A Historic Moment for Advocacy

I’m usually skeptical of good diabetes news (still waiting on that cure, by the way), but Lilly’s recent announcement on reducing insulin prices is a mind-boggling moment in patient advocacy. Surely, there is still much work to be done for truly equitable insulin access to become a reality for all. Yet, Lilly’s move (later followed by Novo Nordisk and Sanofi) is a step most of us never foresaw without federal regulation forcing pharmaceutical companies’ hands. (Without regulation, notably Pharma companies could raise list prices if they so choose). Understandably, all of this recent news doesn’t bring back what and who our community has lost along the way to this historic moment. As we move forward, we should always remember their stories and how our community got to the here and now.

From an advocacy lens, this moment speaks volumes as to the collective power of online health communities. Too often patients are dismissed by conscious and unconscious biases in healthcare. Yet I am inspired by so many in our community who have never backed down on demanding a better world for all people with diabetes. Their persistence is why insulin is in the spotlight, mentioned often in politics for better or for worse. They undoubtedly moved the dial here, and the world is better because of their relentless determination. Thank you to those of you who led the way. This one goes down in my forever record books of why advocacy is worth it.

We Interrupt This Program…

For a special message:

 

Pharma and industry folks, we invite you to discuss your thoughts on insulin in an upcoming Coffee Dates interview.  Here is your chance to share your point of view.  If interested, please contact me.  

To read more Coffee Dates regarding insulin, please see here and here.

Coffee Date #2: Elizabeth Rowley and T1International

Elizabeth Rowley, Founder and Director of T1International, joins Very Light, No Sugar for the second interview in the Coffee Dates series. I encourage readers to visit the links included by Elizabeth and to help the #Insulin4All movement however you can.

 

A:  What led you to develop T1International?

E:  In short, I recognized how privileged I was to grow up in a place with access to good medical care and the supplies I needed to live a healthy life. I could not – and I still cannot – understand why health is not treated like a human right for everyone around the world.

As I learned more about what people with type 1 diabetes face in all parts of the globe, I wanted to address the problems by working with people most affected. I could not find any other groups tackling the issues through advocacy, so I thought T1International could bring the diabetes community together to ensure that no one dies because they cannot access or afford something as basic as insulin or test strips.

 

A:  T1International’s current campaign of #Insulin4All has been making lots of good noise on social media. What is one simple, immediate way for individuals to help out the cause?

E:  Sign our Access Charter and spread the word. It takes two minutes to sign and shout about this on social media. Signing will not only show that you support five basic rights for all people with diabetes, but it will also add to the growing list of individuals and organisations who support these rights worldwide.

Advocates around the world will use this charter and the signatures as evidence for the growing global support behind the #insulin4all movement. It will allow advocates for type 1 diabetes to prove to the government that there is international support and pressure for sufficient access to insulin, diabetes supplies, care, education and protection for everyone with diabetes.

 

A:  There is a persistent call for transparency in the insulin access and affordability realm. Ideally, what would this transparency look like?

E:  In one sense, transparency would mean that pharmaceutical companies would no longer be allowed to raise or set prices for their products without true justification. The excuse that research and development is the main reason for high prices is not cutting it anymore. Insulin pricing is currently a mystery. Costs vary wildly around the world, and even within a single country. Simply being able to know the cost of production and the true list price that companies set for a drug like insulin would be a huge step forward in transparency.

Transparency is also important when it comes to patient advocacy organisations. It is important for all of us to think about how much potential there is to be influenced or ‘bought’ by industry. A recent USA study found that 67% of a sample of patient advocacy organizations (virtually all of which were not for profit) said that they received funding from for-profit companies. Relationships between patient organisations and industry can influence their actions “in ways that might not align with the interests of the constituencies they represent.” The same article notes evidence that financial relationships can create bias in areas like medical research, so non-profits and patient organisations are subject to the same concerns.  [Susannah L. Rose, PhD; Janelle Highland, MA; Matthew T. Karafa, PhD; et al]

Many diabetes organisations take money from pharmaceutical or device companies specifically. No one wants to compromise their income, but there is concern that orgs taking industry funding are keeping quieter than they would if their funding came from other sources. At the very least, organisations can be more transparent about where their funding comes from by having a clear declarations webpage that is obvious to visitors. We hope groups will consider that continually accepting funding from pharma companies often “creates a routine awareness among sponsored groups that one doesn’t bite the hand that feeds it.”  [Ray Moynihan, PhD; Lisa Bero, PhD]

 

A:  We have discussed the great power of personalizing the insulin story. Give us one brief narrative of how T1International’s work directly influences the life of someone with diabetes.

