To the type 1 diabetic, the availability of injectable insulin could spell life or death.
While type 2 diabetics survive on ingested medication, with the generic drug metformin being the most common and available in just about any drugstore throughout the country, insulin is harder to come by since it must be refrigerated to remain effective.
For better or for worse, insulin is usually purchased by type 1 diabetics in Mercury Drug braches. Mercury Drug’s main competitor, Watson’s, does not generally sell insulin, except for a handful of branches.
When a diabetic heads to the nearest branch of Mercury Drug, therefore, it is because there are few other choices where the lifeline medication is available.
On October 31, a retired 62-year-old diabetic whose blood sugar had risen to dangerously high levels, and who had run out of insulin, headed to a branch of Mercury Drug in Makati City. Raul Dimaano had just picked up his son from school when he dropped by the Zobel Roxas branch of the drugstore.
By then, Dimaano felt like collapsing.
At the senior citizen’s counter, he presented the “yellow booklet” and doctor’s prescription. Dimaano, however, forgot to bring his senior citizen’s ID, although he had other government-issued identification like his driver’s license.
Without that senior citizen’s ID, he was told that he would not have gotten the 32 percent discount for his insulin. Under the Senior Citizen’s Law, anyone aged 60 and above is automatically entitled to a 20 percent discount on purchases of medication, and the 12 percent tax is also waived. That law does not say that the ID must be presented. Any valid ID is good enough. Besides, the record of the sale is placed on the yellow booklet.
Depending on the brand, a syringe with insulin would cost somewhere in the vicinity of P800. Less the discount, it becomes less than P600. How long the set lasts depends on how much insulin a patient’s doctor prescribes.
(Note: This writer is also a type 1 diabetic and his Lantus insulin syringe is good for 10 days worth of injections.)
What happened next to Dimaano became a nightmare that could have turned fatal.
The counter clerk refused to sell him his much-needed medication, one that he needed on the spot.
“I told them that I needed the insulin immediately,” he told The Manila Times. The clerk still refused because he did not have the necessary ID. He presented his driver’s license that showed his true age. This was not accepted by the Mercury Drug staff.
Instead, he was told to return with the ID. The clerk even told him that he looked like a strong guy who seemed pretty healthy.
Dimaano admits that he only had enough cash on hand to buy insulin at a senior’s discount. The Senior Citizen’s Act states that any government issued ID is sufficient proof that entitles a Filipino senior citizen to the discounts in the absence of the senior citizen’s card.
Physically, Dimaano does appear to be outwardly healthy. Prior to retiring, he had worked as executive assistant of National Bureau of Investigation Director Magtanggol Gatdula.
But any doctor will say that outward appearances can be deceiving, especially in the case of diabetics. They may appear healthy, but when their blood sugar shoots up or sinks to dangerous levels, a coma will follow. Well-known singer Gary Valenciano is a type 1 diabetic, as is LA Revilla, team captain of the La Salle Green Archers which won the UAAP championship this year.
With insulin, type 1 diabetics can lead very normal lives. Without it when they need it, they can collapse at any moment.
And because diabetes is a debilitating disease that attacks the other internal organs, Dimaano also has a heart condition. He already had an angioplasty. Besides this, he is also suffering from cirrhosis of the liver.
He warned the Mercury Drug staff that this was a matter of life and death, but they still refused to sell him the insulin. Dimaano identified the staff as Mrs. Nannette Manangco (sales supervisor) and Pamela Griego (sales clerk).
Dimaano was not alone when the incident occurred. His son was in his car, but could not come to his rescue because the teenager was recuperating from injuries sustained in a school accident.
How he made it home, he does not recall. He was eventually able to buy his medication at another branch of Mercury.
For ordinary people, a blood sugar count of between 90 and 130 is considered normal.
Once it exceeds this level, a person is officially a diabetic. If a diabetic’s blood sugar is consistently high despite taking medication, his condition is said to have worsened to the point that he becomes a type 1 diabetic. He needs insulin everyday to survive.
At the time that Dimaano related this incident to the Times, his blood sugar level was 400-plus, enough to send him into a coma. He said that he felt just as bad, if not worse, when he went to Mercury Drug that day.
Dimaano said he warned the staff of the drugstore that he would sue, given the fact that they had willfully endangered his life by refusing to sell him his medicine.
Today, more than three weeks after the incident, he is still angry at what he underwent in the hands of people who should have known better.
This diabetic has seen for himself how Mercury Drug seems to have inconsistent policies where the sale of such drugs as insulin is concerned. In one branch of the drugstore in Bicutan, a sales clerk said that the prescription for insulin had to be specific and for one time use only. Meaning any diabetic who needed to buy the drug had to go back to his doctor again and again.
The staff at another branch also in Bicutan know better. All they require is to see the prescription and the sale is consummated without a problem.
As Raul Dimaano mulls whether to sue the country’s largest drugstore chain or not – he is aware that it will cost him a lot in legal fees – he says that he thinks often of what could have happened to him had the fates been less kind.
He could have collapsed and died on the spot because the staff of one branch of Mercury Drug said he looked strong enough to go home and get the necessary ID, one which the law says was not absolutely necessary, given his condition. Given this, refusing a diabetic his insulin is tantamount to denying a drowning man a ring buoy or lifesaver.
Dimaano is one of millions of diabetics in the world. The Philippines has an estimated six million diabetics, and ranks tenth among countries with the highest diabetes incidence worldwide.
Diabetes is four times more common than all cancer cases combined.