August 30, 2018

The Type 2 Medical Device that makes the Biggest Difference for Me - a Bicycle.

Two wheels, pedals, and spandex.  I know that the last thought is not a pretty image. - Sorry.

Biking helps with blood sugars (unless I have a massive Reese Cup craving after a long ride.) Time on the bike helps transfer weight from my gut to my leg muscles and maybe also shed a few pounds off.  I find a calm, meditative state when I ride. Particularly in a group ride where I don't need to think about navigation. Some folks get that in yoga, for me it kicks in around mile three of a long spin.

But even though I love biking, at times, I just don't want to go out. Last week I had 100 miles in five days. This week - zero. It is too hot, I told myself. The sofa is too comfy, whatever. It is super easy to swap being active for the shadow of being active.

I need some help keep at it. Peer pressure can be that nudge. I find knowing that my friends are out running or biking makes me feel I should 'keep up.' Strava.com, an activity tracking site helps me stay motivated.

I was invited to Stava years ago by a friend (thanks Adam) who is much younger, more fit than I am, and thinks about motivation more than I do (follow that link.) I was afraid Strava would put me in competition with him. That is something that I couldn't win. So it took me a while to join.

Turns out, we didn't complete we just gave each other 'attaboys. Who doesn't like a pat on the back?

Being part of a real-world group helps too. I don't socialize a lot on rides (see meditative above), but there is a comradery to groups, an implicit I'll show up and ride with you if you show up to ride with me. I have had rides where my ability/will to keep going broke. I hit the wall. Friends slowed down and helped me back. I have paid that forward for others.

Today Strava and real-world are colliding. I passed on riding on Tuesday. It was crazy hot. But there, on Strava, I see my friends showed up to ride anyway. That is enough to guilt me into a ride in the crazy hot tonight.

Thankfully, I have friends that help pull me back when I feel an excuse to not exercise. My type 2 device doesn't make a difference if I don't use it.


August 2, 2018

Call Lilly for Help with Insulin

The market for medicine in the United States is nuts. It is not always easy for patients to find the options that may help.

Navigating the process for Lilly insulin users is now easier with a newly opened helpline. They say:
Starting August 1, a new dedicated helpline called the Lilly Diabetes Solution Center will assist people who need help paying for their insulin – such as those with lower incomes, the uninsured, and people in the deductible phase of their high deductible insurance plans, Eli Lilly and Company (NYSE: LLY) announced today. A customized suite of solutions for all Lilly insulins, including for Humalog® (insulin lispro), will be used by helpline operators to find answers that best fit the personal circumstances of patients.*
Nothing in diabetes is perfect. Hopefully, this is one step towards better form many.  Better is Better.



*More at https://investor.lilly.com/news-releases/news-release-details/new-lilly-diabetes-helpline-assist-people-seeking-solutions

April 24, 2018

Drug Prices Should Piss People Off, Maybe Not For The Obvious Reason


Drugs are expensive. Like death and taxes, drug list price increases seem inevitable. There is lots of room for justifiable ire.

I think maybe that anger gets aimed at the wrong target. We all feel we understand prices. We go to the store, see an amount for a product on the shelf and choose to buy or not. If the price goes up, we pay more. Sometimes we fill out a form and get a rebate that limits that price increase. But rebates typically are a pain in the ass, and most folks don't factor them in.

But the list price of drugs on the shelf is misleading. In part because few see it. For most, we make a copay and don't know what the actual price our insurance policy paid for the meds.

HUGE rebates are happening, and nobody sees it. How huge? More than $150 billion. Yeah with a "B." So the drug prices keep going up but so do the rebates to the invisible parts of the drug payment system.

In some cases the rebates more than equal the price increases. What that means is that the drug company nets less income even while they raise the price. Where does the money go? Rebates.

Remember back when nobody bought a car without a rebate? It is like that - on steroids. Plans do not buy drugs without rebates.

Those rebates may get back to the insurance plan and in theory, reduce premiums. But that is not true in all cases, and there is no way to know.

So be pissed that $150 billion in drug rebates seems to sift through the cracks of insurance coverage and we the insured patients may or may not get the benefit of that sifting.

What can be done?

Maybe the first thing to do is to start to understand that rebates exist and be pissed that $150 billion is getting shuffled around with nothing approaching transparency. Our anger at drug prices should be focused on this rebate scheme.

What is a good policy solution? Applying rebates at the point of sale for all plan members, whether or not they have met their deductible.

For the uninsured require the average rebate that drug pays insurers to be applied to the uninsured too.

Want to learn more?
This post at Drug Channels.