Businessmillions Rely On Emergency Pandemic Benefits For Rent Food And Medicine Now That Lifeline Has Disappeared
The discount program is in effect while the suit is pending. “The drug manufacturers keep showing us who they really are,” said state Rep. Mike Howard, one of the sponsors.
In a statement, PhRMA told FairWarning that it supports policy changes that make “the system work better for patients,” and listed ideas that stop short of reducing the price of insulin.
The American Diabetes Association, a major advocacy group for patients with the disease, has supported copay caps, but did not endorse Alec’s law and has faced criticism for not calling out insulin manufacturers by name. Unlike the smaller T1International group, which refuses donations from the drug industry, the diabetes association lists all three insulin manufacturers as leading corporate sponsors on its website and has accepted millions of dollars in contributions from drug companies, according to a database compiled by Kaiser Health News in 2015. A spokesperson told Kaiser Health News in 2018 that the diabetes association prefers to focus on “all entities in the supply chain” rather than individual drug companies.
The American Diabetes Association has not responded to repeated interview requests from FairWarning.
PhRMA has also sued Nevada over a requirement to justify insulin price hikes.
In 2017, Gov. Brian Sandoval, a Republican, signed a strict drug transparency bill. Focusing on diabetes medication, it required drug manufacturers to explain in writing the reason for any price hike exceeding the inflation rate.
Trump Boasted He Made Insulin So Cheap Its Like Water Americans With Diabetes Beg To Differ
Early in Tuesday night’s presidential debate, President Trump claimed he had drastically lowered the price of insulin, a lifesaving drug taken in some form by more than 7 million Americans with diabetes.
“Insulin, it’s going to — it was destroying families, destroying people. The cost,” the president said. “I’m getting it for so cheap it’s like water.”
That came as a shock to the Americans who shell out hundreds of dollars a month on insulin, a number of whom posted triple-digit pharmacy bills to social media immediately after the president’s assertion.
“I looked at my husband and slapped my leg and said, ‘Can you believe that!’ ” said Tiffany Garrioch, 36, a public health nurse and educator in Minnesota with Type 1 diabetes, who watched the debate with her family.
“We’re already an underserved and highly vulnerable population,” she said. “To hear the president say it costs as much as water makes us look like we’re crybabies or liars.”
Insulin costs her $36.76 a day, she said. In 2008, it was $9.81.
Insulin prices have ballooned over two decades, including during the Trump administration. A subset of people who will be able to enroll in Medicare drug plans that cap payments at $35 a month would be insulated from those costs. Otherwise a patient with diabetes can spend hundreds of dollars on a monthly insulin supply.
“The consequence of the untenable price of insulin can be measured in body counts,” Greene said.
Your Worst Nightmareis That Your Child Is Going To Wind Up With The Same Horrible Illness
The skyrocketing prices for insulin don’t come as a surprise for Mandy Seaton.
The wife and mother who lives on Columbus’ North Side has battled Type 1 diabetes for almost 32 years, ever since spending a week in the hospital when she was 13.
A blood sugar reading of under 140 is considered normal. Hers was 980.
“I was very lucky I didn’t go into diabetic ketoacidosis,” Seaton said, citing a sometimes-fatal condition caused by a severe lack of insulin.
Although dealing with a chronic condition is difficult, “it’s also taught me how to be really strong and have a lot of perseverance and tenacity. I just made up my mind that my diabetes is not going to stop me,” she said.
Seaton lived in South America for 10 months, ran a marathon and traveled to Mongolia.
She said her toughest struggle — both physically and mentally — came with her pregnancy and delivery of son Ronin, now 9.
“Your worst nightmare is that your child is going to wind up with the same horrible illness you have,” the pre-school teacher said.
At first, Ronin had no problems. But when he was 4, his mother recognized the symptoms right away.
Now, mother and son often do their tests and treatments together. Due to recent strides in technology, she and her husband can monitor their son’s blood sugar via their smart phones, even when the third-grader returns to classes this week at Colerain Elementary School.
While things are OK now, Seaton realizes that “in an instant, it could change” if they lose health insurance.
Eight States Pass Legislation To Place Caps On Insulin Price; Five More Await Ruling
While the coronavirus epidemic has brought federal drug pricing reform to a halt, individual states have been busy enacting their own drug pricing legislation.
