Klobuchar Targets Rising Insulin Prices
Avery Dox is just like a lot of 11-year-olds: she loves gymnastics and is excited for summer break. But she also happens to be Type 1 diabetic. "I have to check my blood sugar about every three hours. Sometimes it's a little more, sometimes it's a little less," Dox said. Since her diagnosis two years ago, insulin has become a critical part of her life. Her mother, Alissa Daire Nelson, said the family has insurance and didn't really feel the rising prices – until a recent night when she accidentally dropped and broke the last bottle. An emergency replacement supply cost $250. "This is literally a matter of life or death. Avery has six or seven doses of insulin a day plus a long-acting one she needs to survive," Nelson said. "It was shocking to me because we had never been in that position that we had to pay out of pocket." Nelson said she can only imagine the burden placed on people who have to pay full price. "Why is it suddenly in the past 10 years the prices have skyrocketed to me? It just doesn't add up," she said. Monday, Minnesota Democratic Sen. Amy Klobuchar sent letters to the heads of the top three producers of insulin -- Eli Lilly, Sanofi and Novo Nordisk -- asking them to justify the higher prices. "And there's no arguable reason," Klobuchar said. "It's not like insulin has improved or there have been changes to it. They have simply jacked up the prices." The companies have denied claims of collusion and said the higher prices are resulting from increased demand. Klobuchar points to one example to illustrate the problem. She said the price of Eli Lilly's Humulin R U-500 insulin increased 325 percent between 2010 and 2015. "This seems like abuse of monopoly power to me, and we've got to get to the bottom of it," Klobuchar said. Added Nelson: "It really is ju Continue reading >>
Drug Makers Accused Of Fixing Prices On Insulin
A lawsuit filed Monday accused three makers of insulin of conspiring to drive up the prices of their lifesaving drugs, harming patients who were being asked to pay for a growing share of their drug bills. The price of insulin has skyrocketed in recent years, with the three manufacturers — Sanofi, Novo Nordisk and Eli Lilly — raising the list prices of their products in near lock step, prompting outcry from patient groups and doctors who have pointed out that the rising prices appear to have little to do with increased production costs. The lawsuit, filed in federal court in Massachusetts, accuses the companies of exploiting the country’s opaque drug-pricing system in a way that benefits themselves and the intermediaries known as pharmacy benefit managers. It cites several examples of patients with diabetes who, unable to afford their insulin treatments, which can cost up to $900 a month, have resorted to injecting themselves with expired insulin or starving themselves to control their blood sugar. Some patients, the lawsuit said, intentionally allowed themselves to slip into diabetic ketoacidosis — a blood syndrome that can be fatal — to get insulin from hospital emergency rooms. A recent study in The Journal of the American Medical Association found that the price of insulin nearly tripled from 2002 to 2013. “People who have to pay out of pocket for insulin are paying enormous prices when they shouldn’t be,” said Steve Berman, a lawyer whose firm filed the suit on behalf of patients and is seeking to have it certified as a class action. In a statement, Sanofi said, “We strongly believe these allegations have no merit, and will defend against these claims.” Lilly said it had followed all laws, adding, “We adhere to the highest ethical standards.” Continue reading >>
Trump's Hhs Secretary Nominee Boosted Drug Prices While At Eli Lilly
President Donald Trump tweeted Monday that his nominee for HHS secretary, Alex Azar will “be a star for … lower drug prices!” But the record of the former top executive for Eli Lilly, which tripled the price of a top-selling insulin drug while he led its U.S. operation, suggests a different story. Lilly is one of three drug companies targeted by a class-action lawsuit that accuses the company, then under Azar’s watch, of exploiting the drug pricing system to ensure higher profit for insulin and has been fined in Mexico for colluding on the pricing of the drug. Azar, who spent almost a decade at Eli Lilly, rising to become president of the drug giant’s U.S. operations before leaving earlier this year, doesn’t deny drug costs are a consumer issue. But his record there and as a top official in George W. Bush’s administration suggests he’s unlikely to push pricing policies that would hit pharmaceutical companies’ pocketbooks. In recent years, Azar has defended pricing practices, and argued against the approaches to reduce costs to consumers as Trump endorsed during his campaign, such as allowing the government to negotiate drug prices and importing medicines from oversees. Instead, Azar has followed the pharma messaging playbook on drug pricing — deflecting attention to other parts of the health system, and even other countries, blaming them for the high drug costs paid by U.S. patients. He’s also justified drug prices as the cost of innovation. Azar’s nomination signals the status quo, Eric Assaraf of Cowen Washington Research Group wrote in a note to clients Monday. “Although Trump specifically called out lowering drug prices in his announcement of Azar, we don't believe his appointment will mark a change in course in that realm.” Trump’s foc Continue reading >>
