Why Diabetic Cats Need Extra Care When Youre Away
Sick pets require additional mental and physical care than your average pet.
Our best buddies are sentient, feeling beings they thrive on routine and the security of familiar surroundings and family members.
So keep your diabetic cats routine as stable as possible while youre away. Besides their medical conditions, these pets may have anxiety disorders. Any changes in routine can cause them dangerous stress.
Ways To Save On Insulin
Its difficult to predict where drug prices will be in the future, but if you take insulin, we hope our analysis gives you some ideas for how to talk to your provider about affordable options. Here are more ways you can save:
1) Use a manufacturer savings card or patient assistance program. Major insulin manufacturers Eli Lilly, Novo Nordisk, Sanofi-Aventis, and MannKind offer copay cards and patient assistance programs for patients with and without insurance coverage. In many cases, these programs can reduce out-of-pocket costs to as little as $0 per month. For more information, just search for your drug on goodrx.com, and click on Savings Tips for details.
2) Shop around. GoodRx offers discounts on insulin drugs, which can save you as much as 50% off the full retail price. At goodrx.com, you can also compare insulin prices at different pharmacies in your area and find information about discount programs at specific pharmacies.
3) Appeal your coverage. If you have insurance and your plan doesnt cover the insulin you need, ask your doctor about submitting an appeal. Your insurance company may require a prior authorization or step therapy before you can fill your prescription, but its worth trying if you want to get your insulin covered.
Co-contributors:Diane Li, Hannah McQueen, Swetha Pola
Methodology
A note about insulin use
Is It Ok For Me To Skip Insulin Doses
With the rise in insulin prices, the financial cost of diabetes is perhaps more serious now than ever before. While skipping insulin may seem like an immediate solution, rationing doses is not a proper nor medically advisable technique for diabetes management. In fact, skipping doses can lead to more serious diabetes-related health issues, such as diabetes ketoacidosis, costing the consumer more out of pocket in the long run.
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Why Is Insulin Cheaper In Canada
In Canada, The Patented Medicine Prices Review Board ensures the price of patented medicine sold in Canada are affordable. However, it doesnt have control over mark-ups by retailers and also doesnt regulation the price of generic drugs.
The United States has no regulations over pharmaceutical pricing which is why you have insulin prices that end up costing patients 2-6 times more than Canada.
Cost Of Insulin For Cats
An avid Petful reader wrote in to tell us she couldnt find Lantus for under $285 a bottle for her diabetic kitty.
She was correct. In the course of a few short years, the cost of Lantus more than tripled!
It is very expensive and very crazy, this reader told us. We agree.
Unfortunately, youre at the mercy of greedy Big Pharma when it comes to filling human scripts, such as insulin, for your pets.
Your vet may go to another insulin, PZI , when Lantus has not worked. Unfortunately, these other, less expensive insulins dont seem to work as well in cats.
Here are some simple facts about the cost of treating cat with diabetes today:
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Other Costs When You First Get A Diabetic Cat
Think of the cost in 2 phases:
Immediately after diagnosis, ask your vet for 2 estimates for stabilization and for ongoing costs so you understand the financial implications.
What Is The Monthly Cost Of Insulin In Canada
People with diabetes have various costs associated with the treatment and maintenance of their health. In this article, we will explore commonly reported costs associated with monthly insulin requirements, overall diabetes maintenance costs, and how small and medium businesses can support employees with diabetes.
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Where Are We Getting Our Prices
As stated, our Canadian drug pricing tool isnt ready for prime time just yet. But we found this story to be so compelling that we opted to publish this part of the story now. So we went to direct sources to pull prices in Canada and the U.S. to manually assemble the comparison. Specifically, we utilized the Formulary Search for the Ontario Drug Benefit Formulary in Canada and the Drug Look Up Tool for our home state of Ohios Medicaid program. Ontario is one of thirteen provinces in Canada, but was selected because of this handy, interactive tool where a brand or generic name can be entered and the drug ingredient cost price in Canadian dollars can be determined. For example, if you enter in Eliquis into the search tool for Ontario and click brand youll get the following results :
Figure 1
Regardless of strength, youll spend $1.63 CAD per pill for Eliquis in Canada. Or the equivalent of $1.28 USD . And if this look-up tool is too hard to use, another province, Nova Scotia, has a formulary which can be downloaded in Excel here.
Enter the same thing into the Ohio Medicaid tool and youll get the following :
Figure 2
Of course, the Ohio Department of Medicaid and other private employers may get rebates on Eliquis after the fact, but before dismissing these numbers because the above U.S. price is pre-rebate, go ahead and divide the above numbers Eliquis in Ontario is 83% cheaper than its list price in the U.S.
Its Relatively Easy To Find A Pet Sitter Friend Or Kennel To Give Injections When Youre Away
If youre used to leaving your cat for long weekends with a big bowl of food and a see you later, your life is going to have to change.
