An uninsured man with Type I diabetes switched from prescription insulin to a less expensive over-the-counter product last year. He died months later due to complications from the disease, according to his obituary.
The story gained national attention this week, widely seen as an example of the dangers faced by those living with a chronic condition and without access to affordable health care.
When Josh Wilkerson, 27, aged out of his stepfather's insurance plan last year, he was no longer able to afford his prescription insulin that cost around $1,200 a month, according to The Washington Post. The insurance offered by his job did not cover insulin treatments.
Wilkerson turned to an affordable alternative to prescription insulin available at national retailers such as Walmart and CVS.
That treatment is safe and effective according to its makers and multiple experts consulted by USA TODAY. However, patients transitioning from traditional insulin to over-the-counter insulin — also known as human insulin — should have regular access to a health provider.
Wilkerson, along with his fiancée Rose Walters, who also has Type 1 diabetes, began taking an over-the-counter solution called ReliOn last year. Manufactured by Novo Nordisk, it currently costs just under $25 for a 10-mL vial.
A 10-mL vial of the prescription insulin Novolog, also manufactured by Novo Nordisk, retails at over $350.
A report by the University of California, San Francisco states that forms of human insulin such as ReliOn are less commonly prescribed by doctors because of their unpredictable rate of absorption, which can result in "more frequent low and high blood sugars."
Patients can save money by switching to over-the-counter insulin. But safely switching is more complex. Doing so incurs other costs, according to Elizabeth Pfiester, the founder and executive director of Type 1 diabetes advocacy group T1International.
"The unpredictability of human insulin means that a person would need to afford additional blood glucose testing strips," Pfiester told USA TODAY.
Wilkerson, she said, struggled to afford the strips.
In June, Wilkerson was tasked with supervising the kennel while his boss was on vacation. On his second day there, he was unresponsive to calls from his fiancée – who later found him unconscious a few hours after taking the over-the-counter insulin, said the Post.
He died five days later.
Struggling to stay alive: Rising insulin prices cause diabetics to go to extremes
After losing his insurance, he rationed his prescription insulin until it ran out, Erin Weaver, his mother, told USA TODAY. When that supply was used up, he switched over fully to ReliOn.
"It just didn't work for him," said Weaver, who noted her son and his fiancée wanted to save money to pay for expenses, contrary to other news reports that they were saving up for an upcoming wedding.
ReliOn is a safe and effective option for people who can't afford prescription insulin, according to Dr. Todd Hobbs, the chief medical officer for ReliOn maker Novo Nordisk.
Patients should work with a medical professional when switching to over-the-counter human insulin products such as ReliOn, Hobbs said.
"This tragic story highlights the need for education concerning the appropriate use of human insulin," Hobbs said in a Thursday statement to USA TODAY.
Dr. Silvio Inzucchi, an endocrinologist at Yale School of Medicine, said that while the product is safe, affordable and effective, its formulation is less reliable hour-to-hour for patients.
If cost weren't an issue, said Inzucchi, prescription "analog" insulin would be preferable for people with diabetes.
Follow Joshua Bote on Twitter: @joshua_bote
This article originally appeared on USA TODAY: Insulin sold over counter: Man dies using ReliOn sold at Walmart, CVS