Healthpartners Endocrinologist Fights Rising Insulin Prices
At 15 years old, David Tridgell, MD, noticed a change in his body. He had an unquenchable thirst. He began urinating frequently. And he lost about 20 pounds. He had an autoimmune disease that destroyed his ability to produce insulin. “As someone with type 1 diabetes, I take insulin injections every day,” Dr. Tridgell said. “Patients like me can lead normal lives with the help of medication.” But as an endocrinologist at Park Nicollet, Dr. Tridgell sees a problem. The cost of insulin has tripled in the last 10 years. And some of his patients can’t afford the medicine they need. Patients who don’t produce insulin can die without daily insulin shots. And those who produce less insulin than their body needs, which is most people with type 2 diabetes, can lead suffer from heart disease, kidney failure, blindness, nerve damage and amputations due to high blood sugars. “Doctors spend too much time deciding what patients can afford,” Dr. Tridgell said. “I deal with these issues nearly every day. It can be embarrassing for a patient to admit they can’t afford medication.” Dr. Tridgell has seen patients shop for unused insulin online. He has other patients who push off retirement. And he has still others who have had to sell some of their possessions. “I saw one patient who stopped taking their own medication so they could pay for their child’s insulin,” Dr. Tridgell said. “This led to a preventable hospitalization. No parent should be forced to make that type of decision.” In 1921, the original patent for insulin sold for $1 to the University of Toronto. The goal was to prevent a monopoly. But competition dwindled when insulin was improved. Today, 3 companies make all of the insulin that is produced. And one vial of insulin can sell for about $300 Continue reading >>
Why The Rising Cost Of Insulin?
Recently, during diabetes management counseling sessions, I taught several patients with type 1 or 2 diabetes about the cost of insulin. They were having trouble affording their daily insulin injections even with health insurance. According to a Bloomberg news report “5 of the 27 branded drugs were diabetes drugs, which climbed at least 20% in cost in the past year.” A study in JAMA (Journal of The American Medical Association) states, “insulin prices have tripled from 2002-2013.” The ADA (American Diabetes Association) announced “a resolution and petition that calls for transparency in the insulin supply chain to ensure insulin is affordable for those who need it.” There is currently an online petition sponsored by the ADA “to solve this crisis and protect millions of Americans who need insulin to stay alive.” Insulin is a necessity, not an option, for those who suffer with diabetes type 1 and many with diabetes type 2. The petition is available at www.stopdiabetes.com/insulin for people interested in signing on. Let’s examine some of the issues surrounding and relating to insulin through the times: History of Insulin: 1921 – Frederick Banting and Charles Best did an experiment using a dog’s pancreas and discovered insulin. 1923 – Nearly a century ago, “a trio of scientists in Canada” sold the patent rights to the University of Toronto for $3.oo. 1923 – Near the end of 1923, Eli Lilly was brought on to mass produce insulin in America. This lead to the commercialization of insulin. Insulin was made from beef and pork and many people developed allergies and intolerances to the insulin. 1978 – Human insulin was produced by using recombinant DNA technology which reduced the problems individuals suffered from insulin associated with pork and Continue reading >>
The Prices For Life-saving Diabetes Medications Have Increased Again
