A Shock at the Pharmacy Counter

In 2017 Robin, a therapist from Missouri, fell very ill to the point where she could not even stand, so her husband took her to the ER. There, they informed her she had ketoacidosis, specifically a life-threatening form of diabetic ketoacidosis (DKA) and that she only had one day to live without treatment. The doctors asked her, “How long have you been a diabetic?” To which she replied, “I’m not.” Next thing they said was, “You are now.”

After processing the shock of her diagnosis and fighting for days in the hospital to stay alive, Robin began to learn how to treat her diabetes. At this time, she was on private insurance and found the cost of her insulin to be manageable. However, a couple of years later, when Robin switched over to Medicare, everything changed.

On her next trip to the pharmacy counter, she met with her pharmacist, a provider she has known for years, and they asked her if she knew the cost of insulin on Medicare. To her disbelief, the cost of her insulin was going to be $1,000 a month, for the rest of her life, a drastic difference from the $25 a month she was paying utilizing a manufacturer coupon and private insurance.

Only working part time, and her husband retired, Robin broke down, not seeing a way to get through this and stay out of debt. She considered the sacrifices they would have to make, trips to see her daughter, to see her grandchildren, and was burdened with guilt that her illness was the root cause of this heartbreak.

Robin and her husband were only just getting by, covering Robin’s monthly insulin until 2023, after the Biden-Harris administration signed the Inflation Reduction Act into law and the first implementation of the $35 monthly cap on insulin went into effect. Robin went from spending $2,000 a month to $70 a month, life-changing savings.

Robin’s message to other Medicare patients is rooted in encouraging them to take advantage of the $35 insulin. She says, “I hope that you do, and I hope that you’re grateful that you can stay alive and keep going and enjoying your life, your grandkids, if you have them, whatever you’re doing. Enjoy your life now.”