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Legislative Commission Examines Intersection of COVID-19, Diabetes

Reports calls for legislative action to address financial barriers to treatment

October 13, 2021

Individuals with diabetes have been among the most critically affected by the COVID-19 pandemic, due both to their increased risk of developing more severe cases of COVID-19 and financial challenges that have increased barriers to treatment.

That was one of the key takeaways from a report recently issued by the General Assembly’s Joint State Government Commission. This latest report is the fifth the commission has produced in response to a 2014 directive from lawmakers to study the public health and financial ramifications of diabetes and make recommendations to inform Pennsylvania’s response. More than 1 million Pennsylvanians—about one in 13—are diabetic.

The commission found that not only are people with diabetes at much greater risk of death or severe complications from COVID-19, they are also more likely to experience financial challenges that complicate access to treatment and, in turn, compound their health risks.

The report cited research demonstrating that:

  • Working from home is not an option for half of working people with diabetes. Of those required to perform in-person work, 90 percent often or sometimes work within six feet of others and only 70 percent work in settings where masking is required
  • During June 2020, the unemployment rate among people with diabetes was 18 percent, compared with the national rate of 12 percent
  • 33 percent of working people with diabetes lost some or all income as a result of the pandemic, forcing them to turn to savings, loans, and stimulus money to pay for medical expenses
  • A quarter of people with diabetes have turned to self-rationing supplies, including insulin, to cut the cost of care

Even outside of the added financial pressures of the pandemic, diabetes is among the most expensive diseases. A 2017 study by the American Diabetes Association found that people diagnosed with diabetes incur, on average, $16,750 in medical expenditures per year, more than double what their medical expenses would be without diabetes. That same study pegged the total cost of insulin and other medications to control blood glucose at $31 billion, a 45 percent jump over the previous five years after adjusting for inflation. Out-of-pocket insulin costs can be hundreds of dollars per month for many patients.

The commission’s report notes that diabetes in Pennsylvania has largely followed national trends. The commission cited research forecasting that the number of U.S. adults diagnosed with diabetes could nearly triple between 2014 and 2060 and that the future burden on public health and the economy will only increase without additional intervention.

To address this challenge, the commission offered several recommendations to the General Assembly. That recommended legislative action includes:

  • Banning non-medical switching of patient medications by insurance plans
  • Mandating that health plans significantly limit step therapy regulations for patients with diabetes and other chronic illnesses
  • Capping patients’ out-of-pocket payments for insulin and other essential diabetes medications
  • Mandating that health care plans treat insulin and essential equipment necessary for diabetes maintenance as preventive coverage so that it would require no copay

The report also includes recommendations for health care providers related to screening, early intervention, and treatment of diabetes; encourages routine evaluation of public programs related to diabetes and obesity prevention programs to ensure their effectiveness; and calls for greater education and prevention efforts that target high risk communities as well as racial and gender disparities in diabetes cases.

Read the full report here.

HAP participates in the Pennsylvania Diabetes Action Network, which represents patient and professional organizations in a unified effort to change the way diabetes is viewed and treated in Pennsylvania. For more information, contact Robert Shipp III, PhD, BSN, RN, NEA-BC, HAP’s vice president, population health and clinical affairs.