The Type 1 Diabetes Defense Foundation Files Lawsuit To Compel Disclosure Of Manufacturers’ Effective Net Realized Prices For Insulin
For immediate release. Summary: The Type 1 Diabetes Defense Foundation has filed a lawsuit in federal court seeking disclosure of manufacturers’ net realized prices on insulin and now calls for support to expand its campaign to make insulin affordable again. The lawsuit alleges that for years insulin manufacturers and PBMs have conspired to hide the actual U.S. price of insulin—the heavily rebated prices that PBMs and insurers actually pay, instead of the artificially inflated list prices used by PBMs to calculate consumer pre-deductible and coinsurance payments. T1DF separately observes that the American Diabetes Association has continued to fundraise off the “staggering cost of diabetes” and engaged in behind-the-scenes meetings with insulin manufacturers, but has failed to take direct action to expose the exploitative dual-pricing scheme and protect people with diabetes from artificially high insulin prices and cost-related stigma. T1DF now seeks to fill the crucial role of U.S. diabetes watchdog that the ADA has thus surrendered. March 30, 2017 - Eugene, OR. The Type 1 Diabetes Defense Foundation has retained class-action law firm Keller Rohrback and on March 17, 2017, filed a lawsuit against the nation’s three largest pharmacy benefit managers, Express Scripts, OptumRx, and CVS Caremark, and the three major insulin manufacturers, Sanofi-Aventis, Novo Nordisk, and Eli Lilly (Boss v. CVS Health Corp, 3:17-cv-01823). Learn more about Keller Rohrback's insulin overpricing case. The lawsuit alleges that PBMs, insurers and insulin manufacturers have conspired to hide from consumers their dual pricing scheme and to mislead consumers to believe that unrebated list prices—assessed at the pharmacy point of sale and used by PBMs to calculate pre-deductible or coin Continue reading >>
The Makers Of Insulin Are Being Accused Of Price-fixing In A Class-action Lawsuit
An insulin pump. Alden Chadwick/Flickr A lawsuit filed Monday alleges that the three companies that make insulin have been part of an "organized scheme to drive up prices at the expense of patients who need insulin drugs to live." Insulin is a hormone that helps people absorb and process the sugar in food. Roughly 1.25 million people in the US who have Type 1 diabetes need to inject insulin to live, as do many people with Type 2 diabetes, the more common form. The complaint filed in the US District Court of Massachusetts details examples of patients who pay $900 a month for the drug, as well as people who induced diabetic ketoacidosis — a potentially fatal condition in which the body builds up too much of a certain blood acid because there isn't enough insulin in the body — to have access to insulin samples in the emergency room. The suit alleges that the drug companies — Novo Nordisk, Sanofi, and Lilly — violate the Racketeer Influenced and Corrupt Organizations Act. “People living with diabetes are practically imprisoned under the price hikes and sadly are resorting to extreme measures to afford the medication they need to live,” Steve Berman, a managing partner at the legal firm representing the patients in the suit. The suit is seeking class-action status. Here's how the three companies responded: "We strongly believe these allegations have no merit, and will defend against these claims," Sanofi said in a statement. Lilly said in a statement that the company is aware of the suit and that "Lilly conducts business in a manner that ensures compliance with all applicable laws, and we adhere to the highest ethical standards." "We are aware of the complaint and its characterization of the pharmaceutical supply chain," Novo said in a statement. "We disagree wit Continue reading >>
Several Probes Target Insulin Drug Pricing
With the price of a crucial diabetes drug skyrocketing, at least five states and a federal prosecutor are demanding information from insulin manufacturers and the pharmaceutical industry’s financial middlemen about their business relationships and the soaring price of diabetes drugs. Attorneys general in Washington, Minnesota and New Mexico issued civil investigative demands this year and are sharing information with Florida and California, according to various corporate financial filings. Insulin makers Eli Lilly, Novo Nordisk, Sanofi and top pharmacy benefit manager CVS Health are targets in the state investigations. Several of the financial filings note that the state and federal prosecutors want information regarding specific insulins for specific dates in relation to “trade practices.” They appear to be looking into potentially anti-competitive business dealings that critics have leveled at this more than $20 billion niche market of the pharmaceutical industry, according to analysts and court filings reviewed by Kaiser Health News. These include whether drug makers and middlemen in the supply chain have allowed prices to escalate in order to increase their profits. At the same time, prominent class-action lawyers are bringing suits on behalf of patients. Steve Berman, an attorney best known for winning a multibillion-dollar settlement from the tobacco industry, alleged collusion and said it was time to break up the “insulin racket.” The price of insulin — a lifesaving drug — has reached record highs as Eli Lilly, Novo Nordisk and Sanofi raised prices more than 240 percent over the past decade to often over $300 a vial today, with price rises frequently in lockstep, according to information technology firm Connecture. Those prices take a toll on patien Continue reading >>
Insulin Is Too Expensive For Many Of My Patients. It Doesn’t Have To Be.
