The most recent installment of The Times, generally excellent Paying Till It Hurts series looking at medical costs sparked the ire of diabetes patients, who sent the Twitter hashtag #NotJustAGadget trending. They felt the article, on pricey diabetes treatments like cutting-edge pumps, cast them as spendthrift rubes duped by evil drug and device makers into paying way too much for nice-to-have but unneeded products (with insurers and taxpayers footing most of the bill). The Times, public editor acknowledged these concerns broadly and conceded that the headline was questionably-worded, but highlighted the key role that several industry-backed patient-advocacy groups have played in heating up the protests. Grey Lady burn!

The high cost of treatment is certainly a legitimate topic, and the piece is actually pretty well balanced, but you could come away from it feeling that patients are getting fleeced especially if you missed the piece the Times ran a few days later about how the rate of complications from diabetes plummeted in the U.S. from 1990 to 2010. Experts quoted in the article credit better education and awareness, coordinated care and a push to treat high blood pressure and cholesterol in diabetes patients as well as better blood sugar control. It's hard to imagine, though, that those pricey gadgets and insulins haven't played a role too.

Catherine Price, a journalist who has type 1 diabetes, has posted a letter taking issue with a number of assertions and omissions in the article. She suggests the paper follow the FDA's lead and convene a patient advisory board to review pieces like the one that inspired #NotJustAGadget. I can imagine that no editor wants to add to their to do list the task of convening a group of patients to poke around in a big piece they're trying to get out the door, but it's not a bad idea.

It's also a reminder that these questions around medical costs are seldom uncomplicated, and that cost/benefit assessments lacking the patient voice never quite add up.

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