Congress investigating insulin cost

Yesterday, the Senate held a hearing to examine the rising cost of insulin. This is a huge concern for people with diabetes, as insulin prices have TRIPLED in recent years.

The ADA’s Chief Scientific, Medical, and Mission Officer, William Cefalu, MD, testified before the Senate, and he shared the findings and recommendations of the ADA’s Insulin Access and Affordability Working Group’s report on insulin prices, released yesterday.

What you should know about the report:

The Working Group report confirmed there is a lack of transparency in the insulin supply chain. After meeting with more than 20 stakeholder entities to learn how each affects the cost of insulin and compiling existing public information we found several important factors that contribute to the rising costs of insulin:

  • The current system encourages high list prices, increasing the profits of intermediaries in the insulin supply chain, while rebates are rarely passed along to consumers.

  • The high list price most affects those who lack insurance, have a high-deductible insurance plan or have to pay co-insurance, or people who are in the Medicare Part D donut hole.

  • Newer, more expensive analog insulins are often prescribed, however older insulins may be an acceptable alternative for some people.

  • Insurance formulary lists determine which insulins are covered and at what cost to individuals.

  • More “generic” biosimilar insulins are needed. Until multiple biosimilars of the most common insulin formulations are available, prices are unlikely to decrease. In addition, the required regulatory burden deters manufacturers from developing biosimilar insulins.

Some of the recommendations proposed by the Working Group focus on providers and pharmacists communicating openly with patients about insulin costs and emphasize there is a role for patients’ health care team. This can include prescribing a lower cost insulin. In addition to transparency throughout the insulin supply chain, suggestions by the Working Group include steps toward developing long-term solutions to improve insulin access and affordability, and a focus on health plans, research, pharmacy benefit managers, advocacy, and more.

Here’s how you help keep the momentum* going: Share the petition with your friends, family, neighbors—EVERYONE. Tell the people in your life why insulin affordability matters to you.

There are millions who rely on insulin to live, and we want millions to join our campaign. Thank you for your support!

LaShawn McIver, MD, MPH
Senior Vice President, Federal Government Affairs
American Diabetes Association