At age 15, I suddenly felt an unquenchable thirst and began urinating frequently. I lost 20 pounds. I had developed Type 1 diabetes, an autoimmune disease that destroyed my body’s ability to produce insulin. Without insulin, I would have eventually developed a condition called diabetic ketoacidosis, which is lethal without (and even sometimes with) treatment. Years later, I’m a practicing endocrinologist. I could never have imagined back when I first started taking insulin that one day I would have so many patients who could not afford the medication because of skyrocketing prices. When the drug was discovered in 1921, the original patent was sold to the University of Toronto for $1 so that no one else could patent it and “secure a profitable monopoly.” Numerous improvements later, insulin is produced by a three-company oligopoly. When the first of the newer insulin “analogs,” Humalog, hit the market in 1996, it sold for $21 a vial. Today, vials of analog insulins, including Humalog, sell for about $300 . Patients with Type 1 diabetes typically require two or three vials of insulin per month, but patients who are more resistant to insulin, such as those with Type 2 diabetes, may require six or more. A recent paper in the Journal of the American Medical Association found that insulin nearly tripled in cost from 2002 to 2013. A lawsuit filed in January accuses pharmaceutical companies of price collusion for allegedly raising insulin prices repeatedly and in lockstep to match their competitors. Prices have gotten so bad that the American Diabetes Association recently launched an online petition at MakeInsulinAffordable.org, which has been signed by more than 250,000 people. Because insulin is so expensive, some people take less than their prescribed dose, causi Continue reading >>
Big 3 Insulin Makers Sued Over Pricing; Racketeering Alleged
The complaint comes on the heels of requests from Congress and the American Diabetes Association for federal agencies to look into why insulin prices are so high. Eleven people with diabetes today filed a class action lawsuit against the world’s 3 largest makers of analog insulin—Novo Nordisk, Sanofi, and Eli Lilly. The suit accuses the 3 for driving up prices in “an organized scheme” that has harmed those who need insulin to stay alive. The suit alleges that in the past 5 years, the 3 companies have raised their benchmark prices for insulin by more than 150%, but that these publicly reported prices differ from the “lower, real price that they offer to certain bulk distributors.” These include large pharmacy benefit managers (PBMs) ExpressScripts, CVS Health, and OptumRx. Publication of these false, misleading prices constitutes violation of the Racketeer Influenced and Corrupt Organizations (RICO) Act said lead attorney Steven Berman, in an interview with The American Journal of Managed Care.® The RICO Act passed in the 1970s to prosecute leaders of organized crime. "We strongly believe these allegations have no merit, and will defend against these claims," said Sanofi spokeswoman Ashleigh Koss in an email to The American Journal of Managed Care.® Novo Nordisk issued a similar statement in media reports, and Lilly said it adhered to high ethical standards. The suit calls current pricing practices an “arms race” as drug makers list ever-increasing benchmark prices as part of a scheme to win favor with PBMs, who collect a percentage of the discount they pass on to their clients, mostly health insurers or large employers. The role of health insurers in the current set-up would be explored as a part of the case, Berman said. “Some may be getting part of Continue reading >>
Class Action Suit Vs. Insulin Mfrs.
