Health

Insulin Prices Dropped. But Some Poor Patients Are Paying More.

Published

11 months ago

January 16, 2025

Insulin Prices Dropped. But Some Poor Patients Are Paying More.

Maricruz Salgado was bringing her diabetes under control. Thanks to a federal program that allowed health clinics that serve poor people to buy drugs at steeply discounted prices, she was able to pay less than $75 for all five of her diabetes medications every three months.

But in July, the cost of three of those drugs soared. Ms. Salgado, who does not have health insurance, suddenly faced costs of hundreds of dollars per month. She could not afford it.

Her doctor switched her to cheaper medicines. Within days of taking one of them, she experienced dizzy spells so severe that she said could barely keep up with her hectic daily schedule as a phlebotomist and an in-home caregiver. By the time she returned to the doctor in September, her blood sugar levels had ticked up.

“We were in a good place,” said Dr. Wesley Gibbert, who treats Ms. Salgado at Erie Family Health Centers, a network of clinics in Chicago that serves patients regardless of their ability to pay. “And then all the medicines had to change.”

The price hikes at the clinic happened for a reason that is symptomatic of the tangled web of federal policies that regulate drug pricing. In 2024, drug makers lowered the sticker price of dozens of common medications, which allowed them to avoid massive penalties imposed by the American Rescue Plan, the Covid relief package passed three years earlier. But that change backfired for low-income people like Ms. Salgado.

The decision to make these medications more affordable for large swaths of patients has quietly created another problem: a severe financial hit to the clinics that are tasked by the federal government with caring for the country’s poorest people. These nonprofit clinics operate in every state and serve nearly 32.5 million people, or about 10 percent of the country’s population.

“It’s the law of unintended consequences,” said Beth Powell, the director of pharmacy at The Centers, which operates five community health clinics in the Cleveland area. Ms. Powell said that while many consumers benefited from the companies’ decision to lower prices, “for our folks, that is not the case.”

More than 1,000 community health clinics around the country rely on a decades-old federal program that requires drug companies to offer them deep discounts.

Under the 340B program, as it is called, companies typically sell their brand-name drugs to clinics at a discount, at 23 percent or more off the list price. The same discount scheme applies to state Medicaid plans. But if a company raises a drug’s list price above the rate of inflation, a penalty kicks in, forcing it to offer even deeper discounts to the clinics.

For years, that meant that every time a company raised a drug’s list price above inflation, community clinics paid less for it. Many drugs, including insulin, essentially became free.

But the American Rescue Plan made a major change that hit drug companies with even larger penalties for raising prices. In January 2024, companies that continued to raise a drug’s price would have to pay state Medicaid plans every time those drugs were used, potentially costing the industry billions of dollars.

“That was a bridge too far” for the companies, said Antonio Ciaccia, a drug-pricing researcher who advises state governments and employers.

Manufacturers lowered the price of at least 77 drugs in 2023 and 2024, according to an analysis by a nonprofit that Mr. Ciaccia leads. The list includes widely used asthma drugs like Advair and Symbicort, as well as diabetes treatments like Victoza, which Ms. Salgado used before the change.

Once the pharmaceutical companies lowered their list prices, the inflation penalties evaporated. That meant community clinics had to start paying the usual discounts of 23 percent or more off the list price — far more than the pennies they used to pay.

“Unfortunately, the complexities of the U.S. health care system can reduce access and affordability for many,” Jamie Bennett, a spokeswoman for Novo Nordisk, which makes Victoza, said in a statement. “Even when we lower our prices, too often people don’t receive the savings — this is a problem.” She said the company also has patient assistance programs to make its products more affordable.

David Bowman, a spokesman for the Health Resources and Services Administration, which oversees the 340B discounts, did not respond to questions about how community health clinics were affected by the lowered drug prices. He said that other recent policies, including directing Medicare to negotiate the price of drugs, had lowered drug costs for low-income patients.

