Out-of-control insulin costs have created a dangerous barrier for many people with diabetes who need to access lifesaving treatments.
According to the Endocrine Society, currently, 7.4 million children and adults use insulin to treat their diabetes.
These patients use at least one vial of insulin per month, and some need to purchase multiple vials or multiple types of insulin each month.
For people with type 1 diabetes, insulin is the only treatment for their life-long disease. Many people with type 2 diabetes will eventually need insulin treatment as their disease progresses.
The Society is calling on stakeholders across the supply chain to help reduce out-of-pocket costs for people with diabetes.
It released a position statement in which it identifies barriers to accessing affordable insulin and potential policy solutions that could address this growing problem.
The position statement indicates the true cost of insulin can often be difficult to pinpoint due to the lack of transparency in financial agreements between stakeholders in the supply chain, geographical differences in cost, and insurance coverage.
For example, from 2001-2016, the list price of Novolog, a commonly used insulin, increased by 353% per vial. Humulin U500 increased from $170 to more than $1,400 since 1987. From 2001-2015, the price of Humalog increased 585% for a vial of insulin, the statement cites.
“Without clear information about expenses incurred by various players in the supply chain, we cannot fully understand what is driving costs up or how to best reduce insulin costs for people with diabetes in the future,” said society spokesperson Dr. Rita R. Kalyani, associate professor of medicine at Johns Hopkins University School of Medicine.
“High costs are forcing some people with diabetes to make the life-threatening decision to ration insulin. This is unacceptable for optimal patient care. Everyone needs to be part of the solution to this problem,” she urges.
The society recommends the following policy changes:
- Future list price increases should be limited, and reasonable financial incentives should be pursued by all stakeholders.
- Patients’ share of costs should be limited to a co-pay, and human insulins should be available at no cost to the patient.
- Rebates should be passed along to consumers without increasing premiums or deductibles.
- Healthcare providers should be trained to use lower-cost human insulins and prescribe them as appropriate.
- Patient Assistance Programs should be less restrictive and have an accessible, common application that can be used for multiple programs.
- Electronic medical records should include up-to-date formulary and price information.
- Physicians should consider prescribing the lowest cost insulin when clinically equivalent options are available.
What are the insulin makers doing?
The three insulin manufacturers are taking steps to address this issue.
Insulin manufacturer Sanofi announced today it is expanding its VALyou Savings Program to include nearly all of its insulins.
The program offers the company’s insulins at one set price: $99 for a 10 mL vial or $149 for a box of pens. The company’s combination insulin product is not included in the program.
This summer, Eli Lilly launched a patient-focused helpline to help individuals with high out-of-pocket costs reduce their financial burden.
Novo Nordisk pledged to limit price hikes in 2016 and has kept annual list price increases in the single digits for the past two years.
What’s Happening at the National Level?
The Congressional Diabetes Caucus is evaluating legislative action to address rising insulin costs, and its members held a hearing to examine what is driving cost increases and potential solutions to the problem.
You can read findings from the Caucus’ insulin probe here.
Congress passed legislation last month that eliminated rules blocking pharmacists from informing patients whether they could purchase their medications for less money.
The Trump administration has proposed having Medicare pay for certain medications based on the prices in other industrial nations.
Supply chain transparency needed to combat soaring insulin costs. The Endocrine Society. 2018, November 1. Retrieved: https://www.eurekalert.org/pub_releases/2018-11/tes-sct110118.php