The fight for medicine
Prya Oliveira, Staff Writer
Over 30 million people in this country are affected by diabetes. Those with Type 1 diabetes have to take a daily injection of insulin, and about one-third of those who have Type 2 diabetes have to inject daily, too. Since there are no generic competitors for insulin, people pay hundreds of dollars.
The prices of insulin have tripled since 2002, with the most innovative type of insulin priced at over $500 for a box of five pens. When taken to a Senate committee, one father claimed that his young son’s 90-day supply in 2017 went from $300 to $900 in 2018. People are choosing to not take their insulin because the prices have been so high. A few tragedies have occurred due to this sharp increase in price. Alec Smith, a diabetic patient, did not have insurance from his job. He then made the choice to pay out of pocket for his insulin. He was told that he would have to pay $1,000, but after the total came out to $1,300 at the pharmacy, he decided not to get the medicine all together. Smith planned on buying insulin after his next paycheck with the intention to ration the insulin, but passed away soon after from diabetic ketoacidosis.
His mother commented on this rising issue, saying, “We have people who are making life and death decisions of, ‘Do I buy groceries and/or do I buy my insulin?’”
It is difficult to cut prices for insulin when costs are so high under medical insurance. The CEO of the Diabetes Patient Advocacy Coalition, Christel Aprigliano explains the rise of prices, saying, “List prices are being raised in order to offset the Primary Benefit Manager (PBM) demands for higher rebates.” People are having to ration their insulin because it is better to have some than to have none at all. Without insulin, other diseases can occur, such as cardiovascular disease and kidney disease. The uncontrolled blood sugars can lead to strokes and poor blood circulation. It is possible to make insulin cheaper by cutting out the ‘middle man’ negotiators and selling insulin at a cheaper cost directly to insurance companies. There are even companies online like InsideRX that offer “any American a 40% discount on insulin at the point of sale,” but these discount programs are either not ready to sell medications, or the prices are still hundreds of dollars for a box of five insulin pens. These programs also don’t cover people who receive healthcare from the government. Aprigliano makes another argument on why insulin prices have raised. “If the list price isn’t raised to meet the PBM’s demands, the PBM won’t include the drug on its formulary, or its list of drugs covered by the insurance plan.” Companies are being forced to overcharge for insulin so it can be covered by insurance. In turn, customers don’t have to pay the list prices. However, the price of insurance as a whole sometimes prevents people from being able to buy insulin because of how expensive the insurance is.
The fact that insulin has no generic forms adds another factor as to why it is so expensive. Under patent law, there can be no generic competitors allowing a company to sell unchallenged products for a certain number of years before getting the generic version to be approved. Pharmacies won’t gain much spending tons of money to create a cheaper version of insulin. The generic form’s price would only be reduced by 20 percent, unlike other drugs that normally get reduced by 80 percent.
With many patients on insulin beginning to expire, new windows are opening up for FDA approval of generic insulin.