A Type 1 diabetes patient holds up bottles of insulin. Reuters/Lucy Nicholson Insulin prices have been rising — increases that mean some people are spending as much on monthly diabetes-related expenses as their mortgage payment. It's led some people living with diabetes to turn to the black market, crowdfunding pages, and Facebook pages to get access to the life-saving drug. At the same time, the companies that make insulin have faced pressure from politicians including Senator Bernie Sanders, class-action lawsuits that accuse the companies of price-fixing, and proposed legislation in Nevada. Even in the face of this criticism, two of those drugmakers — Eli Lilly and Novo Nordisk — raised the list price of their insulins again in 2017. Diabetes is a group of conditions in which the body can't properly regulate blood sugar that affects roughly 30 million people in the US. For many people living with diabetes — including the 1.25 million people in the US who have type-1 diabetes — injecting insulin is part of the daily routine. Insulin, a hormone that healthy bodies produce, has been used to treat diabetes for almost a century, though it's gone through some modifications. As of May 2, the list price of Humalog, a short-acting insulin, is $274.70 for a 10 ml bottle, an increase of 7.8% from what the list price had been since July 2016. On May 2, Lilly also took a 7.8% list price increase to Humulin, an older form of insulin. Novo Nordisk, which also makes a short-acting insulin, increased its prices to the drug in 2017. In February, the drugmaker raised its price to $275.58 for a 10 ml bottle, up 7.9% from what the list price had been since July 2016. In December, Novo Nordisk committed to limiting all future drug list price increases from the company to single d Continue reading >>
Understanding Insulin Sticker-shock
Why are some forms of insulin so expensive, and what happens if you can’t afford the price? Mary Clark, a realtor in Cincinnati, has grown accustomed recently to being the center of attention at the pharmacy. An independent contractor, Clark has had trouble finding affordable health insurance that covers the costs of the insulin she needs to control her Type 1 diabetes. Since 2012, she’s noticed the price she must pay out-of-pocket has increased steeply; it’s been a big enough leap that even the pharmacists pause in their work when filling her order. “Everyone was just stunned and they would just stand and stare at me,” Clark says. Read “Can I Use Insulin Past the Expiration Date?” She knows many other people with diabetes that are in the same situation, especially those who use long-acting insulin like Lantus. She says she can’t afford pump therapy and she has cut out all other expenses, including doctor’s visits and dental care, to keep up with the cost of insulin. “We do without everything. There will be diabetics who will go without insulin and they can’t,” Clark says. “You won’t make it.” sponsor She’s not alone in worrying about the costs of insulin, although not everyone would notice the same price spikes as Clark, says David Kliff, who owns the newsletter Diabetes Investor.com. It’s the underinsured and the uninsured who feel the brunt of it. People with good health insurance might not even notice, as health insurance companies often demand lower prices from insulin makers for their customers, Kliff says. That’s why two people with diabetes standing in line at the pharmacy might pay dramatically different prices for insulin; the difference might even be a couple hundred dollars per vial of insulin, he says. Read about a woman� Continue reading >>
The Crazy Math Behind Drug Prices
David Hernandez, a 44-year-old restaurant worker and Type 1 diabetic, didn’t have insurance from 2011 through 2014 and often couldn’t afford insulin—a workhorse drug whose list price has risen more than 270 percent over the past decade. As a result of his skimping on dosages, Hernandez in 2011 suffered permanent blindness in his left eye, and three years later he experienced kidney failure. He’s since received a lifesaving kidney transplant covered by Medicare and has drug coverage under a New Jersey program for the disabled. But Hernandez’s eligibility expires next January, at which time he’ll have to pay about $300 a month out of pocket for insulin. “I don’t really have that kind of money,” he says. An error has occurred You have 1 free Businessweek article left. Register for more. Register or Sign In Already a subscriber? Link your Bloomberg Terminal account or your Businessweek subscription account to access all articles. That Hernandez is struggling to deal with big price hikes for insulin, a century-old medicine that for most of its history cost $15 a month or less, speaks volumes about America’s failing battle to control drug prices. Key combatants are the secretive drug industry middlemen called pharmacy benefit managers (PBMs), who are hired by insurers, employers, and unions to negotiate discounts from drugmakers. Hernandez is a plaintiff in a lawsuit seeking to prove that dealings between those middlemen and drug companies instead have contributed to the cost of insulin rising, in part to make sure fees to the middlemen keep going up. The same interaction inflates the prices of dozens of name-brand drugs, says Steven Berman, the Seattle-based plaintiffs’ attorney who filed the suit in February in federal court in Trenton, N.J. “It’s Continue reading >>
Why Are Insulin Prices Rising?