In just the past six weeks, six states have passed laws that cap insulin copayments at or under $100 per month: Maine, New Mexico, New York, Utah, Washington, and West Virginia. These states now join two others, Colorado and Illinois, in becoming the first states to legislate on insulin affordability.
States That Have Passed an Insulin Price Cap
$100 cap for 30-day supply
January 1, 2020
$100 cap for 30-day supply
January 1, 2021
$35 cap for 30-day supply
January 1, 2021
$25 cap for 30-day supply
January 1, 2021
$100 cap for 30-day supply
January 1, 2021
$30 cap for 30-day supply
January 1, 2021
$100 cap for 30-day supply
January 1, 2021
$100 cap for 30-day supply
July 1, 2021
March 6, 2020
While we must wait to see how the other insulin price caps will play out in 2021, there are some positive developments. For example, in addition to its $30 copay cap, Utah’s legislature approved allowing pharmacists to refill expired prescriptions on an emergency basis, thus removing a barrier for those in dire situations. Additionally, in some states, including Colorado, Illinois, and New Mexico, the legislation requires the states to produce a report on insulin pricing practices and provides public policy recommendations to increase affordability.
Insulin Prices Are Dramatically Higher In The United States Than In Other Countries
TuesdayOctober 6, 2020
Insulin prices are more than eight times higher in the United States than in 32 high-income comparison nations combined, according to a new RAND Corporation study.
The study compared how much different types of insulin sold in the United States would cost if bought at prices in other countries. The average price per unit across all types of insulin in the United States was $98.70. Other countries would have paid a fraction as much for the same insulins.
U.S. prices were higher than each of the 32 comparison countries individually, ranging from 3.8 times higher than those in Chile to 27.7 times those in Turkey. U.S. prices were 6.3 times higher than those in Canada, 5.9 times higher than those in Japan and 8.9 times higher than those in the United Kingdom.
The study used manufacturer prices for the analysis. The final, net prices paid for insulins are likely to be significantly lower than manufacturer prices in the United States because rebates and other discounts often drive down the price paid by individuals in the United States.
But even if such rebates and discounts drive down prices by as much as 50%, the prices paid by U.S. consumer are likely to be four times the average paid in other high-income nations, according to the study.
The study was sponsored by the Office of the Assistant Secretary for Planning and Evaluation in the U.S. Department of Health and Human Services.
Insulin Prices Are Soaring Ohioans Are Dying And Many Are Calling For Capped Costs
CLEVELAND — Imagine needing a medical treatment to stay alive, but you can’t maintain it because of the costs. Millions don’t have to imagine. They live that every day because they need insulin, of all things.
“I can’t live without it. So, you’re going to pay what you have to pay,” said David Moss, a 50-year-old living with diabetes from Broadview Heights. “If I wasn’t insured the way I am now, I would definitely go get my insulin in another country.”
His family has done that. “I have cousins that were going over the border to buy insulin illegally,” Moss said.
COSTS HAVE SOARED
All of this is because the insulin costs passed along to patients have jumped significantly. Good Rx just released a study showing from 2014-2019 there was a 47% increase on insulin. Insulin is not something new or experimental so, why the increase?
“Actually getting a handle on what the price of insulin is, is not straightforward,”said Sherry Glied. She is the Dean of the Graduate School of Public Service at New York University. She co-authored a recent report for The Commonwealth Fund that shows there are so many levels to the distribution of insulin in our country.
“Most of the increase in the costs is not because the manufacturers are making so much money,” said Glied. “It’s because all the way down that chain people are making money and making deals that work to the disadvantage of people with diabetes.”
CHILDREN ARE DYING IN OHIO
That disadvantage has led to children dying right here in Ohio.
Man Dies Unable To Afford His Insulin Prescription; States Tackle The Rising Cost
The three drug manufacturers have justified the price hikes by saying that their profits from insulin have not increased after accounting for inflation, the cost of research and negotiations with health insurers and pharmacists.
Spurred by stories that diabetics are spending thousands of dollars a year on insulin, or even dying trying to ration it, lawmakers in at least 36 states are trying to tackle the issue, according to a FairWarning review of state bills introduced in the past two years. But the lawmakers are finding that the drug industry is working full-time to weaken or kill insulin price caps.
