August 16, 2022

Washington (AFP) – Curbing high insulin prices has been elusive in Congress so far, although Democrats say they will try again – as part of their economic package focused on health and climate.

The price of the 100-year-old drug has more than tripled in the past two decades, forcing the country’s diabetics to pay thousands of dollars a year for the life-saving drug. Democrats are considering capping the cost of this drug for at least some, though it’s unclear what the final proposal would look like and how many insulin users would get a price cut.

Here’s a look at how expensive insulin has become and why it’s so difficult to bring down the price of the drug.

How many people in the United States use insulin and for what reason?

Nearly 8.4 million Americans use insulin, according to the American Diabetes Association. Not everyone with diabetes needs insulin, but for those who need it, it is an important medication. For the more than 1 million people with type 1 diabetes, regular access to medication is essential and they will die without it.

“People need insulin, which is not an option and no one should decide between life-sustaining drugs or food and rent,” said Dr. Robert Gabay, chief scientific and medical officer of the American Diabetes Association.

Insulin also helps control glucose levels for patients with other forms of diabetes. Some insulin users legalize the drug due to its expense and the risk of numerous health complications as a result.

What is high insulin?

The price varies.

Some people with private insurance pay hundreds of dollars a month for medication. For most Medicare beneficiaries, the average out-of-pocket cost per prescription for insulin was $54 in 2020 — an increase of nearly 40% since 2007, A study released last month by the Kaiser Family Foundation. Others live in one of the 22 states where the maximum joint payment for a 30-day supply is set between $25 and $100.

The cost has prompted some to use less insulin than a doctor prescribes or to defer paying for other medical care.

Why is insulin so expensive?

Only three companies – Eli Lilly, Novo Nordisk and Sanofi – produce insulin, which allows these companies to control a significant part of the market.

“Historically they have raised their own menu prices with each other,” said Dr. Jing Lu, a professor of medicine at the University of Pittsburgh. “There hasn’t been a lot of pricing pressure.”

Lu added that making a generic insulin drug hasn’t been easy, as new manufacturers have to remove regulatory hurdles and questions about how to classify a generic drug. Generic insulin is slated to come to market in 2024 at a price of no more than $30 per vial, which could bring some price drops.

How do Democrats plan to increase the price of insulin?

That remained to be a sight.

Senate Majority Leader Chuck Schumer said some phrases limiting the price of insulin will be added to the economic bill.but it is not clear what this price point is and who will all be protected by this price cap.

Democrats have proposed a $35 monthly cap for those who get the drug through Medicare or private insurance companies as part of a larger package derailed in the Senate. But it was left out of the mini-package that is now heading to a vote in Congress.

Why is the cost of insulin so hard to cap?

Setting the price of insulin would be very expensive.

Insulin is not only getting more expensive, but the number of people using it is also increasing.

A bipartisan bill proposed earlier this year to reduce insulin prices could cost about $23 billion over the next decade, according to estimates by the Congressional Budget Office. While the bill would reduce insulin costs for many consumers, it would also increase government costs and premiums charged by Medicare and private insurance companies, according to the bureau’s analysis.

This is one reason why price caps are controversial.

“If your health insurance company says, voluntarily, that no one who buys the insulin in our plan will have to pay more than $25, the question is who pays the remaining balance?” Luo said. “This then means that its cost will go up, which means it will raise premiums for everyone.”

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