Health

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

Published

1 year 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.”

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Health

Weight gain in certain decade of life may be more dangerous, study suggests

Published

5 hours ago

April 14, 2026

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Weight gain in certain decade of life may be more dangerous, study suggests

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Weight management is often treated as a “middle-age” problem, but new research suggests that the pounds you pack on in your 20s may be the most dangerous of your life.

A massive study of more than 620,000 individuals found that the damage from early weight gain is disproportionately high and surprisingly permanent. According to the findings, the younger someone is when obesity sets in, the higher the risk of early mortality.

The study, published in the journal eClinicalMedicine, analyzed data from the Obesity and Disease Development Sweden project.

MEN FACE HIDDEN HEART RISK YEARS EARLIER THAN WOMEN, STUDY SUGGESTS

“The most consistent finding is that weight gain at a younger age is linked to a higher risk of premature death later in life, compared with people who gain less weight,” Tanja Stocks, a professor at Lund University and one of the researchers behind the study, said in a press release.

New research suggests that the pounds you pack on in your 20s may be the most dangerous of your life. (iStock)

Developing obesity between the ages of 17 and 29 was linked to a 70% higher risk of early death compared to weight gain later in life.

Weight gain later in adulthood, between ages 30 and 60, was also linked to higher death rates, but the connections were generally weaker.

HERE’S THE AGE WHEN STRENGTH AND FITNESS BEGIN FADING, LONG-TERM DATA SHOWS

“One possible explanation for why people with early obesity onset are at greater risk is their longer period exposed to the biological effects of excess weight,” Huyen Le, a doctoral student at Lund University and first author of the study, said in the release.

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When weight gain happens in the 20s, the blood vessels, liver and metabolic systems endure obesity-related strain for decades longer than someone who gains the same weight in their 50s, experts say.

Weight gain later in adulthood, between ages 30 and 60, was also linked to higher death rates, but the connections were generally weaker. (iStock)

The study identified type 2 diabetes as the leading cause of death associated with early-onset obesity. Other significant risks included high-blood pressure, liver cancer in men and uterine cancer in women.

To reach these conclusions, researchers tracked participants’ weight paths across adulthood over more than 50 years, focusing on three specific windows: ages 17 to 29, 30 to 44, and 45 to 60.

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Using a body mass index (BMI) of 30 or higher to define obesity, the team compared weight data against Sweden’s national death registry.

After adjusting for a variety of factors, including smoking habits and marital status, the trend showed that becoming obese later in life still carried risks, but the danger compounded the longer people stayed obese.

While type 2 diabetes is the leading risk, early-onset obesity is also tied to higher rates of high-blood pressure and specific cancers. (iStock)

While these findings highlight the “importance of early and sustained obesity prevention strategies,” the researchers noted that other factors come into play, and that increases in risk within a population can be difficult to interpret.

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“We shouldn’t get too hung up on exact risk figures,” Stocks said.

“They are rarely entirely accurate, as they are influenced, for example, by the factors taken into account in the study and the accuracy with which both risk factors and outcomes have been measured.”

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Because the study was conducted in Sweden, more research is needed to understand the effect of early-onset obesity in other populations, the team noted.

Khloe Quill is a lifestyle production assistant with Fox News Digital. She and the lifestyle team cover a range of story topics including food and drink, travel, and health.

Health

Best Healthy Foods for Weight Loss After 50, Including Cheese and Bread!

Published

17 hours ago

April 14, 2026

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Best Healthy Foods for Weight Loss After 50, Including Cheese and Bread!

Best Healthy Foods for Weight Loss and Fat Burn After 50

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Health

Popular weight-loss medications linked to hidden side effects, study finds

Published

17 hours ago

April 14, 2026

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Popular weight-loss medications linked to hidden side effects, study finds

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In a sweeping analysis of more than 400,000 Reddit posts, researchers have revealed some little-known GLP-1 side effects.

GLP-1 receptor agonists — such as semaglutide (Ozempic and Wegovy), and tirzepatide (Mounjaro and Zepbound) — have been most commonly associated with gastrointestinal side effects, such as nausea, vomiting, diarrhea and constipation.

A new study published in Nature Health, however, uncovered some overlooked effects.

