A sad win for Big Pharma

Insulin has been around since the 1920s, but Big Pharma – at least in the U.S. – is still pricing it as if it was the product of billions of R&D dollars.

In fact, the monthly cost of diabetes in the U.S. is over three times that of India and nearly 20 times that of Italy.

It hasn’t always been this way.

According to a study published in JAMA Internal Medicine, insulin prices tripled between 1996 and 2014 in the wake of Eli Lilly’s introduction of its market-leading Humalog insulin brand.

The U.S. accounts for only 15% of the global insulin market, but generates almost 50% of the industry’s insulin revenue.

Skyrocketing costs now impose an extreme financial burden on the 1 in 7 users for whom insulin consumes at least 40% of income remaining after costs of food and housing.

As many as one in four Americans with diabetes are now shaving insulin doses or going completely without, and those suffering the most either lack insurance or are chained to high-deductible policies.

The Inflation Reduction Act of 2022 caps insulin costs at $35/month, but for Medicare patients only.  A proposal to extend the cap to everyone covered by private insurance – including coverage purchased in marketplaces established under the Affordable Healthcare Act – was thwarted by the opposition of 43 Republican senators.  The seven Republicans who broke ranks to vote for broader coverage were:

In 2020, Colorado was the first state to cap the price of insulin, limiting it to no more than $100 per month, but the cap only applies for those with health insurance.

Western social democracies leverage the buying power of their national healthcare systems to negotiate drug pricing, and their buying clout delivers substantially lower pricing

In contrast, Medicare/Medicaid – the nation’s largest buyers of drugs to the tune of over $1 billion annually – are actually barred from negotiating drug prices.

Reforms that would allow Medicare to negotiate prices, cap out-of-pocket costs for prescription drugs, and limit insulin cost-sharing would make lifesaving drugs more affordable…

...but that will require a working Congressional majority for the Democratic Party.

Something to remember in November.