Speculation grows as state and federal investigations probe price of insulin increase
Rising insulin costs have spurred state and federal prosecutors to demand information from insulin manufacturers and several pharmacy benefit managers (PBMs). The investigation appears to be focused on whether the drug companies and pharmacy industry middlemen have conspired to let the price of insulin increase drastically in order to increase their profits. Prices for a single vial of insulin have soared from less than $100 to more than some patients’ mortgage payments in just ten years, despite that fact that insulin has been in use for more than 90 years. The investigation has raised the hopes of some diabetics who speculate that the scrutiny may finally cause insulin prices to go down.
What’s behind the drastic price of insulin increase?
Drug prices generally rise incrementally over time, but the costs of insulin have skyrocketed in recent years. In a move similar to the excessive increases in the costs of Epi-Pen doses, insulin makers Eli Lilly, Novo Nordisk, and Sanofi have raised prices as much as 290% over the past decade. Drug price increases can gradually spread between companies, but investigators have noticed the price of insulin repeatedly rising across different manufacturers within a close timeframe. The insulin medications of these three companies have risen in price essentially in lockstep for the past ten years. Investigators are looking for signs of collusion among the top insulin makers in regards to the price increases.
Several potential class-action lawsuits against insulin manufacturers are also in the wings, from patients who have seen their cost for a vial of insulin increase drastically in the past few years. A judge recently rolled those cases in with ones against several pharmacy benefit managers (PBMs) including Express Scripts, CVS, and UnitedHealth Group with its division OptumRx.
Some diabetes patients have seen their insulin costs increase by 400%, according to the NBC Nightly News. The lawsuits contend that pharmacy benefit managers play a central role in the price increases, by moving drugs from certain manufacturers into different price tiers on the formulary in return for rebates or other payments. This is how it works: The PBM agrees to the price the drug company sets for insulin, and choose that insulin manufacturer’s drug to be its “preferred medication,” on its formulary. So-called “rebates” are used to pass money from the drug companies back to the PBMs. PBMs have been able to conceal the amount of rebates they receive by labelling them as “trade secrets”.
What is the result of the rising cost of insulin?
The rising cost of insulin is forcing some patients and families to choose between buying food and purchasing the lifesaving medication. Others are trying to stretch out their medication by skipping doses or taking less than they are prescribed, which can cause significant health risks. Purchasing insulin on the black market or through crowdfunding has become common as patients seek sources of the lifesaving medication. Insulin is a necessary medication for people with Type 1 diabetes (and some people with type 2 diabetes), because these individuals’ bodies cannot manufacture insulin on their own.
Will insulin prices go down because of these investigations?
Many patients are wondering if they will see insulin prices go down because the investigations. That would be a wonderful result for patients, but there is no guarantee that this will occur. As of now, patients are stuck struggling to meet the rising cost of insulin. The only thing diabetics can do is to follow a diabetic dining plan to reduce the need for insulin as much as possible and hope the investigations will bring some sanity to insulin drug prices.
Sources:
https://www.nbcnews.com/health/health-news/several-probes-target-insulin-drug-pricing-n815141
http://www.businessinsider.com/insulin-prices-increased-in-2017-2017-5
