Generics And Biosimilars Are Bringing Down The Overall Price Of Insulins
Since 2019, the overall retail price of insulins has declined by nearly 6%. Most of this decline can be attributed to the recent approval of generics, and the biosimilar counterparts that have been on the market.
At present, retail prices for generic insulin lispro and insulin aspart are about half that of their brand-name counterparts, Humalog and Novolog, respectively. The same goes for the generic mixed insulins, insulin lispro 75/25 and insulin aspart 70/30, compared to Humalog 75/25 and Novolog 70/30, respectively.
Generics have been instrumental in bringing down costs for some patients. Instead of paying a retail price of over $140 for a brand-name Humalog KwikPen, patients can now pay about $60 for a generic insulin lispro KwikPen. Similar savings can be found for the other brand and generic alternatives.
, a long-acting insulin approved in 2016, is the follow-on to Lantus, and , a rapid-acting insulin approved in 2017, is the follow-on to Humalog. Now, the average retail price per insulin unit for Basaglar is $0.27, while Lantus is $0.34. Similarly, Admelog has a price per unit of $0.28, while Humalog has a unit price of $0.44.
How Many Canadians Have Diabetes
Studies estimate that 33% of the Canadian population has some form of diabetes or prediabetes. Experts project that number to rise as stress rates go up, and our collective lifestyle habits deteriorate.
Obesity, sugary foods, and sedentary lifestyles are all to blame for skyrocketing diabetes diagnoses.
Average Price Per Unit Across All Types Of Insulin In 2018
- United States: $98.70
- UK: $7.52
- Australia: $6.94
The average price in America, across all types of insulin, was more than ten times higher than the average for all of the other countries combined. In fact, the closest any country came to paying the $98.70 American average was the $21.48 average that Chile pays.
The differences were especially stark when the researchers looked at rapid-acting insulin, which makes up about a third of the U.S. market. Its average price in other countries was just over $8. In America, it was $119.
It comes at a high cost, and not just financially, but in terms of your life, said Mila Clarke Buckley, 30, whose autoimmune diabetes is slowly shutting down her pancreas. She runs a top-rated blog for fellow diabetics, Hangry Woman, from her home in Houston. She has more than 30,000 readers.
It’s not like one day you can just stop taking insulin, she said. You really have to manage your life thinking, OK, this is my No. 1 priority, to be able to get this little pen of liquid so that I can live.
Insulin prices in the United States are higher than prices in nearly three dozen other countries RAND researchers examinedand it’s not even close.
The prices RAND used in its studythe list prices, set by drug manufacturerswere the most available for comparison across different countries. They’re a good starting point for understanding the true cost of insulin. In the cryptic world of drug-price setting, the list price is like an opening bid.
Don’t Miss: Can Diabetics Drink Milk At Night
Living With Diabetes In 2021 Means Skyrocketing Financial Costs
The price of insulin has increased 1,200% since 1996.
When most people think of managing a chronic condition, they think about doctor’s visits, prescription medicine and lifestyle changes. But for many individuals living with diabetes, medical interventions are only part of the strugglea struggle that is only exacerbated by skyrocketing financial costs.
The costs associated with diabetes management have been climbing rapidly since the turn of the century nowadays, many of those living with diabetes have few options to fund their treatment. They’re often forced to ration medicine, not eat, even upend their livesturning down jobs or moving to a state with better coverage, for examplejust to afford the basic care they need to survive.
The Impact Of Diabetes In Canada
As diabetes diagnoses rise, the rate of diabetes-related health conditions rises with it. Those with diabetes in Canada account for 70% of all amputations not related to trauma, 50% of dialysis patients, 40% of heart attacks, and 30% of strokes annually.
Diabetes is a significant contributor to depression, with 30% of patients showing symptoms. It is also the top cause of blindness nationwide, and one in every ten deaths is somehow tied to diabetes. In shortthe healthcare costs of diabetes range far beyond just the cost of insulin.
