Rx straddles the ledge

Rx straddles the ledge

of the countertop

His hand shakes as he reaches

Rx drops

He screams

as the glass splinters

all over the floor

and into his foot

the droplets of life

now mingled in with the dirt

from inside and out

holes punched in the wall

of the kitchen

where he can no longer feed

without those tiny droplets.

What good is the dirt?

 

 
For a life that is so fragile

soft and precarious

so dependent on these molecules

and conversations

and circumstances,

it sure as heck

feels weathered

and hard.

 

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No Rules Poetry

What would have been?

Wonder

What would have been?

if the right provider

had asked the right questions

and I’d replied honestly

all those years ago.

 
“Why is your blood sugar chaotic?”

“Because life is chaotic…”

Firm, and to the point

the question and the answer.

And the response?

 
Or if the nurse /

who connected me to the doctor /

who helps me to stay afloat now /

had been my nurse then /

and she’d been my doctor.

 

What would have been

What is

What will be

Still swimming

 

 

No Rules Poetry

Docto Interview

Many thanks to Docto for our fun interview, which can be found here.  I enjoyed learning more about the Docto app, which uses algorithms to predict blood glucose levels an hour in advance (docto.me)!  I believe there is great potential with this app not only in terms of physical health outcomes, but also in easing the emotional concerns that go hand-in-hand with diabetes.

Having detailed knowledge as to where my blood sugar might be headed an hour from now would allow me to make more informed insulin dosing decisions.  It would also mitigate my anxiety in that the unknown, sometimes-scary diabetes stuff will become known before it even happens.  Docto literally makes the unpredictable more predictable, which is music to my ears from a holistic diabetes management perspective.

Docto did not ask me to write this blog post, but I want to say it:  I am impressed with Docto’s dedication to making diabetes management better for our community, as well as their genuine interest in learning more about the diabetes experience from those who live it firsthand.  Our interview renewed my hope that the diabetes burden will become lighter for all of us in the future thanks to healthcare innovation and teams like Docto.  I encourage readers to visit docto.me to learn more.

April Showers Bring…

Writer’s block.

I’m currently reading four books at once and composing just as many blog posts in my head.  My golden rule of blogging is when the words flow, ride that wave.  But if writing ever feels forced, it is time to take a step back and regroup.

Owning the occasional frustrations of the writing process can be just as important as what is eventually said.  The right words will come along.  They always do.  Isn’t that why God created coffee?!

Here’s a photo of a cute Guinea pig to tide us over until May.

Ah-Ha!

Video of our 2016 Stanford Medicine X panel, Ah-Ha! moments in mental health and chronic disease management, can be viewed here.  The panel speaks for itself; it was brave to participate; it was brave to be a member of the live audience- at Stanford and/or online; it is brave to watch the video; it is brave to reflect on mental health and chronic disease management.

Many thanks to Charlie, Danielle, Sarah, Mark, and so many others in the MedX family for making our 2016 panel such an empowering and enlightening experience for so many.

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Photo credit: Stanford MedX Flickr

 

Featured image photo credit: Mark Freeman

Coffee Date # 3: Lilly Diabetes Takes The Mic

Julie Herrick Williams, Communications Manager at Lilly Diabetes, joins VLNS as the third Coffee Dates guest.  When I requested diabetes industry/pharmaceutical entities to discuss insulin here, two people rose to the occasion- to my pleasant surprise.  Thank you to Mike Hoskins for encouraging this interview, and to Julie and Lilly Diabetes for your candid participation.  Without further ado, let’s pass the mic to Julie.

 

A:  Insulin access and affordability are currently hot topics in mainstream media coverage, as well as diabetes social media conversations. Manufacturing, research and development (R&D), and marketing in pharmaceuticals are all complex. Can you explain how these -or other- factors tie into the pricing of Lilly Diabetes’ insulin?

J:  Many factors go into the list price of Lilly insulin, and that’s true for all of our medicines. Developing and manufacturing insulin actually is very expensive and scientifically precise, so only a few companies invest in it. Billions of dollars in costs (from R&D to technology to capital) and expert scientific and technical know-how are required. Lilly has built state-of-the-art insulin manufacturing facilities around the globe—and, in 2013, we decided to invest another $1 billion to ensure our facilities efficiently meet increasing needs for insulin as the prevalence of diabetes grows. We’re committed to meeting patients’ needs with the highest standards for quality and safety—and to addressing affordability issues for people taking insulin.