She drew the life-saving medication into the syringe, just 10 cc of colorless fluid for the everyday low price of -- gulp -- several hundred dollars. Was that a new chemotherapy, specially designed for her tumor? Was it a "specialty drug," to treat her multiple sclerosis? Nope. It was insulin, a drug that has been around for decades. The price of many drugs has been on the rise of late, not just new drugs but many that have been in use for many years. Even the price of some generic drugs is on the rise. In some cases, prices are rising because the number of companies making specific drugs has declined, until there is only one manufacturer left in the market, leading to monopolistic pricing. In other cases, companies have run into problems with their manufacturing processes, causing unexpected shortages. And in infamous cases, greedy CEOs have hiked prices figuring that desperate patients would have little choice but to purchase their products. Then there's the case of insulin. No monopoly issue here -- three companies manufacture insulin in the U.S., not a robust marketplace, but one, it would seem, that should put pressure on producers. No major manufacturing problems, either. There has been a steady supply of insulin on the market for more than a half-century. And there haven't been any insulin company executives I know of who have been hustled in front of grand juries lately. Yet insulin prices are rising to dizzying heights. In 1991, according to a recent study in JAMA, state Medicaid programs typically paid less than $4 for a unit of rapid acting insulin. After accounting for inflation, that price has quintupled in the meantime. What explains the gravity-defying cost of insulin? I am not an expert on pharmaceutical pricing, but a few factors go a long way to explai Continue reading >>
Insulin Prices Skyrocketing
America’s getting plenty angry about the rising cost of insulin—and no wonder. Between 2002 and 2013, the average price for this life-saving, injectable drug used by nearly 10 million Americans with diabetes has tripled, according to the American Diabetes Association (ADA). “No one who relies on insulin should have to wonder if they’ll be able to afford it,” the ADA asserts in an online petition for its Stand Up for Affordable Insulin campaign.1 The ADA’s action doesn’t stand alone. In November, Vermont senator and former contender for the Democratic presidential nomination Bernie Sanders fired off a letter calling on the U.S. Justice Department and the Federal Trade Commission asking for an investigation of pharmaceutical makers Eli Lilly, Novo Nordisk and Sanofi for possibly colluding on insulin price increases.2 “Not only have these pharmaceutical companies raised insulin prices significantly—sometimes by double digits overnight—in many instances the prices have apparently increased in tandem,” noted the letter, co-signed by Rep. Elijah Cummings (D-MD). “We have…heard from our constituents that the life-saving insulin they need is increasingly unaffordable,” And in early January 2017, the New York law firm Bernstein Litowitz Berger & Grossmann sued Novo Nordisk on behalf of the Lehigh County (PA) Employees' Retirement System alleging the company “reported materially false and misleading earnings and forecasts” that were “inflated” by price fixing. That’s not all. In a rapidly-changing insulin market, the recent introduction in the U.S. of the generic “biosimilar insulin” called Basaglar, which won FDA approval in December 2015, has put a lower-priced type on the market. This development reportedly prompted two major manufactu Continue reading >>
Is Insulin The New Epipen? Families Facing Sticker Shock Over 400 Percent Price Hike
