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 During a two-week period, researchers turned up 327 ads from private
parties selling insulin at a fraction of the retail price, according
to a report in JAMA Internal Medicine.
"The take home message from this study is that patients (with
diabetes) should not have to go to Craigslist to find affordable
insulin," said coauthor, Dr. Jennifer Goldstein of ChristianaCare
Hospitalist Partners in Newark, Delaware and The Value Institute at
Christiana Care. "We have a duty to provide more viable options.
There has to be a better way than patients going out on their own
and seeking out potentially harmful products."
The idea for the study was sparked by a newspaper story about a
person who purchased insulin on Craigslist, Goldstein said. "I
couldn't believe it and started looking into it on my own," she
added. "I was surprised at the number of ads I found. I wanted to
provide a snapshot of what was going on. It's alarming."
Craigslist did not respond to a request for comment, but
prescription medications are on the site's list of prohibited items.
Goldstein and colleagues scoured Craigslist ads in June 2019 looking
for three prescription medical products: insulin, the asthma drug
albuterol, and Epipens, the devices for administering allergy
medications in emergencies.
The team was particularly worried about the ads for the potentially
life-saving insulin. "There is no way to know what you are
purchasing, the potency of it or whether it's been contaminated,"
Goldstein said.
There are also concerns about how the drug has been stored and the
conditions under which it will be shipped, Goldstein said. "Insulin
is very sensitive to extremes in temperature," she added.
Goldstein's team searched all the cities in each state listed on
Craigslist between June 12 and June 24. They found no ads for
Epipens, 105 ads for albuterol and 327 ads for insulin.
Surprisingly, the advertised price for albuterol inhalers was nearly
twice the retail price. In contrast, the average price for analog
insulin was about a tenth of the retail price, $30.24 versus
$372.30.
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Some sellers said they didn't want to waste the medications for
which they had no use, some said they were selling because they
needed the money for co-pays on newer medications, some said they
were selling because they had recently changed medications.
For those who cannot afford the insulin they've been prescribed,
there is an over-the-counter insulin that can be purchased at
Walmart for about $25 a vial, Goldstein said. But patients would
need to speak with their doctors because it doesn't act in exactly
the same way as the prescription products, she said.
Goldstein knows the effects of high priced insulin on patients. "I
have taken care of many patients who came into the hospital in
diabetic crisis because they could not afford their insulin," she
said.
It's a shame patients feel they need to resort to this kind of
measure, said Dr. Albert Wu, an internist and professor of health
policy and management at the Johns Hopkins Bloomberg School of
Public Health.
"Patients need medications like insulin to survive, but these
medications, which were easily available in the past, have become
unaffordable," Wu said in an email. "So now, desperate patients are
seeking medications in online marketplaces that are unregulated and
unmonitored."
"This study reflects the disgraceful situation patients are in
today," Wu said.
SOURCE: http://bit.ly/2WsOgXZ JAMA Internal Medicine, online
February 17, 2020.
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