Yesterday, I saw a flyer taped up at a bus stop headlined “We Buy Diabetic Test Strips”. There was some more text and a phone number below that, but I wasn’t close enough to make them out.
What’s the story behind this? I wouldn’t have thought that there would be much of a market at all for diabetic test strips: Surely, almost everyone who has them needs them, and almost everyone who needs them has them. Is there some other use they weren’t designed for? Or maybe someone wants used test strips, for some reason? Possibly it’s geared to people who have lost a diabetic family member and want to get rid of the leftover supplies, but this seems like an awfully thin market, and you’d think they’d be advertising for other medical supplies as well.
Well, I’ve known people who get free medical stuff, then use less than what they get in order to profit. For instance, if they are supposed to check their blood glucose three times a day, they check once and sell the extra material.
When I was a teenager I knew a kid prescribed Quaaludes for some psychosis. He would take half of his prescribes dose, and sell some.
But to whom would they sell them? Presumably all of the potential customers would be getting free test strips, too. This isn’t like the quaaludes, where there’s a demand for them from people without prescriptions. Or at least, it doesn’t look like that.
Are diabetic supplies legally controlled? E.g. is this primarily an issue of people reselling supplies that they got for “free” through insurance or welfare programs (and thus on a similar moral and legal level to reselling “government cheese” or food-bank handouts), or is there a real black-market demand for diabetic supplies that can’t be bought for any price off the street in a pharmacy because the wannabe customer doesn’t have a prescription?
It depends- Lancets, some insulin, meters and test strips, (usually) syringes, are over the counter. Insulin pumps and infusion sets, new insulin formulations, and such are prescription only. The logic behind the classifications escape me, but that’s what they are. Meters and test strips use the “printer and ink” model, so if you have to pay out of pocket for them- maybe you don’t have insurance or you test more than your insurance covers- there’s trading in black market test strips, just like you can buy cheaper ink cartridges.
EDIT: Go to eBay and see how big the secondary market for test strip is- a quick search turns up 7,000 hits. Also, although trading prescription only supplies is illegal (and eBay pulls them if it finds them) it is done.
Insurance companies are notorious for limiting the number of test strips they’ll pay for, especially for Type 2s. Test strips are also damn expensive; if you pay retail, they’re about $1 each. Some people test up to 10x a day, especially when they’re first diagnosed and trying to figure out what works for their diet and how various foods effect their blood sugar.
I’m guessing the market is created by people who do have insurance, and whose insurance either pays for more test strips than they need, or they don’t test as often as they should have. The buyers are the people whose insurance won’t pay for all the strips they need, or people who have no insurance and who are trying to buy the strips as cheaply as they can.
It’s a racket. The strips can’t cost more than a few cents at most to make, and they’re some of the most expensive diabetes supplies out there. Add in that the stupid things are not particularly accurate and the whole thing is just maddening.
Person A, with insurance, gets free (or cheap) diabetes supplies, and either doesn’t use them as they’re supposed to, or gets more than they really need. They sell the surplus to person B. Free money for A! Person B then sells them on to person C, who doesn’t have insurance, or whose insurance doesn’t cover everything, so that C pays B more than B paid A, but less than C would pay his legitimate supplier. Other than the illegal insurance fraud, it’s a win-win-win.
Right. Two years ago on expensive company Pay’n’Pray insurance plan, I paid $57 for a box of 50 test strips. Six months ago on previous company plan, I paid $15-20 for a box. On my current insurance plan, I pay $2.06.
Now theoretically, I could buy 1-2 boxes per month, sell them and pocket the money. Of course, I make enough money now that the pittance this would actually get me makes no damned sense to do, nor am I the kind of person who would do it. But if you’re poor and ethically challenged, paying $4.12 for two boxes a month that you turn around and sell for $40 or so may sound like easy pocket money.
Person D’s grandmother dies, and Person D finds 50 boxes of not-expired diabetic test strips in her closet, still sealed. No fraud on Person D’s part, nor Alzheimer’s ridden Grandma’s, although it’s certainly possible that there was Medicare fraud on the part of the diabetic testing supply companies who kept sending her more test strips than she could possibly use without becoming anemic.
I’ve been Person D. And yes, I sold most of them through a website that gave me something like $15 a box. I saved some of them to use in my home nursing practice, along with a couple of her 12 meters, because they use less blood than the one my office gave me (which my patients like,) and because they come in canisters of 50, whereas my employer doles them out in packs of 10, which is inconvenient as hell.
OK, so, the consensus I’m getting here is that the black market exists because the current insurance system is just plain screwed up. Is that an accurate summation?
And diabetics with insurance can’t be arsed to test their blood sugar often enough, whereas people without insurance are terrified that they’re going to go too high for too long and end up in the hospital, which will drive them into bankruptcy.
I’m trying to figure out how reselling non-prescription supplies could be illegal. Once an insurance company has agreed to pay and the sale has been made, the supplies are legally yours, right? Based on my experience (albeit not with diabetes supplies), the number of items that my insurance company will pay for is based on the number agreed upon between the doctor and the insurance company - I don’t get a say. If the doctor says “robert_columbia needs a hundred blangwads, stat”, and the insurance company is willing to provide that, they don’t ask me if I really and truly intend to use every single one of those hundred blingwads, honest injun.
Here are my three main theories:
Insurance companies actually retain some sort of (legal) property or security interest in products purchased with insurance benefits, which means that transferring the products to someone else without the insurance company’s permission could be construed as embezzlement or theft.
Patients are required to make some sort of independent statement of need, above and beyond the doctor’s, before insurance companies will pay, meaning that a person who orders supplies at a rate greater than that at which they actually, really and truly-o use them or intend to use them has committed fraud/false pretenses by false statement. E.g. “Mr. robert_columbia, your doctor says you should get 100 diabetes test strips a month. Do you agree that you actually need 100, or do you think you could get by with 50? Be honest, now. If we find out you lied you’re in trouble.”
There’s some sort of statute specifically barring one from selling non-prescription supplies purchased with insurance benefits, above and beyond the regular property law of goods and chattels and contract law.
It’s possible to buy test strips without a prescription, but most doctors will write a prescription for the strips, so that the insurance company pays some or most of the cost.
I got that, but if my doctor says I need a hundred strips a month and I bring the prescription in to the pharmacy and have it filled and the insurance company billed, what, if any, legal consequences are there if I don’t use them as directed, but instead sell them, use them as toilet paper, chop them up into confetti to use at a party, tack them to a community bulletin board, eat them, etc.? At what point has the law been transgressed? Is it illegal to fill a prescription for no prescription required supplies unless you have a firm, positive intent to scrupulously use every last one of them as directed?