Is insulin is the new EpiPen? In the last eight years, the average price per milliliter of insulin has skyrocketed by over 200 percent. But there's one major difference. If you can't get an EpiPen, there's a chance you might die. If your body doesn't have insulin, you certainly will die. "It feels like they're holding my kid ransom," said Tiffany Cara, whose son has diabetes. Only three major companies make insulin in the U.S. and each has steadily ratcheted up prices, sometimes in lockstep. Since 2004, the manufacturer list price for insulin, known as wholesale acquisition cost, is up by triple digits. Novo Nordisk's insulin Novolog is up 381 percent, Eli Lilly's Humalog is up 380 percent and Sanofi's Lantus is up 400 percent, according to data from Truven Health Analytics. That's sending some diabetic families into sticker shock. Six-year-old Dorian Carra loves to play outside his Texas home and dress up as a super hero. Specifically, Captain America, the World War II version. His mom says her outgoing boy has "never met a stranger." But four years ago he couldn't stay awake. He was breathing oddly. His parents brought his rag doll body to the E.R. Doctors said his blood sugar levels had spiked to 965 milligrams of glucose per deciliter of blood. A normal range is 80 to 140. The diagnosis was type-1 diabetes. The prescription was insulin, every day, for the rest of his life. Recently those treatment costs doubled after the Carra's health insurance company switched to cover another brand. Even though the brands are clinically the same, the new medicine isn't available in the dosages he needs, so they have to stick with the more expensive kind. Tiffany Carra, a thirty-two-year-old IT field support analyst, says it now costs them $1,880 a year for insulin and supplies. 6 Continue reading >>
Diabetics Protest Rising Insulin Prices At Drug Company Headquarters
More than half a million Hoosiers have been diagnosed with diabetes, and many of them rely on insulin to live healthy lives. But patients say the skyrocketing price of the medicine ‒ which more than doubled from 2002 to 2013 ‒ is squeezing them to the point of outrage. The frustration bubbled over at a rally in front of Eli Lilly headquarters in downtown Indianapolis Saturday. Protestors held signs reading “Insulin for All” and “Insulin = Life.” The protest of a few dozen people comprised what organizers believe is the first demonstration of its kind. Insulin’s rapidly-rising cost ‒ and lack of an affordable, generic option ‒ is putting people’s health at risk, protestors say, and making them a slave to the price of the vital hormone. Mike Hoskins, a Type 1 diabetic, said he has good health insurance, but still goes without insulin sometimes to save money. “I don’t use it as much,” he said, “Sometimes, I adjust what I’m eating or my routine so I don’t have to spend as much on insulin.” Horror stories abound of diabetics skimping on injections ‒ or even intentionally slipping into a coma to receive doses of insulin inside the ER. Some diabetics can’t function without insulin, and in some cases, not taking enough can be life-threateningly dangerous. The Indianapolis-based Lilly was the first company to mass-produce insulin in the 1980s. The company is now one of three manufacturers, along with the European companies Sanofi and Novo Nordisk, that dominate the market for the hormone. The trio is now facing a class-action lawsuit accusing them of price-fixing. According to the lawsuit, the list price of Lilly’s drug, called Humalog, has doubled in the past five years. In the mid-‘90s, when the drug was first launched, it cost $21 a v Continue reading >>
Rising Insulin Prices Have Diabetics Crying Foul
Insulin prices are only getting more painful. Drugmakers Eli Lilly (LLY) and Novo Nordisk recently boosted their insulin list prices by almost 8 percent each, adding to concerns that treating diabetes is unaffordable for some patients. The average price of insulin almost tripled between 2002 and 2013, according to the American Diabetes Association (ADA). Even before the most recent price hike, some diabetics were cutting back or even going without the drug because of its expense. The price hikes come at a sensitive time for the drugmakers as Eli Lilly, Novo Nordisk and rival Sanofi-Aventis are facing a class-action lawsuit alleging they conspired to raise their prices in lockstep. Almost one in 10 Americans has diabetes, a group of conditions where the body fails to properly regulate blood sugar. People with Type 1 diabetes, often referred to as juvenile diabetes, need to take insulin daily to stay alive. "We were really disappointed in this announcement," said Dr. William Cefalu, the chief scientific, medical and mission officer for the ADA, who noted that his organization has partnerships for research with the drugmakers. "This is really going in the wrong direction." In early May, Eli Lilly raised its list price for Humalog by 7.8 percent, to $274.70, for a 10-milliliter bottle, while Novo Nordisk tacked on a 7.9 percent increase on its Novolog drug, to $275.58. "There's concern and anger in the diabetes community," said Allison Bailey, who has Type 1 diabetes and is a student at Iowa State University. She also volunteers with a diabetes advocacy group called T1International. She called the most recent price hike "a slap in the face." Such price hikes may be absorbed by diabetics' insurance plans, but other people may struggle if they lack insurance or have high-dedu Continue reading >>
