YMCA’s Diabetes Prevention Program
Magazines and Podcasts
- Diabetic Living
- Diabetes Self-Management
- Diabetes Forecast
- Diabetes Mine
- The Huddle
- Juicebox Podcast
Older Formulations of Insulin
If your patients have an immediate need for insulin but lack health insurance, they may turn to older, cheaper formulations, such as the ReliOn brand offered at WalMart. Intermediate-acting, short-acting or mixed insulin is available for $25 a bottle. Ask your patients if they are using this method and, if so, instruct them on how and why these insulins work differently than others.
“It is really difficult for someone with Type 1 diabetes to be able to manage on this insulin,” Memering notes. “We try and live our life with diabetes, not live our life around diabetes or because of diabetes.”
Research shows that the cost of insulin has more than doubled within the past decade. According to Memering, providers must remember that due to these increasing costs and lack of coverage, patients may be stretching their insulin.
“One big thing to ask as a provider is: ‘I know how we talked about taking your insulin, but how are you actually taking your insulin?’” Memering said. “‘No judgment, I just want to know.’”
This way, providers can start a conversation that will allow patients to communicate truthfully, which will in turn help you understand your patient’s circumstances and effectively meet their needs.
Memering also advises providers to get involved with advocacy efforts on state and federal levels to alleviate barriers to access, to form partnerships with diabetes educators and to let medical reps into the office in order to keep up with the latest technology, resources and medications that are available to patients.
“If [providers] really try and understand where [their patients] are at and practice more patient-centered care, we can really make progress with how someone is managing what they’re able to do and what they’re willing to do at that time in their life,” Memering says.
Help with Your Diabetes Prescription and Insulin Costs, JDRF.
Millions of Diabetes Patients are Missing Out on Medicare’s Nutritional Help, Kaiser Health News.
Verily, John Hancock collaborating on life insurance solution that offers virtual diabetes management, Fierce Healthcare.