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Insulin access and affordability

Rising costs of diabetes medication continues to make national headlines

Date Posted: Tuesday, June 05, 2018

 


Rising insulin prices is affecting diabetes care  

The American Diabetes Association (ADA) has provided recommendations for improving insulin access and affordability.  Some people living with insulin dependent diabetes must choose between their medication or paying for other living expenses.  The average list price of insulin nearly tripled between 2002 and 2013.  The rising costs and lack of access for many with diabetes have become a hot button topic across the country. 

Congressional hearing to address insulin affordability

Last month, the U.S. Senate Special Committee on Aging held a hearing about the issue.  William T. Cefalu, MD, Chief Scientific, Medical and Mission Officer for the American Diabetes Association testified, “As a physician and clinician scientist, I have witnessed first-hand how the incredible research advances and innovative therapies resulting from investment in biomedical research have dramatically improved the lives of those with diabetes.  However, I have also observed that the incredible innovation may not benefit those who are not able to access and afford such treatments.”.  He added, “This became even more apparent to me when I joined the ADA, where I have had the vantage point to appreciate more fully the daily struggles of individuals with diabetes through their stories.”

American Diabetes Association policy statement

In their latest policy statement, the ADA addressed four key areas: streamlining the biosimilar approval process; increasing pricing transparency throughout the insulin supply chain; reducing or removing patient cost-sharing for insulin; and increasing access to healthcare coverage for all people with diabetes.  It includes advice for clinicians about how to help minimize out-of-pocket costs for patients.

The ADA recommends specific information about insulin pricing that should be provided by manufacturers, wholesalers, pharmacy benefit managers, health plans, and pharmacies.  The ADA also made recommendations about competition and biosimilar insulins.  As of today, three have been approved by the US Food and Drug Administration (FDA), and two of them are currently available. Unlike generic drugs, which are typically priced between 50 - 80% less than the brand-name, these follow-on insulins are only selling for about 15% less than the original.  The ADA feels that increasing available options could help to bring down insulin cost.

Reaction from the UMass Diabetes Center of Excellence 

“I am glad this issue has finally come to the forefront and that the ADA is trying to help. The substantial increase in the retail cost of insulin is disturbing because of the consequences it has on the health of those for whom insulin is a life sustaining medication.”, says Samir Malkani, MD, who in addition to caring for patients with diabetes at UMass Memorial as well as Milford Regional Medical Center, is the UMass Diabetes Center of Excellence Outreach Director for Affiliate and Member Hospitals.  He added, “Equally disturbing is the lack of transparency on part of insulin manufacturers in providing justification for the price increase, as there have been no substantial improvements in many of the insulin formulations which have seen price increases year after year, for the past 15 years.”  

Cheryl Barry, RN, MS, CDE, Manager, Diabetes Education Program at the UMass Diabetes Center of Excellence says, "For many with diabetes, insulin is not an option but essential for life.  It is abhorrent that in the United States, people need to choose between taking their insulin or paying for other necessities and thus increasing their risk for the long-term complications of diabetes.  This is a start, but we still have a long way to go.”

Barry and her team of diabetes educators consistently hear patients complain that insulin is too expensive and many have admitted that sometimes they skip doses to make it last longer.  “We hear so many people tell us that they used to pay $20 or $30 and now their co-pays are in the hundreds.”, she says.  “It is awful to hear patients tell us that they have to sometimes decide between paying for their necessary insulin or paying their rent.  Unfortunately they sometimes end up going without insulin, which can have severe consequences down the road.”

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