LEWISTON — Michelle Dehetre was driving her son last week when she passed out at the wheel because of low blood sugar.
The 48-year-old wound up in the emergency room – and not for the first time.
Dehetre, who has five children and four grandchildren, told a U.S. Senate hearing Wednesday that paramedics are called to help her several times a month because she cannot adequately control the Type 1 diabetes with which she has lived since she was diagnosed in 1985, her freshman year of high school.
“Treating my diabetes is a matter of life and death,” she told the Senate Aging Committee. “When my body doesn’t get the insulin it needs, it makes my blood sugars go very high, which over time can lead to diabetic complications, such as blindness, neuropathy and even death.”
Dehetre said that she cannot afford the monitor that would keep tabs on her blood sugar levels continuously.
After Dehetre testified, the committee chairwoman, Republican Sen. Susan Collins of Maine, said it “seems pretty obvious” it would be cheaper for Dehetre to have the monitor than to keep paying for paramedics and emergency room visits.
Collins said her staff will discuss the situation with Dehetre’s insurer because the current situation is “dangerous, untenable and, ironically, more expensive.”
Sen. Susan Collins, R-Maine, speaks at Wednesday’s hearing by the Senate Special Committee on Aging. She said Michelle Dehetre’s experience shows what many people face as they try to cope with soaring drug costs. Stars and Stripes/Joe Gromelski
Collins also plans to see what steps could be taken to lower the cost of prescription drugs, including measures to encourage more generic alternatives to brand-name products.
The senator said her office looked through suggestions from physicians and her own caseworkers to find Dehetre as a good example of what many patients face as they try to cope with soaring drug costs. She said the committee invited the Lewiston resident to testify and paid for her to travel to Washington.
Dehetre was one of five people from across the country who testified on Capitol Hill Wednesday about their experience with high drug prices.
Collins said it was the first of three planned sessions on the issue, including one Thursday to discuss possible policy approaches. A third hearing is scheduled for this spring, when administration officials will offer their perspective on how to address the problem.
Since so many Americans are struggling to pay for necessary medication, Collins said, “it is evident that much more needs to be done” to tackle prescription drug costs.
Dehetre told the panel she requires both long-acting and short-acting insulin – both of which are costly.
“I work full time,” she testified, “and shell out nearly $300 per month out of pocket on the insulin, syringes and test strips that keep me alive.”
Sen. Susan Collins greets Michelle Dehetre of Lewiston before the Senate hearing Wednesday on Capitol Hill. Stars and Stripes/Joe Gromelski
That’s more than she can easily afford.
“In addition to buying food, paying the electric bill and other monthly bills for my household, spending at least $300 per month for my diabetes medicine is a major financial strain,” Dehetre told lawmakers.
“I cut back on spending whenever I can. I am always looking for ways to save money on food and gas, and sometimes fall short at the end of the month.”
For Dehetre, diabetes “threatens my life.” She said her dream “is to see my 11-year old son graduate high school.”
Dehetre told senators that “ending up in the ER always scares me, not only because I know it’s a close call, but because on top of my medicine, I cannot afford another medical bill.”
Each time she is taken to the hospital, she said, it costs her about $2,600.
She said she tries to skimp on her treatment to save money.
Instead of using the best choice for insulin, Dehetre said, she settles for an older version similar to what she used in 1985 that she can buy at Walmart for $25. It doesn’t work well, she said.
“As I have grown older, my blood sugar levels have gotten more and more unpredictable, even when I eat the same thing from one day to the next,” she said.
The test strips she needs to use at least six times daily to check blood sugar levels cost her another $51 monthly, Dehetre said.
They, too, are not what she really needs.
She said her blood sugar levels tend to go too low at times and it “has proven very difficult” to keep the problem in check.
“My doctor says that what I really need is a continuous glucose monitor and pump,” like one she had in 2007 that “worked really well,” Dehetre said.
But when her insurance coverage changed, its cost skyrocketed to $500 a month and she could no longer afford it.
“So I am using syringes and test strips,” she said.
Collins said there are many “real people, average Americans, trying to make ends meet.”
She mentioned a Midcoast senior who cannot afford the blood pressure medicine she ought to take, a Yarmouth man with epilepsy who cannot afford the drugs he requires and others who are going without because the tab for prescription drugs can be so high.
Those drugs, the senator said, are “increasingly out of reach for those who need them most.”
Americans are expected to spend about $360 billion on prescription drugs this year, Collins said, with patients picking up $49 billion of that while the federal government shells out $163 billion, mostly for seniors.
Collins said there is a lot the government could do to help patients trying to cope.
She said she co-sponsored a bill with Sen. Tim Kane, D-Virginia, that would “help stop the gaming of the patent system” by pharmaceutical companies that use various tactics to discourage generic alternatives from emerging.
Another bill targets efforts by drug manufacturers to make it difficult for possible competitors to get a large enough sample of their products to create generics and properly test them – a practice Collins denounced as “just wrong.”
She said she has long supported reimporting drugs from Canada to deal with shortages in the United States that can drive up prices.
Collins also credited the Trump administration for pursuing a rule change that would ensure patients benefit when manufacturers offer credits that cut costs, something that often doesn’t filter down to the point of sale in the complicated, opaque distribution system for prescription drugs.
Ultimately, Collins said, the country would be better off with “more transparency and a more competitive marketplace.”
Dehetre said change is needed.
“No one should have to go through this,” she said. “I want insurance companies and pharmaceutical companies to wake up. What they think they are doing to save money is not helping people like me.”
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