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Association Between Cannabis Use and Risk for Diabetic Ketoacidosis in Adults With Type 1 Diabetes

2018; American Medical Association; Volume: 179; Issue: 1 Linguagem: Inglês

10.1001/jamainternmed.2018.5142

2168-6114

Halis Kaan Aktürk, Daniel D. Taylor, Ulaş Mehmet Çamsarı, Amanda Rewers, Gregory L. Kinney, Viral N. Shah,

Diabetes Management and Research

ket.A biosimilar of Sanofi's popular insulin Lantus was approved for use in the European Union in 2014 but was initially delayed for 2 more years by a lawsuit in the United States. 6Now that the biosimilar product, Basaglar, has finally hit the market, its price is only minimally lower than the original brand. 7 The same insulin pen that retails for $140 in the United States costs less than $15 in Germany and Canada. 8 The US insurance system-private and public-does not cut people with chronic disease a break but instead tends to penalize them.People with type 1 diabetes are people who drew a short straw in the disease lottery.Most other developed countries have concluded that their citizens should therefore not be subject to copays or high deductibles."If you have a chronic disease, you shouldn't be burdened by the cost," York F. Zöllner, a professor of health economics at Hamburg University of Applied Sciences, told me in an interview for the New York Times before explaining the German approach, in which out-of-pocket contributions for insulin are less than $100 per year. 9Until very recently, the disease foundations (JDRF and the American Diabetes Association among them), as well as many diabetes patient groups, did not protest much as the prices rose, in part likely because so many receive funding from pharmaceutical companies.Extreme prices can lead to extreme solutions.A 29-year-old student in Missouri with diabetes whom I interviewed for my book 10 told me that she would only consider doctoral programs outside of the United States."My one goal in life has been to move to Europe so I don't have to pay these staggering prices just to survive," she said.But others-that 25%-will quietly skimp on their insulin, taking less than they need but more, perhaps, than they can really afford.Some of them will die.