Congress is railing against Big Pharma companies Sanofi, Novo Nordisk and Eli Lilly -- the top three insulin producers in the U.S. -- for not delivering on their promises to offer cheaper versions of the diabetes medicine quickly.
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The cost of a one-month supply of Eli Lilly's insulin treatment, Humalog, has increased 1,200 percent since 1996, when it hit shelves at $21, according to the American Journal of Managed Care. With a new decade and a presidential election approaching, Washington is heavily focused on lowering prescription drug costs. High-priced treatments for diabetes, which affects roughly 10 percent of the country, are a top target.
Democratic Sens. Elizabeth Warren, of Massachusetts, and Richard Blumenthal, of Connecticut, called out Eli Lilly specifically in a Dec. 16 report for botching its own plan to deliver affordable insulin to those in need. Insulin is a naturally occurring hormone that the human body relies on to convert glucose -- a type of sugar -- to energy, and a vital medicine for some 30 million Americans with diabetes.
Their own bodies either don't produce sufficient insulin or use it efficiently enough to regulate their blood sugar, leading to health complications from fatigue to irritability, slow-healing sores and frequent infections.
"This report shows that pharmaceutical giant Eli Lilly has not lived up to its promise to provide a lower-priced insulin to patients who need it," Warren said in a Dec.16 statement on the report. "With rising prescription drug costs squeezing families in every part of the country, Congress must bring drug prices down for consumers, hold drug companies accountable for needless price hikes and encourage more competition in the prescription drug market."
Senate Finance Committee Chairman Chuck Grassley, an Iowa Republican, and Ranking Member Ron Wyden, an Oregon Democrat, began an investigation of increasing insulin prices in February, noting higher costs have increased the burden on U.S. taxpayers.
"The increased price of insulin has caused federal programs to pay more for diabetes care," the senators wrote.
Rep. Lauren Underwood, an Illinois Democrat, wrote legislation that President Trump signed into law on Dec. 21 called the "Lower Insulin Costs Now Act," which she said will make lower-cost versions of insulin treatments available more quickly nationwide.
The net price for top-selling insulin Humalog – which factors in the rebates and other incentives Eli Lilly provides to customers – fell to $135 in 2018 from $147 in 2014. The list price, however, has still risen 52 percent to $594, according to data released in March by Eli Lilly.
After the House Subcommittee on Oversight and Investigations held a hearing in April regarding the rapidly increasing price of insulin, Eli Lilly issued a press release in March promising a cheaper, generic option to Humalog.
"Vials and pens of the lower-priced insulin have been manufactured, and Lilly will now work with supply-chain partners to make them available in pharmacies as quickly as possible," the company said at the time.
But Warren and Blumenthal conducted a 50-state telephone survey of 190 chain pharmacies and 195 independent pharmacies over several months and found that the generic option wasn't available at most locations across the U.S. Of the nearly 400 pharmacies surveyed, 83 percent didn't have it in stock, according to the report.
"In most cases (69 percent), pharmacies that did not have the generic drug in stock indicated that they could not order the drug, even if the consumer did not need it immediately," the report noted.
The research also found that pharmacies didn't adequately inform patients about generic insulin options, and that Eli Lilly didn't take sufficient steps -- "such as simply lowering the list price of Humalog, as it has in foreign markets -- to provide lower-cost access."
Lilly issued a statement just days after the report, doubling down on its previous commitments. The company said it offers options such as limiting monthly prescription costs on many insulin treatments to less than $100, providing the treatment free of charge in some cases and making a half-prized authorized generic available.
"We've heard too many stories about people with diabetes who struggle to afford their insulin," CEO David Ricks said in a letter published in more than 40 newspapers that listed a company helpline: (833) 808-1234. "We're anxious to help anyone who needs assistance. The calls are short, and there's no paperwork to fill out. We've worked to keep the process as simple as possible."