The condition impacts more than just individuals and healthcare costs, too. Companies suffer due to employee sick time and missed work for medical emergencies. Employees who are not feeling well wont perform at their best, leading to work that needs to be redone or reassigned.
Prospective employees will also turn down jobs that they dont feel offer them proper insurance benefits. Since the cost of having diabetes and insulin is so high, many employees will take lower-paying work to have their medication covered.
If youre a business owner, its a good business practice to work with your employees and find plans that suit their medical needs. At Group Enroll, we work with top Canadian insurance providers to ensure you have plenty of options to make your company far more attractive to prospective employees.
Read Also: High Glucose Dmem
Legislation And The Future Of Insulin Affordability
There are multiple efforts underway to reduce the cost of insulin. Lawmakers and advocacy groups alike are working to help people afford insulin.
The ADA has endorsed three possible pieces of legislation that could affect insulin affordability if they were passed. These are:
- The Insulin Price Reduction Act. This act would provide incentives for manufacturers to lower the cost of insulin.
- The Safe Step Act. This act would eliminate insurance company step therapy programs that can drive up costs.
- The Chronic Condition Copay Elimination Act. This act would remove copays for medications used to treat conditions such as diabetes.
These acts may not pass and become law. However, theyre among the current suggestions to help bring down the cost of insulin. Broader healthcare laws and acts that aim to bring down the cost of accessing care in the United States could also affect the cost of insulin.
Traditional Insulins Are Cheaper Than Modern Insulins
Average retail prices of Novolin and Humulin have gone down, or held steady, while prices of modern rapid- and long-acting insulins continue to go up. On average, traditional insulins now cost less than half of what modern insulins cost.
Why? Traditional insulins have historically been cheaper than their newer competitors. Modern insulins offer better blood sugar control but are synthetic analogs of traditional insulins, which makes them more difficult to produce.
Additionally, when patents on Humulin and Novolin expired around 2000, manufacturers Eli Lilly and Novo Nordisk had to test new pricing strategies to remain competitive.
In 2017, for example, Novo Nordisk partnered with CVS to offer Novolin at roughly 80% less than its list price. Both Novo Nordisk and Eli Lilly have also worked with Walmart to heavily discount Novolin and Humulin under Walmarts ReliOn line of insulin products.
Retail partnerships havent been their only strategy. Eli Lilly had been increasing prices for Humulin every 6 months until May 2017, when they decided to stop anymore increases. In fact, prices of traditional Humulin and Novolin insulins, their rapid-acting analogs , and their mixed products have not gone up since then.
and are currently the cheapest traditional insulins, with average unit prices of around $0.10.
Don’t Miss: What Kind Of Sweets Can A Diabetic Eat
How Much Does Insulin Cost In Canada
The price of insulin varies depending on where you live. Canadians pay an average $35 per vial, but without coverage for syringes and alcohol swabs which are sold at full cost making it difficult to maintain a healthy lifestyle with diabetesThe main issue faced by those living in Canada is that there isnt any way around these high costs when using human injection devices like needles or pens some even require purchase before delivery! Theres also no assistance from government programs paying towards medical expenses despite how much time we spend administering our own medicine each day.
President Trump Announces Lower Out Of Pocket Insulin Costs For Medicares Seniors
Today, under President Trumps leadership, the Centers for Medicare & Medicaid Services announced that over 1,750 standalone Medicare Part D prescription drug plans and Medicare Advantage plans with prescription drug coverage have applied to offer lower insulin costs through the Part D Senior Savings Model for the 2021 plan year. Across the nation, participating enhanced Part D prescription drug plans will provide Medicare beneficiaries access to a broad set of insulins at a maximum $35 copay for a months supply, from the beginning of the year through the Part D coverage gap. The model follows on the Trump Administrations previously announced 13.5 percent decline in the average monthly basic Part D premium since 2017 to the lowest level in seven years.
