“Sunflowers make me happy. You need something happy when you’re dealing with this disease,” she said while counting out pills from five bottles meant for her Type 2 diabetes. Keenya Taylor, 52, has good time management skills, from when she wakes up at 4 a.m. to when she goes to bed precisely an hour after dinner. Her diabetes doesn’t entertain spontaneity.
Citizens in the United States experiencing a chronic disease such as diabetes face many complications, from obtaining medications and medical devices to navigating insurance companies, pharmacies, and specialists.
The disorganized and confusing healthcare system forces patients to handle their medications independently, schedule doctor’s appointments and copays, call insurance and drug companies, and plan meals down to the last gram of carbohydrates.
The Ongoing Battle
She uses Metformin and Jardiance for her diabetes, Omeprazole for acid reflux, and Lipitor for her cholesterol. Taylor individually separates each pill and swallows them. She takes a pre-filled syringe of Ozempic from the top shelf of her refrigerator door. On Wednesdays, she injects a 2-milligram dose of the medication with the highlighter-sized device.
The metformin, omeprazole, and cholesterol medication are roughly $2,000 out-of-pocket for a 90-day supply. Only the Ozempic, a brand name for the generic diabetes and weight-loss drug semaglutide, is approximately $3,000 for a 90-day supply, while the Jardiance costs $2,100.
Furthermore, at night, she takes nightly insulin, costing $500 for three months. During the day, she depends on her regular glucose monitor to get updates to her phone. The patch device runs at roughly $90 for two 14-day sensors.
“It’s a constant battle,” Taylor said. “It takes time… you have to do so much leg work.”
In some challenging times, Taylor consults medical device and drug companies for discount cards and coupons. She also requests samples from her doctors, which works for medications like metformin and omeprazole, but recently, it’s been harder to purchase Ozempic.
The Diabetes Dilemma
The American Diabetes Association recently noted that the overall expenses of diabetes in the United States have increased from $245 billion in 2012 to $327 billion in 2017. Ozempic, which increased those costs, was initially licensed for sale in 2017.
Ozempic is scarce despite a prescription and adequate coverage. The high demand for it and its sister weight-loss drug, Wegovy, has led to a consistent shortage. Taylor discovered that her sugars increase when she doesn’t use the medicine for a month or two despite maintaining her regimented diet and active lifestyle.
“I don’t have $2,500 sitting in my bank account to pay for pens,” she said. “I’m sure if my life depended on it, if I was going to die tomorrow, you’d find the money. But most people don’t have that just sitting to pay for medication.”
The Physician Shortage Challenge
“You’ll find an endocrinologist, and then they would move and leave and settle practice somewhere else, or they would no longer be in the healthcare system my insurance was in,” Taylor said.
Research found that delays in care may increase the risk of disease and mortality among patients with underlying, preventable, and treatable conditions. A 2021 study discovered that half of diabetes-related lower leg amputations could have been avoided with proper medical care. However, experts claim few specialists are available to meet the growing demand, and others blame the worsening physician shortage.
“There are shortages everywhere,” Wachter said. “Physician burnout rates are very high. Patients are feeling that. Doctors are being asked to do more and more in less time.”
The American Medical Association classifies physician burnout as an epidemic in the U.S. healthcare system, with approximately 63% of physicians indicating signs of burnout, like emotional exhaustion and depersonalization, at least once weekly.
Patients unable to receive timely care from specialists resort to their primary care providers for help. However, Rao said the brunt of care depends on patients’ capacity to self-manage between appointments, which are usually few and far between.
“A lot of that burden we’re putting on patients,” he said. “Patients have to take a huge responsibility in managing their health. That can be overwhelming for patients.”
The healthcare system’s disorganized nature, as well as rising costs and physician shortages, makes living with Type 2 diabetes in the United States challenging. Keenya’s experience shows the immediate need for a more patient-centered approach to chronic disease management, streamlining healthcare processes, and ensuring affordable access to vital medications. Until then, people like Keenya Taylor will struggle to lead fulfilling lives and cope with their chronic conditions.
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