I just read the article on the sidebar today about the class action suit brought against Novo, Lilly, and Sanofi over insulin pricing. I have just joined the suit. I generally prefer a hands-off, market-driven, libertarian type approach to things like this, and would say, "let the market determine the cost"... But I don't think you truly have a "free market" here. Look at the graphics below, especially given the CPI inflation index has supposedly been about 2% annual in these years. (of course, there is the whole "3rd party payment" issue with insurance obscuring and adding to the cost of the drug, but that's another rabbit hole for another day). The suit link is here, if you wish to join: Thanks, Mike. And even though I don't use them because of the high cost and my high deductible, I was able to join the lawsuit. I too am in the High Deductible boat, since 2008. I have been buying Humalog and Lantus (now Levemir) from Canada since about 2010 and 2015, respectively. I've had to pay cash for these transactions, but it costs about 30-50% of US price, so it's a trade off. Also, I've started buying Regular insulin OTC at walmart, since that is $30 cash and I can use it in concert with Humalog for bolusing low carb meals. There is nothing like High Deductible insurance to give you a taste of what drugs really cost, and how formularies work. It's been an education. D.D. Family Type-3c/1b, Dx 79 On MDI, CKD-3, SA Late last year I switched to getting my insulins thru the VA. The co-pays alone were eating me UP! Medicine is NOT a normal FREE MARKET, market, especially drugs we NEED to LIVE! We have seen this in non-diabetes meds as well. I liked the Humalog better, fit my profile best IMO, and had to switch to Novalog for bolus. I still use Lantus. If you THINK diabetes drugs Continue reading >>
News Archives | Page 8 Of 18 | Stand Up For Affordable Insulin
The leading U.S. drugmakers and pharmacy benefit managers colluded to fix prices for insulin, leading to skyrocketing costs and windfall profits for the companies, a new lawsuit alleges ( Boss v. CVS Health Corp. , D.N.J., No. 2:17-cv-01823, complaint filed 3/17/17 ). Some of the biggest players in the American health-care industry are targeted in the 69-count class action complaint, filed March 17 in a federal court in New Jersey. Drug manufacturers Sanofi-Aventis, Novo Nordisk and Eli Lilly are included. Also named are the countrys three largest pharmacy benefit managersCVS Health, Express Scripts and OptumRxwhich together control 80 percent of the PBM industry and manage benefits for 180 million people. This week, Novo Nordisk and CVS Health announced a new program that will offer discounts on insulin, a life-sustaining drug for people with diabetes. CVS says this could result in savings up to $100 per 10ml bottle. Sounds superb, right? And the timing couldnt be better, coming on the heels of the GOPs plan to repeal the ACA and replace it with a program that puts millions of people at risk of losing coverage. But before we laud two corporate giants for a big-hearted deed, we should examine whats actually being offered. Senator Bernie Sanders of Vermont brought the issue of unaffordable insulin to the forefront last November when he criticized drugmakers Eli Lilly and Novo Nordisk. He tweeted, Why has the price of Humalog insulin gone up 700% in 20 years? Its simple. The drug industrys greed. Shortly thereafter, he and Representative Elijah Cummings called on the Department of Justice and the Federal Trade Commission to investigate three insulin makers for price collusion, Stat News reported. Too many diabetics in the U.S. are inadvertently getting stuck with a big b Continue reading >>
People living with Type 1 diabetes must take insulin by injection or infusion every day. Insulin is life support – we all need it to stay alive, as much as we need oxygen, water, and food to eat. Without access to insulin, nothing else we do here at Beyond Type 1 matters. Unfortunately (and alarmingly) many people living with T1D in the United States and around the globe do not have reliable access to affordable insulin. If you live in the United States and you’re struggling to pay for this month’s refill or dedicated to advocating to make insulin accessible to all, you’ve come to the right place. If you need insulin If you are in emergency need of insulin right now, always go to the emergency room. The below resources address those struggling to afford monthly costs. Programs, plans, discounts, and other available resources worth exploring: The Affordable Insulin Project – whether you have insurance through your employer, no insurance, or a prohibitively high deductible, the Affordable Insulin Project has compiled free guides to understanding exactly what you can do in your specific situation. If you have no insurance or a prohibitively high deductible, start here + explore discount programs that might help you get insulin you need now. Discount Programs – Insulin manufacturers Eli Lilly, Sanofi, and Novo Nordisk each have programs worth exploring if you’re struggling to afford your insulin. Eli Lilly: Lilly Cares – To receive free insulin from Eli Lilly, you must be a legal resident of the United States and have a household income under the annual income limit. Additionally, you cannot be enrolled in or eligible for a government healthcare plan (such as Medicaid or Veteran’s Administration Benefits). Sanofi: Patient Assistance Program – Through San Continue reading >>
- How did I get fat? How did I get diabetes? How did I get so unhealthy?
