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Stemming the Rising Tide of Insulin Prices
https://www.managedhealthcareexecutive.com ^ | September 16, 2021 | Keith Loria

Posted on 09/17/2021 11:44:38 AM PDT by Red Badger

States are putting caps on prices, and Semglee, the first interchangeable biosimilar in the United States, may exert some downward pressure.

More than 30 million Americans have diabetes, according to the American Diabetes Association, and many rely on insulin.

But insulin prices have been rising in recent years, and that has put many people with diabetes at risk because the price leads to people skipping doses or not taking insulin altogether.

The latest figures from the American Action Forum show that the price of insulin rose 14% a year, on average, between 2012 and 2018, and the past few years have followed this growth trajectory.

Many patients, policy makers and experts blame companies that manufacture insulin for dialing up the price of an established therapy. Sally Pipes, president and CEO of the Pacific Research Institute, a California-based think tank that favors free markets and limited government, says it’s easy to point the finger at pharmaceutical companies, but she finds fault elsewhere: in a dysfunctional market for insulin and many other prescription drugs and in pharmacy benefit managers.

“Pharmacy benefit managers — middlemen hired by insurance companies to manage their prescription drug plans — are driving those list prices up,” she asserts. The Pharmaceutical Care Management Association, the trade group for PBMs, says its member have done quite the opposite with programs that cap out-of-pocket costs or eliminate them. A spokesperson for the group says insulin makers have used patent extensions to avoid competiton.

States take action

In the summer of 2020, then-President Donald Trump signed an executive order aimed at reining in prescription drug costs, requiring federally qualified health centers and hospitals, which purchase insulin through the 340B Drug Pricing Program, to pass along any savings they receive from discounted drug prices to medically underserved patients. The Biden administration halted its implementation. The National Association of Community Health Centers, among others, expressed support for the new administration’s move, saying the Trump rule would not have lowered the cost of insulin (and EpiPens) for most Americans.

Some states are moving to control insulin prices. This summer, Colorado joined Illinois in passing legislation that caps out-of-pocket costs of insulin. Maine, New Mexico, New York, Utah, Washington and West Virginia are considering similar legislation.

Prices may also come down if interchangeable biosimilars start coming on the market. In July 2021, the FDA designated Semglee (insulin glargine-yfgn) as an interchangeable biosimilar to Lantus (insulin glargine), a long-acting insulin analog. The designation means a pharmacist can switch the brand-name product for the presumably less expensive biosimilar, although state pharmacy laws can put some limits on interchangeability. Even so, the FDA approval should result in some competition between Semglee and Lantus and price decreases for patients and payers

Keith Loria is a freelance writer in the Washington, D.C., area.


TOPICS: Business/Economy; Culture/Society; Government; Politics/Elections
KEYWORDS: diabetes; insulin; medicaid; medicare
download issue

Download Issue : MHE September 2021

https://cdn.sanity.io/files/0vv8moc6/mhe/66adc9862f3e34705c47662ca286878b46974b22.pdf/MHE0921_ezine.pdf

1 posted on 09/17/2021 11:44:38 AM PDT by Red Badger
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To: Red Badger

$25 a bottle at walmart


2 posted on 09/17/2021 11:46:33 AM PDT by struggle
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To: Red Badger

My wife’s insulin went way up after the American voters put in their idol Joe Biden.

Vote fraud was not all the voting. There were millions of actual Dem voters. Not off the hook with me personally.


3 posted on 09/17/2021 11:46:49 AM PDT by frank ballenger (You have summoned up a thundercloud. You're gonna hear from me. Anthem by Leonard Cohen)
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To: Red Badger

When the deep state is completely dead, we won’t have this problem.


4 posted on 09/17/2021 11:51:40 AM PDT by reasonisfaith (What are the implications if the Resurrection of Christ is a true event in history?)
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https://www.rand.org/news/press/2020/10/06.html

Insulin Prices Are Dramatically Higher in the United States Than in Other Countries


5 posted on 09/17/2021 11:55:08 AM PDT by smoky415
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To: frank ballenger

My wife is one of those who had to have no more mean tweets.

Orange man bad, no orange man greatest evil in all of space and time plus every dimension.

Don’t ask me why.

She doesn’t remember me going through a lot of misery during the time of the wun.

I guess it will take some real heavy dose of reality to change her mind on super joe. It might cost many, many lives though.


6 posted on 09/17/2021 11:55:32 AM PDT by wally_bert (I cannot be sure for certain, but in my personal opinion I am certain that I am not sure.)
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To: frank ballenger

“Heather Bresch, Joe Manchin’s Daughter, Played Direct Part in EpiPen Price Inflation Scandal

Heather Bresch, the former president and CEO of the drugmaker Mylan, worked directly with the CEO of Pfizer to keep prices of the company’s EpiPen product artificially high, according to new documents released as part of an ongoing lawsuit.

The documents also show Bresch approving a scheme to force customers, captured by the company’s monopoly, to purchase two EpiPens at once, regardless of medical need. The EpiPen is an auto-injectable device that injects epinephrine into the body and can be the difference between life or death for a person suffering a severe allergic reaction”

https://theintercept.com/2021/09/07/joe-manchin-epipen-price-heather-bresch/

Trump was bringign he prices down- thel eft were furious at him for it


7 posted on 09/17/2021 11:56:23 AM PDT by Bob434
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To: Red Badger

Insulin has been around a long time - patents on many versions are long-expired, so there should be many generic versions available at something fairly close to cost. Newer, improved versions are still patent-protected and expensive, but I don’t see how people can’t afford some reasonably functional medication. (Unless the government has banned them.)