 

A:  Insurance plans and pharmacy benefit managers (PBMs) also impact what the consumer pays for insulin. Lilly recently coordinated with Blink Health to make insulin more affordable and accessible for some people with diabetes. Please tell us how this program works and who may be eligible. 

J:  We’re working hard to address concerns about the cost of insulin. On January 1, 2017, Lilly introduced a new insulin discount program. In partnership with Express Scripts and using Blink Health platforms, we’re offering a discount of up to 40 percent off most Lilly insulins for people who pay full retail price at the pharmacy (those without insurance or in high-deductible health plans). For more details, see blinkhealth.com and the attached patient brochure.  Since this is a discount program, not insurance, people should check their insurance before making a purchase through Blink Health.

 

Source: Lilly Diabetes

 

A:  I inquired of a fellow healthcare advocate which question she would ask if given the opportunity to have you answer it here. Her reply: “My main question: ‘Why?’.” [To paraphrase: Putting aside the R&D or insurance influences for a moment, why raise the price on a product that keeps us alive by hundreds of percentages over time?]

J:  It’s important to note that the price people pay at the pharmacy is the result of many different factors, most notably their insurance benefit design. While list prices for insulin have gone up, Lilly’s average net realized price for Humalog (the amount we receive after rebates and fees are paid) has been flat since 2009. A big reason is that we pay rebates and fees to PBMs and health plans to keep our insulins available on formularies. Unfortunately, people with high-deductible insurance plans do not benefit from these rebates; instead, at the pharmacy, they’re forced to pay list price, or “sticker price.” We’re working with others across the healthcare system to ensure that insulin is affordable for all who need it; our discount program is just the first step.

 

A:  What about the healthcare advocates who will say that more can be done, that perhaps we should not need a discount program to begin with if insulin could be more reasonably priced from the get-go? Are there any ideas in the pipeline to make this more of a reality?

J:   While our offer of discounted insulins through the Blink Health platform was an important first step, we know that we must do more. We need a broad-based, long-term solution. Through conversations with stakeholders—from payers and employers to patients and advocates—we’re seeking a multi-pronged approach where we assess and improve health insurance design, out-of-pocket costs, rebate streams and transparency in drug pricing. We want to be part of the solution—to improve care, increase efficiencies, and lower costs.

 

A:  Previous Coffee Dates have discussed what the term ‘transparency’ embodies for those who rely on insulin to live. What does transparency mean from the Pharma perspective? What improvements can be made to ensure all sides of the healthcare equation are well-informed and able to access resources for optimal health?

 J:  Over our 140–year history, Lilly has strived to enhance the public trust of our company and industry by being forthright and ethical in the conduct of our business. For instance, we believe our process of openly reporting financial interactions with healthcare providers builds trust and confidence with those providers, as well as with patients and caregivers. Yet, we realize more can be done to respond to society’s fast-changing expectations, so we are constantly working to improve. (By the way, participating in this blog chat is just one way that we like to be transparent!).

 

A:  Will biologics and biosimilars help to drive down insulin costs in the future? What are the options if the element of consumer choice in treatment is affected by insurance coverage of certain products?

 J:  The launch of Basaglar in 2016 as the first follow-on insulin did, indeed, introduce additional competition into the basal insulin marketplace. Fortunately, that should reduce some healthcare costs. But most of those healthcare savings are realized on the net cost level to PBMs, health plans and others. What a person pays for insulin at the pharmacy is the result of many factors—most notably, their insurance benefit design.

While we are strong advocates for treatment choice, we recognize that healthcare providers and insurance plans ultimately select the treatment options for people. Consumers will need to talk to individual insurance companies or pharmacy benefit managers about their list of covered medicines.

 

A:  Does Lilly have charitable programs for those who need insulin outside of the U.S.? Where can readers go to learn more about these options?

 J:  Yes, we are deeply committed to the International Diabetes Federation’s ‘Life for a Child’ program in developing countries. The program provides insulin and syringes, blood glucose monitoring equipment, clinical care, HbA1c testing, diabetes education, and technical support for health professionals. Over the past decade, Lilly has donated more than 1 million vials of insulin through this program, helping thousands of children access the care they need. To learn more about ‘Life for a Child,’ email lifeforachild@idf.org or click here: http://www.idf.org/lifeforachild/contact. And, the Lilly Cares Foundation’s Patient Assistance Program provides medicines at no cost to qualifying U.S. patients. To learn more, please go to www.lillycares.com.

 

A:  Finally, inquiring minds want to know: What is Ryan Reed’s lucky coffee order on race day?

J:  It’s pretty simple: he likes regular coffee – black!