The big three insulin makers in the U.S. have now all succumbed to intense public pressure and shaming—and a demonstration of political power from President Joe Biden and congressional Democrats—and are doing the right thing. On Thursday, Sanofi joined Eli Lilly and Novo Nordisk in promising to lower the monthly price of insulin to $35 per month for people with private insurance. These three pharmaceutical companies provide about 90% of the insulin used in the U.S.
“As of this afternoon, all three of the leading insulin producers in America have agreed to substantially reduce their prices, following my calls to expand my $35 cap for seniors to all Americans,” Biden said. That is precisely how it happened—through political pressure. Let’s also not forget that Republicans actively fought this.
Making it law is the next step, because you cannot count on the beneficence of PhRMA lasting. Without the constraint of federal law, there’s absolutely no guarantee that those prices don’t go up again. Or that the companies don’t just phase out this generation of drugs, with the lower prices, and replace them with new ones that they say they have to price higher. Because that’s what they do.
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But right now, they are afraid. They’re afraid because after years and years of trying, Democrats finally cracked through and were able to enact drug pricing reforms. They’re limited—for right now it’s just a handful of drugs for Medicare, including the $35/month insulin cap for Medicare recipients. That was just a foot in the door, however, and Democrats and the administration are going to keep pushing it wider.
So generating a little goodwill by not making absolutely obscene profits from the people whose lives depend on insulin is a small price for PhRMA to pay in the upcoming political fights.
It’s absolutely life changing for the 8.4 million people in the U.S. with diabetes rely on insulin for their very survival. The American Diabetes Association estimates that 1 in 4 insulin users regularly ration their insulin, “skipping doses or taking less than they need, putting themselves at risk for serious and even deadly complications.”
Insulin costs as much as 10 times more in the U.S. than in any other economically advanced country, because they all have strict regulations that make life-saving drugs affordable.
What’s also missing from these commitments on insulin pricing is doing something about the rest of the costs diabetics face in managing their disease. One estimate from 2018 put the annual average total spending—by the patient and by insurance and the medical system—for a person with diabetes at $16,750 with more than half of that—$9,600—directly tied to diabetes. For the patient, that includes treatment for related illnesses, doctors visits, hospital care, other prescription and all the paraphernalia that goes with being insulin dependent—the test trips, syringes, meters, pumps, etc.
That’s one reason that the American Diabetes Association is applauding the news, but not letting up. “We are encouraged that all of the major manufacturers have taken steps to make insulin more affordable, but the fight is not over.” Lisa Murdock, ADA Chief Advocacy Officer said in a statement. “We will continue advocating for efforts in Congress and states across the country to ensure insulin is affordable to everyone with diabetes who relies on it to survive.”
There’s no reason to let up now and every reason to keep pushing. Which is what Biden appears to intends to do.
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