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| According to the CDC, 37.3 million people, or 11.3% of the US population, have diabetes, making it the eighth leading cause of death in the United States. Simon Dawson |
Medicare capped out-of-pocket costs this month, but many people with diabetes still struggle to pay for insulin.
California, with a population of 39 million, is now the most critical state to sue big players in the insulin market, accusing them of illegally inflating treatment costs and creating a financial and public health crisis.
Attorney General Rob Bonta announced the lawsuit late last week, alleging that the company engaged in "illegal, unfair and deceptive practices" in violation of California's competition laws.
Bonta sees the U.S. insulin market as an "oligopoly," with his three pharmaceutical companies, Eli Lilly, Novo He Nordisk, Sanofi, and Pharmacy Benefits Manager, controlling 90% of the world's insulin supply. I'm here. I am here. I am here. filed a state lawsuit against CVS Health. , Express Scripts and his OptumRx control 80% of the US insulin market.
About 38 million Americans have diabetes, which is about 11% of the US population. In addition, approximately 8 million people require insulin treatment, including all type 1 diabetic and many types 2 diabetics. Insulin costs between $20 and $35 a month, but can cost hundreds of dollars a month if you don't have insurance or a plan with a high deductible.
This currently limits the monthly cost of insulin to $35 for over 3 million insulin users on Medicare Part D drug plans. According to a study released at JAMA Network Open on Friday, nearly half of this population is expected to benefit from the cap. Researchers found that 45% of people with a Part D plan that covers insulin paid $35 or more a month between 2013 and 2019, up from 22% in 2006. bottom. predetermined.
But while lawmakers and public health experts hope Medicare's pricing rules will pressure the industry as a whole, people under 65 won't benefit from the new cap.
Insulin was discovered a century ago. Following this medical breakthrough, the researcher sold the patent to the University of Toronto for $1 in hopes of promoting affordable access permanently.
History and the pharmaceutical industry had other ideas. Critics say recent price increases for off-patent drugs are hurting competition from the big three pharmaceutical companies. Aspects of Insulin Formulations and Injectors He fine-tunes delivery methods such as pens to extend lucrative patent protection for the brand's insulin products.
Dr. Jeremy Green, professor of medicine at Johns Hopkins University, said:
Some companies targeting the California lawsuit claim that costs have already come down for many consumers.
Eli Lilly's spokeswoman Daphne Dorsey said the California lawsuit "ignored the right of everyone to buy her Lilly prescriptions for $35 or less each month." It averaged $21.80, down 44% over the last five years. ”
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| California Attorney General Rob Bonta (center) announced the California lawsuit on Thursday. Adam Beam/Associated Press |
Eli Lilly and Novo Her Nordisk representatives highlighted the company's program to provide financial assistance to those struggling to buy insulin.
A representative of Her CVS Health and Her Optum Rx, Her Optum Rx is a pharmacy benefits administrator who works on behalf of insurance companies and negotiates rebates from list prices set by pharmaceutical companies. obtain. rejected the country's claim that
Arkansas, Kansas, Kentucky, Minnesota, and Mississippi are suing drug companies over insulin costs.
A recent GoodRx analysis of U.S. pharmacy and insurance company data found that the average retail price of insulin rose 54% from 2014 to 2019, but has risen slightly in recent years. obtain. reported to have fallen. According to his 2020 RAND Corporation study, led by senior policy researcher Andrew Mulcahy, the average list price of insulin in the United States has reached about $200 per vial, with prefilled pens costing more than other forms of insulin. are also becoming more expensive. morning. ten times stronger. the country has been identified. An insulin user usually needs 2-3 vials per month.
Twenty-two states, including the Washington D. Association, are lobbying Congress to consider a bipartisan law called the Insulin Act, according to the American Diabetes Association. Monthly insulin costs for diabetics are only $35.
Dr. Kasia Lipska, an associate professor at Yale University School of Medicine, said in a July study that one in seven people using insulin in the U.S. was "devastatingly spending" on the drug. I discovered what I was going through. toward their healing. A research study published in November found that 17% of insulin users reported that they were rationing drugs to save money.
People who need insulin but don't take it as prescribed are at increased risk of heart attack, kidney failure, amputation, blindness, and death.
Rising insulin prices are disproportionately affecting Hispanics and blacks, who have a higher incidence of type 2 diabetes and are at a higher risk of dying from the disease than whites, according to a California lawsuit.
Larry Levitt, executive vice president of health policy at the Kaiser Family Foundation, said the interaction between drug companies, pharmacy benefit managers, and insurers "is a fairly modest cost for insurers, but it has to be paid."
He and others hoped the lawsuit would help clarify what they characterized as an ambiguous pricing scheme for insulin.
"This is pure profit padding," Bonta said.
In June, the Federal Trade Commission published an unrelated study of the impact of pharmacy benefit managers on drug affordability and access.
Isaac Sorensen, a spokesperson for OptumRx, a UnitedHealth Group subsidiary, said the California lawsuit misunderstood the function of pharmacy benefit managers.
“Only pharmaceutical companies set list prices for their products,” said Phil Blando, a spokesman for CVS Health. Claims that manufacturers play any role in determining the prices they charge are false. ”
The rebate negotiation process among industry players contributes to higher drug costs, and reducing or eliminating rebates lowers list prices, reducing out-of-pocket costs for some people, according to a University of Southern California research paper. I know you can.
Her 33-year-old Los Angeles girlfriend, Sammi Lappin, has type 1 diabetes and has been living on expensive insulin since she was 20, making her life choices difficult. increase. gain. get. She is reported to be restricted. under.
Lappin, who works in talent acquisition in the aesthetic medicine industry, said