According to interviews with lawmakers in nine states, often the only way to pass an insulin price cap is to write it in a way that pushes the cost on to insurers. Lawmakers in two states, Tennessee and Minnesota, said their proposals faced pushback from pharmaceutical industry lobbyists when they tried to reduce the price for all patients, not just those with insurance. Lawmakers in several other states said that the pharmaceutical lobbyists were neutral or even helpful when they proposed controlling insulin costs through insurance copays.
Some lawmakers said they decided on copay caps because they knew from having gone against the pharmaceutical lobby in the past that otherwise their bills would fail. A lawmaker in West Virginia said that a report commissioned by Eli Lilly stating that copay caps were the best way to reduce insulin costs helped sell her on the idea.
Key Findings From The Investigation Into United States Insulin And Drug Costs:
• Drug manufacturers “aggressively” raised the list price of their leading insulin brands an average of 300% over the past decade “absent significant advances in the efficacy of the drugs.” As Sen. Grassley remarked, “There is clearly something broken when a product like insulin that’s been on the market longer than most people have been alive skyrockets in price.”
• Getting on a PBM’s formulary — the list of drugs covered by health insurance plans that hire the PBMs — is critical to pharmaceutical companies. Thus, the drugmakers offer rebates of as much as 70% of the drug’s list price to the PBMs. While most of the rebate is passed on to health insurers, PBMs keep a certain percentage — meaning the higher the drug price the more money the PBMs make. It’s the same incentive for an administrative fee of as much as 5% often collected by PBMs.
• : Instead of seeking to undercut their competitors’ prices, drugmakers closely monitored what their rivals charged so they could raise their own prices as quickly as possible — sometimes matching the competitor’s increase in as little as 25 minutes. This practice is dubbed “shadow pricing.”
Facts about diabetes:
* 7th leading cause of death in America
* More than 34 million Americans have the disease
* 7.3 million adults were not even aware of, or reported having diabetes
* 88 million Americans have prediabetes, which can lead to Type 2 diabetes
* Another 1.5 million are expected to be diagnosed with the disease this year
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There have been several initiatives carried out in the commercial sector to address insulin affordability. Last year, for example, the insurer Cigna and its pharmacy benefit management division Express Scripts announced a program designed to cap out-of-pocket costs for diabetic patients at $25 a month.
Moreover, the recent advent of biosimilar insulin products may help reduce out-of-pocket costs, as could the possibility of automatic interchangeability of biosimilar insulin and originator products.
Nevertheless, for a comprehensive approach to improving insulin affordability that reaches a larger number of diabetic patients the federal government would need to get involved, and it has to a certain extent.
Trump Administration has lowered out-of-pocket insulin costs for some
President Trump has made some dubious claims on insulin prices, including one he uttered during a September presidential debate. There, he boasted that he had helped lower the price of insulin to the point that it’s “so cheap,” it’s “like water.”
Trump also signed an executive order in July that would require federally qualified health centers to share the steep savings they receive through the 340B program with indigent patients, specifically for epinephrine and insulin products. But, this only applies to a very small portion hospitals participating in the 340B program. And, it doesn’t resolve the much larger issue that the 340B program discounts aren’t generally winding up where they’re supposed to.
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 , 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.
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Walmart announced Tuesday it will start selling private-label insulin this summer at a much lower price for the lifesaving diabetes drug than branded varieties in vials and pens.
The new brand, called ReliOn NovoLog, includes analog insulin vials for $72.88 and $85.88 for a package of prefilled insulin pens.
Walmart says its lower-priced brand will translate into savings of 58 percent and 75 percent, respectively, compared with the current cash price of branded insulin products when bought without insurance.
The product, which is manufactured by Novo Nordisk, is used to control high blood sugar in adults and children with diabetes. Walmart said it will require a doctor’s prescription.
It will be available in Walmart pharmacies this week, and in Sam’s Club pharmacies in mid-July, the company said.
More than two decades ago, Walmart launched a human insulin private label brand called ReliOn that costs about $25 per vial, but that’s an older formula that some doctors say isn’t as effective as the latest offerings.