Rising Prices Of Insulin
Have your patients noticed an increase in their insulin prices over the last few years? Several news reports like this one in The Washington Post are featuring patients and their stories of prices consistently rising. A news story from Rochester, NY reported a 43 percent increase in the cost of insulin over the past four years. WebMD reports that the wholesale price of a 10mL vial of Novolog went from $116 in 2011 to $264 in July of 2016. Vermont Senator Bernie Sanders and Maryland Representative Elijah Cummings, the ranking Democrat on the House Oversight and Government Reform Committee have asked the Federal Trade Commission and the Justice Department to investigate the potential collusion among pharmaceutical companies who manufacture diabetes products. Let’s have the tough conversation and be patient advocates to make it a little easier to live with diabetes. In Mexico, Eli Lilly was previously fined for colluding on insulin pricing in 2010. In the letter, Sanders and Cummings state, “We are concerned that the potential coordination by these drug makers may not simply be a case of 'shadow pricing,' but may indicate possible collusion, and we believe this egregious behavior warrants a thorough investigation.” I dearly love the local representatives from such companies as Eli Lilly and Novo Nordisk and the educational literature they have produced for educators over the years. But with any good friend, there comes a time we have to have accountability and make sure we are all on the same page with a mission help patients with diabetes live healthier lives. I know there has been a lot of healthcare change in the past several years but let’s have the tough conversation and be patient advocates to make it a little easier to live with diabetes. About the Author Am Continue reading >>
High Cost And Rising Insulin Prices Affect The Neediest In Our Community
High cost and rising insulin prices affect the neediest in our community by Lindsey Verano, RD, LDN, CDE and Mary Laxton, DHSc, PA-C Nearly 30 million Americans have diabetes mellitus. A small percent of diabetics have Type 1 diabetes that requires insulin to replace the non-existent native insulin produced by the pancreas. A much larger percent are Type 2 diabetics whose disease can be managed with diet, exercise, and oral prescription medications. Increasingly even Type 2 diabetics require some form of injectable insulin to treat their condition, avoid hospitalizations, slow the pace of organ damage, and maintain as healthy a lifestyle as possible given the progressive and unrelenting nature of this disease. According to the American Diabetic Association, 1 in 5 health care dollars and 1 in 3 Medicare dollars is spent caring for patients with diabetes. People with a diagnosis of diabetes have health care costs 2.3 times greater than those without diabetes. Diabetes-related complications lead to high morbidity and mortality and an increase in disability-adjusted life years, meaning a loss of years of a “healthy life.” According to the World Health Organization (2017), the accumulative effect of DALYs identifies the gap between current health status and ideal health status that allows an individual to live to an advanced age free of disease and quality-of-life-limiting disabilities. In an article in the Journal of the American Medical Society (2014) the authors noted continued increases in the incidence and prevalence of diabetes among non-Hispanic blacks, Hispanic subpopulations, and those with a high school education or less. The American Diabetes Association reported in March, 2017 that African Americans, Mexican Americans, and American Indians are more likely to Continue reading >>
