Fighting to survive

John P. Cleary | The Herald BulletinSa’Ra Skipper speaks at the Anderson Chapter Indiana Black Expo 2019 Corporate Luncheon recently where she was presented a “Fighter Award” for her efforts to transform adversity into advocacy.

ANDERSON — When Sa’Ra Skipper went to college, she had to contend with more changes to her life than she expected.

In addition to settling into a new home, Skipper, a 2013 Anderson High School graduate, had to find out how to manage her insulin for her Type 1 diabetes after she aged out of her pediatrician’s care and could no longer receive what she needed.

Without any insurance, she’s scrounged for samples or shared with her sister, who is also a Type 1 diabetic.

It’s a problem that’s been called “insulin rationing,” with one in four diabetics having admitting to doing it but, for Skipper, it’s much more complicated than that.

“They think it’s just eating right, avoiding sugar and everything like that and you should be OK, but that’s not the case,” Skipper said. “If you don’t have the right amount of insulin, then you can’t really eat like that. During that year-and-a-half, two-year time period I was rationing my insulin, I was rationing my food, too. I couldn’t eat a lot because I didn’t have enough insulin to take for the food that I was going to consume.”

For Skipper, it was something that couldn’t continue. She needed to find a way to get involved.

In December 2018, she saw a story of a woman who died due to complications with her diabetes after rationing. Skipper, knowing the story could have easily been about her, left a comment on the story and was quickly contacted by WRTV in Indianapolis for an interview.

It snowballed from there.

Soon after, she was interviewed by NBC’s Lester Holt, as well as NPR and other media throughout the country.

“Really, it just started in December and it stems from me commenting on a Facebook story,” she said.

Now, Skipper is a face for advocating for cheaper insulin prices. She’s helped drive forward House Bill 1029, which commissions an interim study committee on public health, behavioral health and human services the task of studying issues consumers face related to prescription drug pricing, access and costs.

The bill was authored by state Rep. Robin Shackleford, who represents Indiana House District 98. It was passed into law unanimously on April 10.

Shackleford, who has dealt with chronic migraines since she was in college and takes an injectable medication that can reach $400-$500 to ease her pains, says the bill is aimed at helping more than those who are affected by high insulin drug prices.

She was introduced to Skipper through IU McKinney Law School professor Fran Quigley, who teaches in the Health and Human Rights Clinic at IU McKinney and is the founder of People of Faith For Access to Medicines, or the acronym PFAM.

Talking with Skipper helped open her eyes to the methods some people use to cope with expensive drug prices.

“If they couldn’t fill prescriptions, they would leave the pharmacy, they would just use half their medicine or halve their pills,” Shackleford said. “So, people were rationing not only insulin but other types of medication.”

Widening the scope of the legislation made it easier for the study bill to pass both the Indiana House and Senate. Shackleford notes, however, moving forward will take some time while the committee studies how drug prices affect Hoosiers as opposed to people living in neighboring states.

Some fixes have been made available by larger retail pharmacies like Walmart, which sells Novolin ReliOn Insulin 70/30 for $24.88 a bottle without insurance.

According to Novonordisk, which makes Novolin Relion, the drug is injectable and should be taken 30 minutes before eating. It is also typically dosed twice daily and comes in 10-milliliter vials or 3-milliliter pens.

For Skipper, this isn’t a good enough fix to a problem that isn’t universal for everyone.

“It’s like giving a kid some candy and telling them to stop crying,” Skipper said. “You pay for what you get. It’s $25, but it’s $25 for a reason.”

Eli Lilly also recently released a cheaper version of its rapid-acting insulin Humalog called Lispro. It’s billed at 50% less than Humalog and is listed at $137.35 per vial and $265.20 for package of five pens, according to Lilly’s website.

This, too, is not a good enough fix for Skipper, who still rations her insulin.

“It’s a discounted rate but it’s only at a discounted rate for certain people,” Skipper said. “That price is not for everyone.

“Take someone like myself. I was working a full-time job and I had these benefits. But just because my employer might have a contract with a particular insurance company, I may not be able to get that insulin at that half price.”

Lilly has also said in a release that it will work with payers to gain broad insurance coverage for Lispro.

Skipper is hopeful House Bill 1029 will lead to change, but contends it’s still not enough. She’ll continue to use her voice to advocate and force the issue because, as she claims, the steadier the pressure, the more likely lawmakers will get something done.

Follow Dylan Trimpe on Twitter @Trimp3, email him at dylan.trimpe@heraldbulletin.com, or call 765-640-4840.