- Relative effectiveness of insulin pump treatment over multiple daily injections and structured education during flexible intensive insulin treatment for type 1 diabetes: cluster randomised trial (REPOSE)
- Think skinny people don’t get type 2 diabetes? Think again.
Timeline: Insulin Market Under Scrutiny
The price of lifesaving diabetes drugs has skyrocketed over the past decade. And patients aren’t the only ones who have noticed. Five states and a federal prosecutor are demanding information from insulin manufacturers and the pharmaceutical industry’s financial middlemen. Below, we detail when legal action related to insulin drugs began, with links to documents. March 2016 The U.S. Attorney’s Office for the Southern District of New York launches the first of several civil investigative demands (CIDs), beginning with Sanofi and Novo Nordisk. The federal prosecutor’s demand of Novo Nordisk specifies information is needed regarding insulins Novolog, Novolin and Levemir, according to the company’s annual report; Sanofi reports the request for information is also in relation to pharmacy benefit managers and regarding top-selling insulin drug Lantus as well as Apidra since 2006, according to the company’s annual 20-F filing. July 2016 Eli Lilly discloses that the U.S. Attorney’s Office for the Southern District of New York issued a CID also for information related to pharmacy benefit managers, according to its July 2016 quarterly filing. August 2016 Express Scripts receives a CID from the U.S. Attorney’s Office for the Southern District of New York. It too notes the federal prosecutor is asking for information about relationships. No specific drugs are named, according to the company’s 2016 annual report. November 2016 Bernie Sanders (I-Vt.) and Rep. Elijah Cummings (D-Md.) ask the Department of Justice and the Federal Trade Commission to investigate whether insulin makers have colluded or engaged in anti-competitive behavior. January 2017 Minnesota’s attorney general launches what appears to be the first state investigation, issuing civil investigative d Continue reading >>
Diabetes Health Type 1: The Good And The Bad In Our Diabetes Advocacy World
Diabetes Health Type 1: The Good and the Bad in Our Diabetes Advocacy World Lets look at some recent examples of activism that have largely been driven by patients with diabetes and why these accomplishments are so exciting. There are three notable examples, which are as follows: Getting CMS Medicare coverage for CGMs was once seen as unlikely. We can thank patient advocacy for this 2017s decision by the Centers for Medicare & Medicaid Services (CMS) for Medicare/Medicaid coverage of Dexcom G5 continuous glucose monitoring systems for people with diabetes. Dexcom CGMs were previously labeled by the U.S. Food and Drug Administration (FDA), as an adjunctive device, meant to complement but not replace, the information obtained from more traditional fingerstick blood glucose monitoring systems. Essentially, the FDA previously determined CGM readings could not be used to make therapeutic treatment decisions (such as insulin dosages). Dexcom concluded that the best way to attain Medicare coverage of CGMs was to work within the confines of CMS, and in September 2015, it took the first step by requesting that the FDA re-label the G5 device as a therapeutic CGM which could technically be used as a replacement of fingerstick blood glucose testing for diabetes treatment decisions. Diabetes patient voices played a critical role in persuading the FDA to approve the new labeling request for the Dexcom G5 system. For example, in early July 2016, the diaTribe Foundation (see for the recommended letter text) began seeking signers for a letter it had drafted in support of the new label indication Dexcom was seeking, and it aimed to get at least 1,000 signers to the letter. Its letter was actually signed by over 10,000 people with diabetes and their families; see for details. diaTribe wa Continue reading >>
Generic Pricing Lawsuit Against Cvs Dropped; Walgreens Suit Stands
