Enough is enough–it is time for Congress to address rising insulin prices. Congress has failed to take any action to address the rising cost of insulin. However, the Protecting Access to Biosimilars Act of 2019, introduced by Rep. Diana DeGette (D-CO) in early April, is a promising first step to address the issue. The Energy & Commerce Committee held a series of hearings about the rising cost of insulin. The first hearing, held on April 2th, focused on how patients, providers, and advocates have been impacted by the rising cost of insulin. The second hearing, held on April 10th, investigated PBMs’ and drug manufacturers’ contributions to price increases. As a juvenile diabetic, I sympathized with my fellow juvenile diabetics that testified on April 2nd, and I believe that Congress must make meaningful change to address this issue.
The hearing on April 2nd hosted Gail DeVore, an advocate and diabetic from Colorado, Dr. William T. Cefalu of the American Diabetes Association, Dr. Alvin C. Powers of the Endocrine, Society, Dr. Kasia Lipska of Yale School of Medicine, Christel M. Aprigliano of the Diabetes Patient Advocacy Coalition, and Dr. Aaron Kowalski of the Juvenile Diabetes Research Foundation.
Ms. DeVore has been a juvenile diabetic for 47 years. She shared personal stories about how the cost of insulin has hindered her quality of life. Ms. DeVore said that she is an advocate and problem solver, but there is “no solution” to being able to afford insulin. As a comfortably middle-class woman with good health insurance, Ms. DeVore maintained that insulin is still extremely unaffordable.
Dr. Cefalu stated that pharmaceutical industry claims that the rising cost of insulin, among other drugs, can be attributed to research and development expenses. Yet, the chemical composition of insulin has not changed and prices continue to soar. Dr. Cefalu identified policy solutions to address the issue, such as promoting transparency in pricing. Further, Dr. Cefalu said that groundbreaking innovation is useless without affordable and accessible insulin.
Dr. Lipska noted that the internal supply chain between PBMs, drug manufacturers, and insurers is failing. Dr. Lipska called upon drug manufacturers to reduce the cost of insulin, because they have a “moral obligation” to address the rising cost.
Dr. Kowalski outlined three differing goals that Congress needs to address to lower the price of insulin and improve the health of juvenile diabetics across the nation:
1. Rebates must be eliminated from the drug reimbursement system
2. Aid the uninsured population in getting insulin
3. Invest in research to find a cure
Further, congressional leaders empathized with the advocates and diabetics that spoke at the hearing. Chairman Pallone addressed the Hearing beforehand and noted that the prices of insulin have tripled between 2002 and 2013. Further, even those with employer-based insurance could not afford their medication: “People with diabetes with employer-sponsored insurance saw the average price for a 40-day supply of insulin rise from $344 to $666 [between 2012 and 2016].”
In the private sector, Walmart sells a cheaper, human insulin called ReliOn. This version of insulin costs about $25 per vial, and is an affordable solution for those that fall in the insurance coverage gap. However, this solution is not permanent or sustainable. Walmart is currently contracted with Novo Nordisk to provide this cheaper version of insulin. This contract can dissipate at any time. Although this is an effective, short-term option, federal action must address the issue for a more longstanding resolution.
In a previous blog post, NCHC proposed policy solutions to address the rising cost of insulin. Yet, without immediate Congressional intervention, in conjunction with private sector intervention, prices for insulin, and other life-saving biologics, will continue to rise.