Because of a six-month lag in the way that 340B discounts work, clinics were hit by the change last July. Some clinics began calling patients before their prescriptions expired, offering to switch them to less expensive medicines even though they sometimes had more serious side effects. Others decided to cover the higher out-of-pocket costs, which required dipping into already scarce reserves.

Ms. Salgado said a nurse from Erie called over the summer to tell her about the pricing changes. Until then, she had paid about $15 for a three-month supply of Victoza, which is injected daily to keep blood sugar down. After July, the cost rose to more than $300.

After a few weeks, Ms. Salgado adjusted to the replacement, Byetta, and her dizziness subsided. But the drug must be injected twice a day instead of once. And Ms. Salgado must now use a special pharmacy 20 minutes from her house to qualify for the federal discount on the two insulin drugs she was switched to, the result of increasingly strict rules that companies are imposing on health clinics.

Ms. Salgado, who is 39, said she is determined to avoid the fate of her mother, who died of diabetes complications at 54. But keeping up with frequent pharmacy visits and medication changes is tough. “Sometimes it does get to a point where it’s like, I just don’t want to do this anymore,” she said.

The changes are also making it harder for community clinics to offer other services.

Under the 340B program, clinics buy the discounted drugs on behalf of their patients. When those patients have insurance, the clinics can then bill insurers for the regular, higher price, pocketing the difference. But now that spread — the difference between how much they pay for the drug and what insurance will cover — has dwindled. That has left clinics with less money to spend on services that are not otherwise covered by government grants or insurance, such as helping patients find housing.

At Valley View Health Center, a network of clinics that serves patients in rural Washington, the 340B money once financed a mental health program that employed eight therapists. In September, the clinic halted the program, laying off the therapists.

“It was such an abrupt change for us that it has definitely affected our ability to care for our patients the way that we needed to,” said Gaelon Spradley, the clinic’s chief executive.

Some patients who have seen costs go up have qualified for patient-assistance programs offered by drug makers. That was the case for Lorena Sarmiento, another patient at Erie Health who uses Lantus, an insulin pen. Last fall, after the 340B discount changed, she was quoted $490 at her pharmacy — the retail price for a box of insulin pens. Erie Health sent her to another pharmacy, which helped her sign up for a manufacturer’s coupon that lowered her cost to $35 per month.

Doctors and pharmacists at several health clinics said such drug-company assistance programs can be hit or miss. Sometimes they last for a limited time or require that a patient reapply regularly. Patients often have to be legal residents of the United States or have a fixed address.

“It’s a lengthy process, and it’s a lot of hoop-jumping,” said Michael Lin, the chief of pharmacy operations at Family Health Centers in Louisville, Kentucky.

Ms. Sarmiento and her husband, Luis, spend about $500 per month on her medical needs, including special food, medications and a glucose monitor. They are no longer facing the highest insulin price, but their costs are still 10 times what they were just a few months ago, when they spent about $10 on three months’ worth of insulin.

Mr. Sarmiento said he tries not to complain. “You always have to look on the good side,” he said. “But lately, that’s been hard.”

Click to comment

Health

‘Aggressive’ new flu variant sweeps globe as doctors warn of severe symptoms

Published

8 hours ago

December 15, 2025

Press Room

‘Aggressive’ new flu variant sweeps globe as doctors warn of severe symptoms

NEWYou can now listen to Fox News articles!

Flu season is among us, and a new strain has emerged as a major threat.

Influenza A H3N2, or the subclade K variant, has been detected as the culprit in rising global cases, including in the U.S.

In an interview with Fox News Digital, Dr. Neil Maniar, professor of public health practice at Boston’s Northeastern University, shared details on the early severity of this emerging strain.

MAJOR MEASLES OUTBREAK LEADS TO HUNDREDS QUARANTINED IN US COUNTY, OFFICIALS SAY

“It’s becoming evident that this is a pretty severe variant of the flu,” he said. “Certainly in other parts of the world where this variant has been prevalent, it’s caused some severe illness, and we’re seeing an aggressive flu season already.”

