During a two-week period, researchers turned up 327 ads from private parties selling insulin at a fraction of the retail price, according to a report in JAMA Internal Medicine.
“The take home message from this study is that patients (with diabetes) should not have to go to Craigslist to find affordable insulin,” said coauthor, Dr. Jennifer Goldstein of ChristianaCare Hospitalist Partners in Newark, Delaware and The Value Institute at Christiana Care. “We have a duty to provide more viable options. There has to be a better way than patients going out on their own and seeking out potentially harmful products.”
The idea for the study was sparked by a newspaper story about a person who purchased insulin on Craigslist, Goldstein said. “I couldn’t believe it and started looking into it on my own,” she added. “I was surprised at the number of ads I found. I wanted to provide a snapshot of what was going on. It’s alarming.”
Craigslist did not respond to a request for comment, but prescription medications are on the site’s list of prohibited items.
Goldstein and colleagues scoured Craigslist ads in June 2019 looking for three prescription medical products: insulin, the asthma drug albuterol, and Epipens, the devices for administering allergy medications in emergencies.
The team was particularly worried about the ads for the potentially life-saving insulin. “There is no way to know what you are purchasing, the potency of it or whether it’s been contaminated,” Goldstein said.
There are also concerns about how the drug has been stored and the conditions under which it will be shipped, Goldstein said. “Insulin is very sensitive to extremes in temperature,” she added.
Goldstein’s team searched all the cities in each state listed on Craigslist between June 12 and June 24. They found no ads for Epipens, 105 ads for albuterol and 327 ads for insulin. Surprisingly, the advertised price for albuterol inhalers was nearly twice the retail price. In contrast, the average price for analog insulin was about a tenth of the retail price, $30.24 versus $372.30.
Some sellers said they didn’t want to waste the medications for which they had no use, some said they were selling because they needed the money for co-pays on newer medications, some said they were selling because they had recently changed medications.
For those who cannot afford the insulin they’ve been prescribed, there is an over-the-counter insulin that can be purchased at Walmart for about $25 a vial, Goldstein said. But patients would need to speak with their doctors because it doesn’t act in exactly the same way as the prescription products, she said.
Goldstein knows the effects of high priced insulin on patients. “I have taken care of many patients who came into the hospital in diabetic crisis because they could not afford their insulin,” she said.
It’s a shame patients feel they need to resort to this kind of measure, said Dr. Albert Wu, an internist and professor of health policy and management at the Johns Hopkins Bloomberg School of Public Health.
“Patients need medications like insulin to survive, but these medications, which were easily available in the past, have become unaffordable,” Wu said in an email. “So now, desperate patients are seeking medications in online marketplaces that are unregulated and unmonitored.”
“This study reflects the disgraceful situation patients are in today,” Wu said.
SOURCE: bit.ly/2WsOgXZ JAMA Internal Medicine, online February 17, 2020.