By Serena Gordon
health day reporter
TUESDAY, Feb. 18, 2020 (HealthDay News) — Maybe you’ve gone to Craigslist to find a used car or a second-hand couch, but imagine having to turn to the internet to pay for lifesaving medication.
It’s already happening: a new study has found that hundreds of ads were placed on Craigslist for insulin and asthma inhalers over a 12-day period in June 2019.
“This study sheds light on how difficult it is for some patients to afford lifesaving drugs. Patients shouldn’t have to go to Craigslist to try to find affordable insulin and inhalers,” said the The study’s lead author, Dr. Jennifer Goldstein, a researcher with The Value Institute at ChristianaCare, in Newark, Del.
People with type 1 diabetes cannot survive without a regular supply of insulin, which must be injected. People with type 2 diabetes who need insulin are at higher risk of serious diabetes complications if they cannot get the insulin they need. But it became increasingly difficult to pay. The American Diabetes Association says the average cost of insulin in the United States nearly tripled between 2002 and 2013.
The cost of asthma medications has also risen significantly over a similar period, according to published reports. People with asthma need “rescue” inhalers like albuterol when they have symptoms such as wheezing and shortness of breath.
The idea for the study originally came from a news article Goldstein saw detailing how someone purchased drugs on Craigslist. When she did a quick search on the internet, she was surprised to see several lists of medications.
“It’s illegal to sell prescription drugs without a license and to buy drugs without a prescription,” Goldstein explained.
For the study, researchers looked at Craigslist ads across the country over a 12-day period. They included all 50 states in their research.
Investigators found advertisements for insulin and albuterol inhalers in 240 cities in 31 states.
Insulin was often offered at a very favorable price. For example, a vial of Humalog insulin sells for nearly $300, but was listed on Craigslist for $37.
Altruism was one of the reasons people sold insulin online. “I was blessed with an overabundance of insulin and I know what it’s like to need it and not have a few hundred dollars to pay out of pocket,” one salesperson said.
Not everyone had such altruistic motives. Some sold older supplies to earn money to buy new drugs after their doctor changed their prescriptions.
A big concern with insulin is that it needs to be refrigerated. Once at room temperature, it should be used within one month. And you can’t tell by looking at the insulin if it’s ever been left out of the fridge.
Another issue is whether the insulin is sterile or not. A vendor was offering a three-quarters full vial of insulin that had been used on a pet. Although the seller claimed to have always used new needles on the vial, there is no way to verify this information.
“It’s just not a safe way to get medicine,” Goldstein said.
Interestingly, asthma inhalers seemed to be more expensive to buy on Craigslist than at a retail outlet. The retail price of an albuterol inhaler was $25, but the average selling price on Craigslist was $44.
Goldstein said researchers don’t know why the asthma inhalers were priced above retail.
She noted that the researchers could not verify the sale of any of these products. They only knew that they were offered for sale.
Goldstein said it’s likely Craigslist isn’t the only online forum where these sales are taking place. The researchers attempted to contact Craigslist through their online contact link, but did not hear back from them.
Craigslist also did not respond to HealthDay’s request for comment.
Dr Kasia Lipska, Assistant Professor in the Department of Internal Medicine at Yale School of Medicine, said: “This adds to the growing literature that suggests patients are desperate. They need life-saving medicine and are forced to to do so or ration their insulin.”
Lipska did not participate in this study. But she published research in 2018 in the journal JAMA internal medicine found in a group of 200 people with diabetes, more than one in four had rationed their insulin.
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Lipska said buying drugs from strangers on the internet is risky. If patients are having trouble paying for their medications, she said they should talk to their doctor. She said it’s also important that doctors try to help by addressing the issue. “Patients can’t talk about it unless the clinician asks,” Lipska said.
“The finding in this study – that people can get drugs from unregulated places – is a symptom of a failing system. It’s a symptom of a system that isn’t working for patients. Insulin and other drugs need to be more affordable for patients,” Lipska said.
Goldstein’s study was published online February 17 in JAMA internal medicine.
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SOURCES: Jennifer Goldstein, MD, research scientist, The Value Institute, ChristianaCare, and hospitalist, ChristianaCare Hospitalist Partners, Newark, Delaware; Kasia Lipska, MD, MHS, assistant professor of medicine, department of internal medicine, Yale School of Medicine, New Haven, Conn. ; February 17, 2020, JAMA internal medicinein line