8 posted on 09/17/2021 11:58:35 AM PDT by Glenmore
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To: wally_bert

God bless you both.


9 posted on 09/17/2021 12:00:54 PM PDT by frank ballenger (You have summoned up a thundercloud. You're gonna hear from me. Anthem by Leonard Cohen)
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To: frank ballenger

It wasn’t always this way.


10 posted on 09/17/2021 12:15:14 PM PDT by wally_bert (I cannot be sure for certain, but in my personal opinion I am certain that I am not sure.)
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To: Glenmore

“...so there should be many generic versions available at something fairly close to cost.”

Cost is a small issue when requiring insulin, being effective is.

Biologic drugs like insulin are usually nearly impossible to recreate. Instead, manufacturers often create close copies of biologic drugs, referred to as “follow-ons” or “biosimilars.” Biosimilars tend to be more expensive than generics (though still less expensive than brands) and aren’t identical to the chemical structure of the brand counterpart. So the effectiveness of the product is different. And different can mean the life or death with insulin. I use a long term and short term inject ables along with oral meds.

Another issue with drugs is drug interaction. The long term insulin I use cannot be mixed with thiazolidinediones (TZDs), insulin sensitizers, among othjer drugs, as TZD mixtures can cause heart failure. So that comes into effect depending on which insulin is being replaced as a doctor will use other drug consistent with the insulin being prescribed, or vice versa. And if there are other illness that must be treated, it becomes a major issue.

So it’s a lot more than just replacing a drug with a generic based upon cost. It has to do with the overall treatment of the patient. And that can get really complex…and very expensive. And very dangerous as treating diabetes is not an exact science.

Wy69


11 posted on 09/17/2021 1:17:39 PM PDT by whitney69
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To: Red Badger

Typical asinine “solution” by those commie states, limiting “out of pocket” expenses.

There is no price reduction, it just means other people pay the rest of the charge, all the other people buying insurance pay for it whether they have diabetes or not.

Its “from each according to their abilities, to each according the their need,” the commie way, in another form. It’s also another way commies subsidize their friends in high places, the drug company continues to get its fake price.

Two real problems that need solved are:

(1) different prices for different people with no one knowing the real price, breaking a free market.

This is due to insurance and is also by intent.

Everyone’s price should be the same, and should be known, there should not be a FAKE very high price and then a wide variety of prices that different people pay according to their “plans.”

Make it illegal to charge different prices to different individuals for the same thing.

When doctors prescribe drugs nowadays, they cannot even call the pharmacy and get a straight answer about how much the drug will cost the patient!

And half the time they cannot find out if the drug is “covered” on insurance!

It ends up being a Nancy Pelosi situation, “you have to pass the bill to find out what’s in it” — instead “you have to prescribe the drug to find out if it is covered and how much it costs!”

So the second aspect of this different prices situation is the term “no price transparency” — that goes to hell too.

Breaking the free market is just fine with sociocommunomarxiofascists.

(2) Second is the price itself is too high. However this will settle down with the return of the free market made possible by fixing (1) above.


12 posted on 09/17/2021 1:18:51 PM PDT by Weirdad (Orthodox Americanism: It's what's good for the world! (Not communofascism!))
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To: struggle

Yup that’s where I get mine.👍


13 posted on 09/17/2021 9:30:11 PM PDT by BiteYourSelf ( Earth first we'll strip mine the other planets later.)
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To: whitney69

Wife is on other ‘bio-similar’ or ‘bio-identical’ medications so I do understand. That said, the old bio-similars that are now generic and relatively inexpensive do work well enough for now that we are letting others pay for the R&D of the next generation. Somebody has to pay those costs, which are real and not insignificant. It is unfortunate for those who have no choice, but the alternative is horrible abuse.


14 posted on 10/14/2021 1:44:42 PM PDT by Glenmore
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To: struggle

How many doses in that $25 vial?


15 posted on 10/14/2021 1:47:53 PM PDT by AFreeBird
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To: wally_bert

I know someone like that. The mean tweets.

My lord. So you trade mean tweets for the shitstorm we’re in now?


16 posted on 10/14/2021 1:50:07 PM PDT by AFreeBird
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To: AFreeBird

For some absurd reason, yes.


17 posted on 10/14/2021 2:07:15 PM PDT by wally_bert (I cannot be sure for certain, but in my personal opinion I am certain that I am not sure.)
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To: wally_bert

It was rhetorical.

I Now know why the Good Lord took my dad home when he did.

I miss him so. But he would not have passed as peacefully as he did, if He had not.


18 posted on 10/14/2021 2:12:54 PM PDT by AFreeBird
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To: AFreeBird

Lasts me about a month


19 posted on 10/14/2021 3:43:58 PM PDT by struggle
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To: Glenmore

” do work well enough for now ...”

Sorry to hear about the wife. As a “seasoned” diabetic, I can understand the difficulties.

But the truly unfortunate part of generics is that they are not as effective as the main drugs as they are watered down to cut costs and availability. There is a market for them however as these are the drugs advertised as being sold to other countries at cut costs, in many cases even more watered down, so it appears to be inexpensive but really is cheap.

And how much collateral damage to heart and kidneys cannot be measured with their limited capacity and the inconsistent with the severity of the illness. So, they may be partially effective at the moment, for numbers, but the wolf is at the door for other reasons. Hope she lives to 100.

wy69


20 posted on 10/15/2021 7:05:36 AM PDT by whitney69
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