SHOULD YOU MICRODOSE OZEMPIC? EXPERTS ARE SPLIT ON RISKS VS BENEFITS

University of Pennsylvania researchers used artificial intelligence to analyze more than five years of Reddit posts from more than 67,000 people taking the popular drugs for diabetes or weight loss.

While clinical trials are still the “gold standard,” the researchers noted that Reddit community feedback reflects a different population.

“People often use medications differently than they’re prescribed, so it’s also important to look at real-world usage, which can diverge from usage in a clinical trial,” lead researcher Neil Sehgal, a PhD student at the University of Pennsylvania, told Fox News Digital. “So there are many possible reasons we’re seeing signals that the trials may have missed.”

Overlooked effects

Nearly half of the users reported one or more side effects. The most common were nausea, vomiting and constipation, which aligned with what clinical trials found, according to Sehgal.

“We’re almost certainly capturing a skewed slice of the full picture.”

“We did notice a few side effects that have not previously been reported for these drugs,” he told Fox News Digital.

“For example, about 4% of users who described side effects reported menstrual irregularities. Other Redditors described unusual temperature-related symptoms, like chills or hot flashes.”

OBESITY EXPERT REVEALS THE BEST WAY TO DECIDE IF GLP-1S ARE RIGHT FOR YOU

Nearly 13% of users also experienced psychiatric symptoms, such as anxiety, depression and insomnia. More than 5% also complained of abdominal pain, acid reflux, headache and dizziness.

“Fatigue was also the second most commonly reported symptom overall, but has met relatively few reporting thresholds in existing trials,” Seghal noted. “This gap between what patients are self-reporting online and what gets captured in trials is really what motivated this whole line of work.”

Clinical context

Dr. Sue Decotiis, a New York City-based board-certified weight-loss physician, noted that many of the reported symptoms, such as disorientation and fatigue, are most likely due to dehydration and hypoglycemia (low blood sugar).

“People often use medications differently than they’re prescribed, so it’s also important to look at real-world usage, which can diverge from usage in a clinical trial,” the lead researcher said. (iStock)

“Patients should be carefully monitored using a structured protocol that ensures proper nutrition and adequate hydration, ideally under the direct supervision of a physician experienced in metabolism and weight loss,” Decotiis, who was not involved in the study, told Fox News Digital.

“Additionally, body composition analysis can help identify issues such as muscle loss, excessive water loss or insufficient fat loss.”

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A significant concern, according to the doctor, is that many individuals are accessing these medications through online platforms or without receiving appropriate medical care.

“In my experience treating thousands of patients with various GLP-1 medications, complications are rare and typically occur only when patients are noncompliant,” she added.

Study limitations

As the data came from Reddit users, who tend to be younger, primarily male and mostly based in the U.S., it may not represent everyone taking these medications, the researchers noted.

“In my experience treating thousands of patients with various GLP-1 medications, complications are rare and typically occur only when patients are noncompliant,” a weight-loss doctor shared. (iStock)

“And even within Reddit, the people who post about their side effects are probably not typical of everyone on the medication,” Sehgal said. “If you had a good experience, you’re less likely to be writing about it online. So we’re almost certainly capturing a skewed slice of the full picture.”

The researchers also noted that the study can’t prove the drug caused the reported symptoms.

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“To be clear, we can’t say for certain whether these drugs are causing menstrual irregularities,” Sehgal said. “Patients on Reddit aren’t going to self-report every symptom they have, and they may also report things that aren’t actually linked to the medications. So it’s important to treat this as hypothesis-generating signals and do more research.”

The researchers noted that the study can’t prove the drug caused the reported symptoms. (iStock)

The study also didn’t include GLP-1 dosage, duration of the medication and symptoms, or other health conditions the users experienced. There is also the chance that the AI tools misunderstood meanings or context, the researchers noted.

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The results must be confirmed with more rigorous research, Sehgal said. “That’s how we’ll get real answers about prevalence and causality, which social media data alone can’t provide.”

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“These are signals, not conclusions – but I do think it’s always worth talking to your doctor about anything unexpected you’re experiencing while on a new medication, even if you’re not sure if it’s related,” he advised. “So if something feels off, say something.”

Melissa Rudy is senior health editor and a member of the lifestyle team at Fox News Digital. Story tips can be sent to melissa.rudy@fox.com.