“We know many people with diabetes struggle to manage the financial burden of this condition, and we are focused on helping by providing affordable solutions,” said Dr. Cheryl Pegus, executive vice president of Walmart health and wellness.
About 34 million Americans live with diabetes, or nearly 10 percent of the US population, according to the Centers for Disease Control and Prevention. It’s the fastest-growing chronic disease in the country.
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 don’t 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.”
As Prices For Insulin Skyrocket Walmart Launches ‘affordable’ Brand
The price of insulin in the U.S. is 10 times higher than in most OECD nations.
Walmart unveils discounted insulin brand
Walmart announced it is launching its own private brand of insulin, which the big box chain says will save customers with diabetes up to 75% on the lifesaving drug.
Walmart’s ReliOn brand will sell private label NovoLog short-acting insulin that is manufactured by the pharmaceutical firm Novo Nordisk.
The analog insulin vials and pens will save customers between 58% to 75% off the cash price of branded insulin products, or up to $101 per vial or $251 per package of “FlexPens,” the retailer said.
The medication will be available in Walmart pharmacies starting this week, and Sam’s Club pharmacies beginning in mid-July.
“We know many people with diabetes struggle to manage the financial burden of this condition, and we are focused on helping by providing affordable solutions,” Dr. Cheryl Pegus, the executive vice president of Walmart Health and Wellness, said in a statement Tuesday. “We also know this is a condition that disproportionately impacts underserved populations.”
Pegus said Walmart’s new insulin offerings are part of their commitment to improve access and lower the cost of care.
Fact Check: Is Joe Biden Responsible For The Rising Cost Of Insulin
Out of roughly 330 million people living in the U.S., about 34 million are living with diabetes.
For individuals with type 1 diabetes, access to insulin is the difference between life and death.
Recently, many Americans have been expressing their outrage on social media at the rising cost of insulin and wonder who is to blame.
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 struggle—a 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 lives—turning down jobs or moving to a state with better coverage, for example—just to afford the basic care they need to survive.
Why Am I Paying So Much More Than $130 Per Year For My Insulin
Right now, there is no competitive biosimilar insulin market. Not just in the United States – anywhere in the world. This study sites the insulin oligopoly, regulatory challenges and regular incremental developments in insulin as three reasons we haven’t seen the emergence of a healthy biosimilar market. In order for the low prices suggested here to become a reality, multiple new manufacturing competitors need to enter the ring.
Not only are the big three insulin manufacturers financially opposed to biosimilars entering the market, they’ve actively taken legal steps to prevent it. In July 2017, Merck received FDA approval for Lusduna Nexvue, a biosimilar of Lantus. It has not launched in the United States because of an outstanding lawsuit — Sanofi, maker of Lantus, sued Merck for patent infringement. Just this month, Merck announced that Lusduna will not come to market because of the cost associated with getting it there.
The answer to why you’re paying so much for insulin depends on where you live, what kind of insurance you have, and a slew of other variables. The study’s authors remind us: “final prices to patients or health systems may include additional mark-ups added during the supply chain. These mark-ups will vary between countries, as they may be subject to local negotiations, regulations, and other factors. In some cases, these additional markups can be very large.”
The Cost Of Insulin: What Determines The Cost And How To Save
Government regulation on drug prices has been heavily debated across the healthcare atmosphere. Drug prices seem to be reaching new heights every year. And, insulin prices are no exception. Before rebates or discounts, insulin costs make up approximately $48 billion, or 20 percent, of the direct costs for treating diabetes. Based on current trends, gross insulin costs are projected to reach $121 billion by 2024.
Diabetes is one of the most expensive chronic conditions to treat in the U.S. over a lifetime. With around 30 million Americans living with diabetes and almost 90 million Americans living with prediabetes, insulin may be a household necessity for many people. But what exactly is driving up the cost of insulin and are there ways to save on insulin? Read on to learn more about the cost of insulin.
What determines the cost of insulin?
The cost of insulin depends on the type of insulin and who it’s manufactured by. Three major pharmaceutical companies control the majority of the pricing of insulin in the U.S. These companies include Sanofi, Eli Lilly, and Novo Nordisk. Many people might ask why manufacturers make insulin prices what they are, and the answer is because they can, quite simply.
Insulin savings programs
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 aren’t 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 don’t 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 Grassley’s statement True.