Under President Trumps leadership, for the first time, CMS is enabling and encouraging Part D plans to offer fixed, predictable copays for beneficiaries rather than leaving seniors paying 25 percent of the drugs cost in the coverage gap. Both manufacturers and Part D sponsors responded to this market-based solution in force and seniors that use insulin will reap the benefits.
The Part D Senior Savings Model builds on steps the Trump Administration has already taken to strengthen Medicare and improve the quality of care for patients with diabetes. CMS has taken the following actions to address the needs of beneficiaries with diabetes:
You May Like: Metformin Dosage For Diabetes
Building A Unique Data Set Of Insulin Expenses
Due to lack of transparency in the system, the researchers had to leverage several sources to develop a data set that enabled them to map expenditure flows at each step in the distribution system. Sources included data from Medicare and Medicaid, Securities and Exchange Commission filings as well as state-level audit reports that were the result of state drug pricing transparency laws passed in recent years.
It is telling that we had to combine data from more than a dozen sources to understand expenditures on a single class of drug over a five-year period, said Ribero, research scientist at the USC Schaeffer Center.
Keep Reading For More Details
On January 20, 2021, the Biden administration announced a Regulatory Freeze Pending Review which states that any rules published in the Federal Register that had not yet taken effect would be postponed for 60 days to give the new administration an opportunity to review.
It is important to note that although Trumps Executive Order was published in the Federal Register on December 23, 2020, it had not yet been put into law. The order was not scheduled to go into effect until
Web Of Insulin Costs And Distribution
To understand how money in the insulin distribution system has flowed over time, Van Nuys and colleagues Rocio Ribero, and Neeraj Sood leveraged 15 different data sources to create a database of insulin expenditures between 2014-2018.
Of a hypothetical $100 spent on insulin, they find manufacturers accrued about $70 in 2014, falling to $47 in 2018. During this time, the share going to pharmacies increased from about $6 to $20, pharmacy benefit managers share increased from $6 to $14, and the share going to wholesalers increased from $5 to $8. Health plans saw their share decrease from $14 to $10 per $100 spent on insulin.
The breakdown of who benefits from insulin savings
Clearly all entities in the pharmaceutical distribution system profit from the sale of insulin, said Sood, USC Schaeffer Center senior fellow. But these data suggest increasing profits to intermediaries in the system are playing a key role in keeping net expenditures high.
Factors That Impact The Price Of Insulin
How much is insulin in Canada annually? It can be through the roof when you consider that some people with diabetes go through several insulin vials per week. The cost of insulin in Canada can be high for those without private insurance and eats up a considerable part of a typical household budget. Many Canadians will pay close to $7,000 annually for insulin.
Those with Type 2 diabetes will generally pay more. The insulin cost in Canada is too much for some people, and they opt to skip doses of their insulin rather than pay massive out of pocket fees. This practice is dangerous both for individuals and the Canadian healthcare system.
Although insulin itself is far more sophisticated than ever, many people with advanced diabetes find that they need more and more insulin just to feel okay. While some people with diabetes only need three doses a week, severe cases require close to ten. These people are often the ones who have problems when the price rises.
Also Check: Best Instant Oatmeal For Diabetics
Why Are Insulin Prices Going Up Chuck Grassley Explains It
If Your Time is short
- Insulin costs have increased dramatically in recent years, and innovations alone arent enough to justify the higher prices.
- A bipartisan Senate report documented that the business practices of of manufacturers, health plans and PBMs, or pharmacy benefit managers, are key contributors to high prices.
- There are some discounts available to offset high prices, but the discounts dont go to everyone with diabetes, and they vary from vendor to vendor.
More than 7 million Americans require insulin to treat their diabetes but some people struggle to afford the cost. On Jan. 14, 2021, Sen. Chuck Grassley, R-Iowa, tweeted, “2day Sen Wyden & I released Finance Cmte report on INSULIN costs Prices hv gone THRU THE ROOF for patients/taxpayers bc of manufacturer, health plan & PBM biz practices They make $$ as % of ballooning list price so no incentive to lower price on 100 yr old drug.”