Generic Pricing Lawsuit Against CVS Dropped; Walgreens Suit Stands The Latest , The Latest , Walgreens , Generics CVS Health executives are pleased that a class action lawsuit, which alleged that the pharmacy chain colluded with PBMS to drive up the cost of generic drugs, was recently withdrawn. The plaintiff in the Rhode Island suit , a CVS customer,said she paid more out-of-pocket for drugs when she used her health insurance than she would have if she had paid cash. She blamed the pricing disparity on CVSs collusion with third parties such as PBMs. However, the lawsuit against CVS Health was voluntarily withdrawn a few weeks ago, Michael DeAngelis, Senior Director of corporate communications for CVS Health, told Drug Topics. The complaint contained numerous demonstrably false assertions that a reasonable prefiling investigation by the law firm would have discovered. As such, we are pleased that the suit was voluntarily withdrawn, DeAngelis said. The same plaintiff also filed a similar class action suit against Walgreens, also alleging PBM collusion on drug pricing. That legal action appears to be moving ahead. "Our case against Walgreens was not dismissed and will remain on file until we achieve a just outcome for consumers, said Steve Berman, managing partner of Hagens Berman, the law firm that filed the suit. The complaint lacks merit and we will vigorously defend against the allegations, Jim Cohn, a spokesperson for Walgreens, told Drug Topics. For its part, CVS Health notified Hagens Berman that the complaint contained numerous factual misstatements that, when corrected, make it clear that the plaintiff named in the suit was not overcharged for her prescriptions atCVSPharmacy, DeAngelis said. The complaint misrepresented the cash prices for drugs the plaintiff pu Continue reading >>
Nevada Coalition Wants Drugmakers To Reimbursediabetics
Nevada coalition wants drugmakers to reimbursediabetics CARSON CITY Nevadans dismayed by soaring drug prices told lawmakers Wednesday the state should take unprecedented action to curb costs. A coalition of hotel and casino owners, union leaders and Democratic lawmakers are attempting to mandate pharmaceutical companies refund people for overpriced American insulin. The bill targets diabetes medications, which regulate glucose and insulin levels, and would require drugmakers to reimburse Nevada patients and insurers for what they pay above the highest price in other developed countries for the same prescriptions. Drugmakers would also have to reimburse people if American insulin prices increase more than inflation would suggest they should. Diabetics and the family of people who died after they could not afford crucial blood sugar treatment pleaded with lawmakers for change at a legislative hearing. "Essentially it would mean a lot more people would be alive today and it would mean a lot of my friends would be able to live a healthy life," said Christopher Hughes, a 14-year-old Las Vegas resident who was diagnosed with Type 1 Diabetes when he was 1 years old. The policy under consideration in Nevada is unique among crusades against America's colossal, free market pharmaceutical industry. Similar to proposals in other states, though, it's unclear how drug companies would react to the rules or whether the government can viably force private businesses to take action on prices. In an effort to determine what drives price increases, whether companies are synchronizing them and why more generic drugs are not on the market, the bill also seeks drugmakers' business expenses relating to insulin. Senate Bill 265 would require manufacturers to disclose the costs of all research, Continue reading >>
Insulin Overpricing - Keller Rohrback | Complex Litigation Law Firm
United States District Court, District of New Jersey On March 17, 2017, the nationally recognized class-action law firm of Keller Rohrback L.L.P. filed suit against the nations three largest pharmacy benefit managers (PBMs), Express Scripts, OptumRx, and CVS Caremark, and the three major insulin manufacturers, Sanofi-Aventis, Novo Nordisk, and Eli Lilly, who produce the well-known and widely-prescribed analog insulins: Lantus, Apidra, Levemir, Humalog, and Novolog. The complaint, which was filed in the New Jersey federal district court, alleges that the PBMsinsurance industry middlemen who negotiate drug prices and create drug formularies that determine how much patients payconspired with the insulin manufacturers to artificially inflate the price of insulin for their own collective benefit. This profit-seeking move has directly injured individual patients and other purchasers of insulin financially and put the lives of