Josh Wilkerson was alone in the sleeping quarters above the northern Virginia dog kennel where he worked when he began to suffer a series of strokes that ended up killing him.
After aging out of his stepfather’s health insurance on his 26th birthday, he eventually switched to over-the-counter insulin as like many other diabetics his age, he could not afford the prescription brand he needed.
Just a few hours after taking another dose of the lower-grade medication that day in June, Wilkerson was in a diabetic coma with his blood sugar level 17 times higher than what is considered normal.
Wilkerson’s death reveals just one of many thousands of lower-income people living with diabetes in the United States who depend on over-the-counter insulin that for just $25 a vial at Walmart sells for one-tenth of what the more effective version costs.
“It’s very hard,” said Rose Walters, his 27-year-old fiancee.
She like Mr. Wilkerson, was also born with a congenital form of the disease, or, type 1 diabetes.
“How many more young type 1 diabetes patients have to die before something finally changes?”
With the shooting price of insulin, which emulates the hormone secreted by the pancreas to regulate glucose in the blood, has created fury in the US while reports of people dying after rationing the medication.
Under its ReliOn brand – the more affordable form of the insulin – it has been sold by Walmart since 2000.
It is known as the “human insulin,” and take up to four hours to take effect with varying levels of success while the non-generic version, analogue insulin, is more precise and takes as little as 20 minutes to regulate blood sugar levels.
But with analogue insulin prices almost tripling since 2002, doctors have started to recommend the cheaper version.
But for the estimated 1.25 million people with type 1 diabetes in the US, using human insulin is riskier.
Typically, their bodies are unable to produce any natural insulin — which leaves them more susceptible to fluctuations in blood sugar levels without careful monitoring.
Wilkerson first discovered ReliOn from his doctor after he turned 26 and was no longer covered by his stepfather’s health insurance plan according to his family.
At that point, monthly insulin cost was close to $1,200 — a feat that was near impossible on the $16.50 per hour he made as a supervisor at the dog kennel, which offered a limited form of health insurance.
Walters began to use the insulin they purchased at Walmart together in the winter of 2018.
Walters said her body reacted more positively to the over-the-counter medication.
Then in June, Wilkerson agreed to watch the kennel for a week while his boss was on vacation to make some extra cash.
During this time, he was having stomach issue and became increasingly moody which would happen when his blood sugar levels were high.
Walters frequently checked in with her fiancé using Facetime. During his second night away, Wilkerson told her his stomach had been bothering him, promised to take the insulin and hung up.
12 hours later, Walters realized the next morning that she had not heard from her fiancé.
She then called his phone but with no answer. She then took off to the kennel and there he was, on the floor, unconscious.
Doctors determined it was due to multiple strokes.
Wilkerson had fallen into a vegetative state and was removed from a hospital ventilator just five days later.