Grassley has a history of attempting through proposed legislation to lower the cost of the drug, and Sen. Ron Wyden, D-Oregon, worked with him as the ranking minority member on the Senate Finance Committee when Republicans controlled the Senate.
Is Grassley right when he tweets about why insulin costs so much? To answer that question, we look, first, at those costs.
We rate Grassleys statement True.
Robin Feldman Professor Of Law Uc Hastings College Of Law San Francisco
One would have to see how these orders were implemented to know how powerful and effective they will be.
We are still seeing many struggle in clinical practice with affordability, says Redmond. So it is unclear to most healthcare providers who gets these insulin cap benefits. Even myself as an expert would really love any more guidance on this. There are eligibility requirements that many patients still dont meet.
As with any legal order, the devil’s in the detail, Robin Feldman, Arthur J. Goldberg Distinguished Professor of Law at UC Hastings College of Law San Francisco, tells Verywell. One would have to see how these orders were implemented to know how powerful and effective they will be. We are, however, going to need some systemic changes to try to address the problems that are driving drug prices higher in general, and insulin prices higher specifically.
Also Check: Elevated Sugar Symptoms
What This Means For You
You or a loved one might be paying high prices for insulin. Check with your insulin manufacturer to see if you qualify for a patient assistance program. If you aren’t eligible for these programs, talk to your healthcare provider or certified diabetes care and education specialist about other options.
New Product Features Can Come With A High Price Tag
and both contain a long-acting insulin and another non-insulin diabetes medication. Xultophy is a mix of insulin degludec plus liraglutide , and Soliqua is a mix of insulin glargine plus lixisenatide . Average retail prices for Soliqua and Xultophy are more than double the price of cheaper alternatives like Basaglar and Tresiba, which have the same exact kind of insulins.
Fiasp contains insulin aspart, the same insulin in Novolog, but it also has vitamin B3. This added ingredient may speed up insulin absorption, but it doesnt necessarily make Fiasp more effective than Novolog at lowering blood sugar. Interestingly, the retail prices for Fiasp and Novolog are about the same on a per insulin unit basis.
Then theres , an ultra-long-acting insulin that stays active for up to 42 hours. For this unique property, its average retail price is about $624.76 for a carton of 5 KwikPens .
Along with these new formulations, insulin manufacturers have also started offering their insulins at higher concentrations to make them more convenient for people who need more insulin than average. Humulin R, Humalog, and Tresiba all come in higher-concentration versions, and is a higher-concentration version of Lantus. At first glance, their prices may seem high, but they actually go for the same per unit retail price as their lower-concentration counterparts.
Recommended Reading: What Happens If You Have Diabetes
What Is A Fqhc / Community Health Center
Federally Qualified Health Centers, or FQHCs, are care clinics that qualify for specific reimbursement systems under Medicare and Medicaid and receive federal Health Center Program grant money intended to finance care for uninsured populations. Their patients are disproportionately poor, uninsured, and minorities. They receive subsidies in the form of federal grants and enhanced Medicaid reimbursement. They are located in underserved rural communities and central cities, where other providers are unable economically or unwilling to locate.
The National Association of Community Health Centers confirmed that its member health centers already provide deeply discounted drug prices to the low-income families they serve. In a press release, NACHC explained that the regulation, , was based on a fundamental misunderstanding that would have imposed extensive administrative burdens and targeted EpiPens and insulin dispensed by health centers and purchased under the federal 340B drug discount program. The 340B rule would have blocked Community Health Centers from receiving future grant funding unless they provided a complete pass-through of 340B discounts on insulin and epi-pens to low-income patients. Community Health Centers strongly opposed the order, arguing that it would add significant bureaucratic obligations to operations while making a minimal impact on the costs of drugs it already provides to patients.