Influenza A H3N2, or the subclade K variant, has been detected as the culprit in rising global cases. (iStock)

The variant seems to differ from prior strains of the flu, with heightened versions of typical symptoms like fever, chills, headache, fatigue, cough, sore throat and runny nose.

Subclade K is the “perfect storm” for an aggressive flu season, Maniar suggested, as vaccination rates overall are down and this year’s flu vaccine does not address this specific strain.

CLICK HERE FOR MORE HEALTH STORIES

“The vaccine is very important to get, but because it’s not perfectly aligned with this variant, I think that’s also contributing to some degree to the severity of cases we’re seeing,” he said. “We’re going in [to this flu season] with lower vaccination rates and a variant that in itself seems to be more aggressive.”

“There’s a lot of concern that this could be a particularly difficult flu season, both in terms of the total number of cases [and] the severity of those cases.”

Staying indoors during the colder months increases the risk of exposure to winter illness. (iStock)

Because subclade K is “quite different” from prior variants, Maniar said there is less natural immunity at the community level, further increasing the risk of spread and severity.

Those who are unvaccinated are also at risk of experiencing more severe symptoms, as well as a higher risk of hospitalization, the doctor emphasized.

CLICK HERE TO SIGN UP FOR OUR HEALTH NEWSLETTER

In addition to getting vaccinated, the doctor recommends washing hands frequently and properly. While the flu can spread via airborne transmission, a variety of other illnesses, like norovirus, can stick to surfaces for up to two weeks, he added.

The holiday season also boosts the risk of infection, as gatherings, large events, and packed planes, trains and buses can expose people to others who are sick.

The flu vaccine can help to prevent hospitalization and reduce severe symptoms, doctors agree. (iStock)

Those who are not feeling well or exhibiting symptoms should “please stay home,” Maniar advised — “especially if you think you are in that contagious period of the flu or any of these other illnesses that we’re seeing … whether it’s norovirus or COVID or RSV.”

“If you’re not feeling well, stay home. That’s a great way to recover faster and to ensure that you’re not going to get others around you sick.”

CLICK HERE TO DOWNLOAD THE FOX NEWS APP

For those who are unsure of their health status or diagnosis, Maniar recommends seeing a healthcare provider to get tested. Some providers may be able to prescribe medication to reduce the severity and duration of the illness.

TEST YOURSELF WITH OUR LATEST LIFESTYLE QUIZ

“It’s important that everyone stays vigilant and tries to take care of themselves and their families,” he added.

Angelica Stabile is a lifestyle reporter for Fox News Digital.

Health

Are you too old to shovel snow? Experts reveal the hidden heart risks

Published

20 hours ago

December 15, 2025

Press Room

Are you too old to shovel snow? Experts reveal the hidden heart risks

NEWYou can now listen to Fox News articles!

As snow blanketed parts of the U.S. this week, heart health experts have shared warnings of the physical strain shoveling can take — particularly for older adults.

A 2025 Mayo Clinic review found that just 10 minutes of heavy snow shoveling can push the heart to about 97% of its maximum rate. Exposure to cold air was also found to increase blood pressure and reduce coronary blood flow.

While there isn’t an official age that’s “too old” to shovel, some cardiologists recommend that individuals over 45 should exercise more caution to lower their chances of a cardiac event.

When to take caution

“While there’s no strict age cutoff, generally above the age of mid 40s and above, we tend to be a little more cautious — particularly in people who are less active [without] regular exercise,” Dr. Navjot Kaur Sobti, M.D., an interventional cardiologist at Northwell’s Northern Westchester Hospital in Mount Kisco, New York, told Fox News Digital.

Heart health experts have shared warnings of the physical strain shoveling can take — particularly for older adults. (iStock)

“Certainly in people who are above the age of 65 — and who have risk factors for heart disease, such as high blood pressure, high cholesterol, diabetes, obesity or sedentary lifestyle — we recommend being very, very cautious about shoveling snow,” she advised.