E:  It is literally the difference between life and death. It is also the difference between feeling alone and knowing you have a community rallying behind you. Salomey and [her] mother in Ghana had to sell most of their belongings to be able to afford Salomey’s insulin – they were running out of options. With support from a local group (Diabetes Youth Care) and T1International, Salomey was able to get the supplies and support she needed. She finished high school in 2015 and she is working to ensure she can purchase the supplies on her own. T1International continues to work with Salomey and other Diabetes Youth Care advocates in Ghana on a larger scale, advocating for #insulin4all so that Salomey’s story will be replicated many times over.

 

A:  Where do you see T1International’s work going in future years?

E:  All of our work moving forward will support our strategic plan, which focuses on four different areas including:

  1. raising awareness of the global lack of access and affordability of diabetes
  2. connecting and collaborating with groups around the world to provide resources and outreach
  3. pushing for better data and resources about global type 1 diabetes
  4. campaigning and advocacy advocating for systemic change

More specifically, in the near future we plan to carry out online advocacy trainings focused on the content from our advocacy toolkit. We would like to hold open sessions for advocates to come together to talk about best practice, share ideas, and talk strategy related to the specific issues they want to tackle locally or globally. Further afield, we would like to do larger, in-person training sessions with groups around the world. In the meantime, we won’t stay quiet about the need for transparency and #insulin4all!

 

A:  Is there a specific geographical area that is high on the priority list for insulin access assistance in 2017?

E:  It is impossible to prioritise one country over another when so many people are still dying from type 1 diabetes in so many countries. We would like to see more data collected, perhaps through establishing diabetes registries, in Africa as a whole. There needs to be more government prioritisation of access to medicines in nearly every country, which is why we are committed to supporting people and communities worldwide.

 

A:  Favorite beverage?

E:  Flat white  🙂

Coffee Date #1: Laura Marston + Insulin

Many thanks to Laura Marston for joining us as the inaugural guest on Very Light, No Sugar’s Coffee Dates interview series.  With a template similar to the brief “getting to know you” interviews in pop culture magazines, VLNS’ Coffee Dates provides a snapshot of important people, entities, and topics in the healthcare world.

 

A:  I just have to ask: How badass is it to be a video game lawyer?

L:  It’s an absolute dream job. I work alongside the most brilliant minds in the gaming industry (*cough* Todd Howard *cough*) and work for a truly incredible company. Plus, after spending ten years working for large law firms as an IP trial attorney, I’m just happy I don’t have to wear a suit. 🙂

 

A:  You have elevated the insulin access and affordability causes through Twitter and interviews with the likes of the Washington Post. Even President Obama has noticed your humble yet lifesaving advocacy! What would you recommend to individuals looking to get more involved, whether at the local level or beyond?

L:  Start small. Start anywhere. TELL YOUR STORY because it’s important and it matters. You may be surprised who relates (in my case, it happened to be Senator Bernie Sanders!) Passion and the truth will trump greed and lies every. single. time. And our passion is endless because our lives literally depend on this issue.

 

A:  If you were to describe the affordable insulin cause in 140 characters (give or take- humor me here!) to someone who does not know much about diabetes, what would you highlight? 

L:  The patent for insulin was sold in 1921 for $3. Almost 100 years later, a month’s supply of insulin costs over $1,000. The price of insulin affects not just the un- or underinsured, but all of us. Our country was founded upon the individual rights to life and liberty. All humans need insulin to live, and injections of insulin are necessary to sustain life for T1Ds. Thus, access to insulin is a basic, fundamental human right.

 

A:  What’s up next for 2017? 

L:  Look for more localized advocacy work, as well as a federal advocacy initiative highlighting the importance of the ACA in the wake of skyrocketing insulin prices. Anyone interested in getting involved in our US-specific insulin advocacy efforts should contact me at laura.marston@gmail.com.

 

A:  Cream in your coffee?

L:  Cream + about a million Splenda. 🙂