If your cat needs insulin injections, youll need to find a reliable pet sitter familiar with diabetics, a family member or a pleasant boarding situation.
If you travel constantly, caring for a diabetic cat will not be easy. But for most of us with average home/work situations, being home morning and night for 2 kitty meals and 2 injections shouldnt be that difficult.
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Factors That Impact The Price Of Insulin
How much is insulin in Canada annually? It can be through the roof when you consider that some people with diabetes go through several insulin vials per week. The cost of insulin in Canada can be high for those without private insurance and eats up a considerable part of a typical household budget. Many Canadians will pay close to $7,000 annually for insulin.
Those with Type 2 diabetes will generally pay more. The insulin cost in Canada is too much for some people, and they opt to skip doses of their insulin rather than pay massive out of pocket fees. This practice is dangerous both for individuals and the Canadian healthcare system.
Although insulin itself is far more sophisticated than ever, many people with advanced diabetes find that they need more and more insulin just to feel okay. While some people with diabetes only need three doses a week, severe cases require close to ten. These people are often the ones who have problems when the price rises.
Something Has To Give
Think about it this way, drug manufacturers are supposedly interested in offering their best price when they are the only option in a competitive therapeutic category . This is because when they are the only product out of many options, they know that they have secured for themselves the largest market share for that category and thus are willing to give the lowest price point to the payer. In general, rebate offers get worse, or a higher net price for the payer is realized, when manufacturers are offering rebates as a one-of-two, or one-of-three preferred products in a category. And this supposedly makes sense because the manufacturer will not secure as much market share for their product when there are more therapeutic options being covered.
With that in mind, what justification would explain what we observe in Canada? Why wouldnt Eliquis or Pradaxa forgo participating in the Ontario market? And why instead of forgoing participation are they lowering their net price to the same level as Xarelto? Said differently, why are they willing to offer a price 80% cheaper in Canada, despite being in a competitive therapeutic category with other brand, and not in an exclusive one-of-one position? And since the manufacturers are willing to lower their price to compete in Canada, shouldnt these same market forces exist in the U.S.?
To be clear, we do not know, but the math doesnt add up. And we know math.
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New Product Features Can Come With A High Price Tag
Xultophy and Soliqua both contain a long-acting insulin and another non-insulin diabetes medication. Xultophy is a combination of insulin degludec plus liraglutide , and Soliqua is a mix of insulin glargine plus lixisenatide . Average retail prices for Soliqua and Xultophy are more than double the price of cheaper alternatives like Basaglar and Tresiba, which have the same exact insulin ingredient.
Approved in June 2020, Lyumjev contains insulin lispro, the same insulin in Humalog, and some additional ingredients. In studies, Lyumjev was found to start lowering blood glucose sooner than Humalog, though this doesnt necessarily make Lyumjev more effective than Humalog or generic insulin lispro at lowering blood sugar. At present, per insulin unit prices for Lyumjev are about double that of generic insulin lispro.
Fiasp contains insulin aspart, the same insulin in Novolog, but it also has vitamin B3. Like Lyumjev, Fiasps added ingredient may speed up insulin absorption. Interestingly, the retail prices for Fiasp and Novolog are about the same on a per insulin unit basis.
Then theres Tresiba, an ultra-long-acting insulin that stays active for up to 42 hours. For this unique property, its average retail price is about $630 for a carton of 5 KwikPens .
Insulin Injections For Cats With Diabetes Are Actually Not Complicated
Injections are not that difficult to give, even when cat, Mr. Mug, is acting like Mr. Angrypants.
Stick the furry face in some food and pop in the tiny amount of insulin, and its over. Pilling a cat is probably much more difficult on a daily basis than giving an injection.
Your vet and staff should give you all the help you need when learning how to give insulin to your cat.
Theres lots of debate about which insulin works best in cats. Each vet has their favorite, and if your cat doesnt do well, they will switch to a different option. Be prepared for some trial and error.
For information about the cost of insulin for cats, see Part 2 of this article below.
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Factors That Influence The Cost Of Insulin
Between 2001 and 2018, the average list price of insulin increased 11% annually. This equates to average annual per capita insulin costs nearing $6000. Since a patient’s out-of-pocket costs are based on the list price, consumers have undoubtedly felt the burden of these price increases.
Diabetes patients’ need for insulin to survive is indisputably one of the largest determinants of insulin cost. Insulin and insulin analogs are the only drugs able to save the lives of diabetes patients therefore, consumers’ need for these drugs to stay alive gives way to high pricing for profits. In other words, since diabetic patients have no other options, they have no other choice but to pay the price that the stakeholders set.
The three primary factors in the pricing of insulin vials are as follows:
Buying Insulin In Canada Without A Prescription
by Lucia Mueller, VP, PharmacyChecker.com | Sep 1, 2017 | Drug Importation |
With insulin prices skyrocketing, no wonder the diabetic community is taking to social media to network and share their experiences as they swap tips and tricks not only for moral support, but also financial.