Dr. John Osborne, M.D., a practicing Texas cardiologist and volunteer for the American Heart Association, shared similar guidance for people older than 45, especially males over 65.

SIMPLE NIGHTLY HABIT LINKED TO HEALTHIER BLOOD PRESSURE, STUDY SUGGESTS

“Unless you are in good cardiovascular shape and conditioned, it may be a good idea to ask someone for help,” he said in an interview with Fox News Digital.

The impact of snow removal is especially concerning for those with existing cardiovascular risks and a history of heart attack or stroke, according to the cardiologist. “People with these characteristics and those who have had bypass surgery or coronary angioplasty simply should not be shoveling snow in any conditions,” he said.

Just 10 minutes of heavy snow shoveling can push the heart to about 97% of its maximum rate, a 2025 Mayo Clinic review found. (iStock)

Osbourne said he often sees cardiac episodes in people who are typically sedentary and sit at a computer most of the day with little or no exercise. “Then once or twice a year, they go out and try to shovel the driveway after a heavy snowfall, and that unexpected exertion can unfortunately lead to tragedy.”

Hidden strain

The stress that is placed on one’s heart while shoveling snow is similar to what occurs during a cardiac stress test, Sobti pointed out, and may even exceed it.

Cold temperatures can cause blood vessels to constrict and blood pressure to spike — which, coupled with existing hypertension and the exertion of lifting snow, can significantly tax the heart, she warned.

“It’s almost like an at-risk person is putting themselves through an unsupervised maximal exertion stress test without a cardiologist actively monitoring them,” Sobti told Fox News Digital.

The stress that is placed on one’s heart while shoveling snow is similar to what occurs during a cardiac stress test. (iStock)

In addition to the exertion of shoveling, frigid temperatures can also strain the heart. Recent research has shown that cold exposure accounts for nearly twice as many cardiovascular deaths as heat exposure, including heat exhaustion.

CLICK HERE TO SIGN UP FOR OUR HEALTH NEWSLETTER

That study, published in the Annals of Internal Medicine last month, also found that those over age 65 had higher rates of temperature-related deaths.

“So the risk is very, very high,” Sobti cautioned. “It’s really that sudden rise in blood pressure coupled with the physical stress of snow shoveling itself.”

Safer shoveling tips

The cardiologist said it’s ideal to have someone else help with snow removal — but if you do choose to use a shovel, she recommends pacing yourself and using a “pushing or sweeping” motion instead of heavy lifting.

Recent research has shown that cold exposure accounts for nearly twice as many cardiovascular deaths as heat exposure. (iStock)

To protect against the cold, Sobti also recommends covering your mouth, nose and extremities, wearing a hat and gloves, and using extra caution in windy conditions.

Using an automated snow blower can still raise the heart rate — up to 120 beats per minute, compared to 170 while shoveling, the American Heart Association states on its website.

TEST YOURSELF WITH OUR LATEST LIFESTYLE QUIZ

It is also important to be aware of any symptoms of a potential cardiac issue while shoveling, Sobti emphasized.

If a person starts to experience warning signs such as chest pain, shortness of breath, a racing heart or palpitations, those should not be ignored.

CLICK HERE FOR MORE HEALTH STORIES

Even if the symptoms resolve after a few minutes, a person “could still be experiencing symptoms of a heart attack” and should call 911 for evaluation, Sobti said.

“It’s better really to be safe than sorry.”

Amy McGorry is a contributing health writer for Fox News Digital. Follow her on Twitter @amymcgorry.

Health

Nutrient deficiency linked to heart disease risk for millions, new study warns

Published

1 day ago

December 14, 2025

Press Room

Nutrient deficiency linked to heart disease risk for millions, new study warns

NEWYou can now listen to Fox News articles!

More than three-quarters of the global population is falling short on omega-3 intake, a nutrient gap that may increase the risk of heart disease, cognitive decline, inflammation and vision problems.

