“Should I choose insulin over groceries for my children?” When a patient asks this to John Spangler, M.D., he worries about those who face a hard choice when it comes to spending. Do they buy food for their children at the risk of their own health? What can be done?

Dr. Spangler is a primary care physician in Winston-Salem, serving patients from 2 months old to 90 years old. He is also part of the faculty at Wake Forest School of Medicine, serving as a professor in the Department of Family & Community Medicine. He recently wrote an op-ed for the Greensboro News & Record on the high cost of prescription drugs. The increasing cost of drugs have affected two of his patients.

He writes:

“‘Dr. Spangler, I couldn’t afford that long-acting insulin, Lantus.’ Ms. Smith told me.

‘Even with that discount coupon, it costs $250 for a month. I have to buy groceries for my growing boys and pay rent and utilities. Most months I don’t have enough to get my medicines.

‘So that’s why my blood sugar is 320 today.’

Good sugar control in diabetes is about 80 to 120. If sugars regularly run in the 300s, the long-term risks dramatically increase for heart attacks, stroke, blindness, foot amputations and kidney failure.

There are also immediate risks of profound dehydration, coma and death.

Ms. Smith (not her real name) was my first patient on a Monday. Over the next week, I would see one or two patients a day with the same distressing issue: Should I choose insulin over groceries for my children?

She works at a local carry-out restaurant, taking on extra shifts now that her children are older.

But the increasing costs of medications have gotten way out of hand for her.

And, I suggest, for the nation.”

While coupons can go a long way in easing the cost of prescription medications, Dr. Spangler believes that more can be done to help N.C. patients. When tax-paying, hard-working families cannot afford medication, charity organizations, lower-cost medications, and coupons can step in as supplements. But that may not be enough to cover the entire bill.

“Let’s advocate for transparent pricing,” he writes. “Let’s advocate for competitive bidding by drug companies to sell drugs through Medicare with the program’s huge leverage.”

For additional thoughts from Dr. Spangler, and the story of another patient struggling with a medication bill, visit the Greensboro News & Record to read more.

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