This month, we received an interesting consumer comment via our asking if we knew that Americans are driving to Canada to buy insulin without a prescription. Well, no. As our primary focus is mail-order pharmacy, it wasnt on our radar. Nevertheless, it sparked our interest and wed like to share our findings with the PharmacyChecker community.
There are some important nuances about insulin sales in Canada that might interest you. To start, insulin is not on the Health Canada Prescription Drug List. Health Canadathe regulatory agency in Canada that is comparable to the FDA in the United Stateslists insulin as a Schedule II drug. The word schedule in the U.S. is used to identify those medications associated with greater potential for addiction, such as Ambien or Vicodin and other controlled substnaces. The lexicon is confusingly different in Canada and important to explain here! In Canada, Schedule II drugs, while not as strictly regulated, do still require professional intervention from the pharmacist at the point of sale and possibly a referral to a practitioner. Click here for the drug schedules regulations in British Columbia.
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Breaking Down The Cost Of Canine Diabetes Treatment
- Diagnosis
There are various signs that would make a veterinarian suspect diabetes. These include increased thirst and urination, appetite changes, muscle wasting, and cataracts.
First, the veterinarian will do a full physical exam which costs $50 to $80. The vet will look at the eyes to check for any damage from diabetes.
The most cost-effective way to confirm diabetes is a urine glucose test. This costs $5 to $20 but will give you little information about your dogs health beyond a diabetes diagnosis.
A urine test can only find more severe diabetes. Blood chemistry, CBC, and urinalysis are the recommended tests for a diagnosis.
These tests will reveal how diabetes has affected your dog and if there are any other issues occurring. The cost is roughly $175 to $250.
- Insulin
In dogs, diabetes is always a deficiency of insulin production in the pancreas. This insulin will need to be replaced with injections every 12 hours.
The amount of insulin required is different for every dog. Even the same dog can require different amounts of insulin over time.
For a 10-pound dog, a 10 ml vial of Vetsulin will last 20-40 days. For an 80-pound, a 10 ml vial will last 5-20 days.
Brands of insulin sold for humans are 2.5 times more concentrated. This means that a 10 ml vial will last 2.5 times as long.
However, insulin expires 30-40 days after it is opened. Generally, the cost of insulin for dogs will range from $40 to $80 per month for small dogs and $80 to $150 per month for large ones.
More Voices On Healthcare:
But her relief soon turned to aggravation. Even if she had flown from her home in Philadelphia, buying insulin across the border would have saved her money.
“I was angry that I had to go to Mexico in the first place to get a drug that keeps me alive. I live right next to a , yet had to travel 3,000 miles to another country to get affordable insulin.”
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Ways Canadians Can Offset Insulin Costs
Since the price of insulin in Canada is relatively steep, many Canadians with diabetes are looking for ways to offset their insulin costs without damaging their health.
Traditional health insurance can cover some prescriptions, but many Canadians find that its not enough. Often, they turn to other creative avenues for getting money, like GoFund me accounts or fundraisers.
One somewhat effective way to offset the insulin price in Canada is to open a Health Spending Account, or HSA. Theres no need to pay any premiums upfront, and patients can write off all their costs.
Its like a separate tax-free bank account strictly for insulin costs.
Is It Legal To Buy Insulin From Canadian Pharmacies
The question of whether it is legal to buy insulin from Canada if you are a U.S. citizen is rather dubious:
- On the one hand, the U.S. Food and Drug Administration watches out for purchasing medications from Canada
- On the other hand, however, it is legal for Canadian pharmacies to deliver medications to the U.S.
Moreover, this technically illegal option to buy medications from Canada has been decriminalized by the following regulation: a person in the U.S. might import a less than a three-month supply of drugs for personal use from Canada.
Therefore, it is legal to get a less than three-month supply of insulin shipped from Canada in case it will be administered for personal use.
Thus, you might order insulin products from a Canadian prescription referral service and, as a result, benefit from reasonable prices.
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The Sitter Should Watch For These Signs Of Trouble
If your diabetic animal will be in a pet sitters or kennels care, make sure the caretakers will call your vet if there is any change in behavior, such as:
- Lethargy
A pet sitter should spend at least 1 hour twice a day in your home.
Just feeding and giving insulin injections is not a sufficient level of monitoring for a diabetic animal:
- Make sure the caretaker knows your cats daily routine and personality.
- The cat must be seen eating, walking around and exhibiting a bright and alert demeanor.
- If your cat is sleeping every time the pet sitter visits and the sitter just refreshes the food and water and gives the required insulin, this cat could be on their way to a diabetic crisis.
Too often, a client tells the vet that the pet sitter couldnt find the cat and left. This is bad in any case, but it could be life-threatening to a diabetic cat.
This may be a tough topic for many of you who love your pet dearly but are also in desperate need of a vacation. Take the time to find a solution that prioritizes your pets health so everyone can have a pleasant time while youre away.