That’s according to an analysis published in Nutrition Research Reviews, in which researchers from the University of East Anglia, the University of Southampton and Holland & Barrett analyzed omega-3 intake patterns across multiple countries and age groups.

The review found that 76% of people worldwide are not meeting the recommended levels of two omega-3 fats that are essential for heart health: eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).

TREATING GUM DISEASE COULD REDUCE RISK OF HEART ATTACKS AND STROKES, STUDY SUGGESTS

The analysis considered recommendations from global health authorities and assessed how closely populations follow them.

Most adults should aim for at least 250 milligrams of EPA and DHA per day, though actual intake is far lower in many regions, according to the researchers.

A new study found that 76% of people fall short of their recommended omega-3 intake. (iStock)

To explore the health implications of low omega-3 intake, Fox News Digital spoke with Michelle Routhenstein, a New York–based preventive cardiology dietitian at Entirely Nourished.

HIGH-POTASSIUM FOODS COULD ‘SIGNIFICANTLY’ LOWER RISK OF HEART FAILURE, STUDY FINDS

Low omega-3 levels can have a noticeable impact on heart health, cognitive function and inflammation throughout the body, the expert confirmed.

Low intake can also increase the risk of heart attacks and sudden cardiac death, she added. It’s also associated with higher triglycerides, irregular heart rhythms and plaque in the arteries.

Most adults should aim for at least 250 milligrams of EPA and DHA per day, researchers say. (iStock)

Inadequate omega-3 levels have also been linked to changes in brain function, including faster cognitive decline, a higher risk of Alzheimer’s disease and increased rates of depression.

Routhenstein noted that low levels may also worsen inflammation in autoimmune conditions such as psoriasis, and can negatively affect eye health, since omega-3s play a key structural role in the retina.

SITTING ALL DAY? NEW STUDY SAYS CERTAIN FOODS MAY PROTECT YOUR HEART FROM DAMAGE

To improve omega-3 levels, the expert said it’s important to understand how much is needed and where to get it.

“The richest dietary sources of EPA and DHA are oily fish, such as salmon, mackerel, sardines, herring, trout and anchovies,” Routhenstein told Fox News Digital.

Oily fish, such as salmon, are among the richest natural sources of omega-3s. (iStock)

Many people benefit from eating oily fish more frequently, often three to four times per week, Routhenstein noted. For individuals who do not eat fish regularly, supplements can help raise EPA and DHA to healthier levels.

CLICK HERE TO SIGN UP FOR OUR HEALTH NEWSLETTER

For those taking omega-3 supplements, dosing should be based on lab results, medications, omega-3 levels and overall medical history, according to Routhenstein. Moderate, quality-controlled supplements are generally considered safe for most people.

CLICK HERE FOR MORE HEALTH STORIES

There is also some evidence supporting prescription-strength omega-3 products.

“High-dose EPA, such as 4 grams per day of icosapent ethyl, has been shown to reduce major cardiovascular events in certain high-risk populations, while similar doses of mixed EPA/DHA have not consistently shown the same benefit,” Routhenstein said.

Omega-3 dosing should be individualized based on lab data, medication use, current levels and overall medical history. (iStock)

Testing omega-3 levels can also help determine whether intake is adequate. The omega-3 index, a blood test that measures EPA and DHA in red blood cells, is considered one of the most reliable ways to assess status.

CLICK HERE TO DOWNLOAD THE FOX NEWS APP

“Levels around 8% are associated with lower cardiovascular risk, while levels below approximately 4% are considered low,” Routhenstein said.

Understanding baseline levels can help guide more personalized decisions about diet and supplementation.

TEST YOURSELF WITH OUR LATEST LIFESTYLE QUIZ

Those who are unsure about their omega-3 status or whether supplementation is appropriate should speak with a healthcare provider to determine the best approach.

Kelly McGreal is a production assistant with the lifestyle team at Fox News Digital.