millions of diabetes sufferers at risk. The Insulin Pricing Scheme alleged in Plaintiffs complaint explains how PBMs sell exclusionary or preferential access to their formularies in exchange for a cut of rebates and other fees paid by the drug manufacturers to the PBMs. Formularies are ranked lists of drugs that health insurers rely upon to determine how much of their members drug costs they will cover. Manufacturers sales depend on access to these enormous purchaser pools for their profits. Although the PBMs claim the rebates and other payments lower the cost of insulin, in fact, this is misleading. The rebates and other payments decrease the cost of insulin for the PBMs and the insurers with whom the rebates are shared, but drive up the cost for consumers, whose pre-deductible or coinsurance payments at the pharmacy point-of-sale are based on the unre Continue reading >>
- Linking Readmission, Reimbursement Exposes Complex Needs of Diabetes Patients
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- Relative effectiveness of insulin pump treatment over multiple daily injections and structured education during flexible intensive insulin treatment for type 1 diabetes: cluster randomised trial (REPOSE)
Class Action Suit Vs. Insulin Mfrs.
Hi Mike G.....thanks for the information. Seems a bit odd based on my own experiences. I have been on Lantus for 7-8 years now. Until 2015 when I found this website and converted myself to LCHF, I was taking 126u of Lantus each night, and still not keep my BS under control. When I injected I had to inject one full load, then crank up some more and inject it. I was beginning to 'slush' when I walked...At that time I was on Blue Cross Blue Shield through an employer. The Lantus, as you said had become extremely costly, not only in unit price, but I was taking so dang much. Then I went on Medicare with supplemental in June of 2015. Thankfully I had reduced my daily dosage of Lantus down to 25u with LCHF eating and my A1c was between 5.8 and 6.2! Yet the Lantus was still like $1,500 per box of pens (5 pens, 300u). This year, keeping the same insurance supplemental, the cost per box dropped to $25 per box of pens (5 pens, 300u) I do not think these price issues are with the manufacture, I think they are with the providers....at least that has been my experiences. If we get to shop across state lines (and I believe we will), thus opening up the free markets, the need for a law suit will go away..! Continue reading >>
Trump's Pick To Lower Drug Prices Is A Former Pharma Executive Who Raised Them
Trump's pick to lower drug prices is a former pharma executive who raised them President Donald Trumps pick for health secretary previously served as a high-ranking executive at a pharmaceutical company that repeatedly hiked the prices of its drugs, doubling the U.S. list price of its top-selling insulin over the five years he served as a company president. Trump endorsed Alex Azar, a previous Deputy Secretary of Health and Human Services under President George W. Bush and pharmaceutical executive at diabetes pharmaceutical giant Eli Lilly, as a star for better healthcare and lower drug prices on Twitter. Supporters said that Azars understanding of the complicated dynamics behind pharmaceutical pricing would give him an advantage in figuring out how to make drugs more affordable. Critics, however, noted that Azars tenure at Lilly coincided with massive list price increases on insulin and made him particularly ill-suited to lower drug prices. While Azar led Eli Lillys largest affiliate, Lilly USA, the U.S. list price of Humalog insulin more than doubled, from $123 per vial in Jan. 2012 to $255 per vial when he left the company in early 2017, according to data from Truven Health Analytics. Lilly, along with other insulin makers, was hit by a class action lawsuit alleging overpricing of insulin earlier this year. Alex had a successful career at Lilly, and we wish him the best in his future work, Lilly spokesman Greg Kueterman said in an email. Azar joined Lilly in 2007 as a senior vice president of global corporate affairs and communications. He rose to become president of the companys largest affiliate, Lilly USA, in 2012. Kueterman said his responsibilities included direction over the sales and marketing operations of the entire U.S. commercial business, including diabe Continue reading >>