Have you been rationing or are you considering rationing your insulin due to surging costs over the past several years?
If so, there may be some relief coming from the world’s leading insulin manufacturers.
Novo Nordisk, one of the “big three” insulin manufacturers worldwide, is offering an immediate one-time insulin supply option for people in the United States who’ve been rationing their insulin, the company announced earlier this month.
The one-time supply is intended to help people bridge the gap until they can find a more sustainable regular source of insulin.
The company is also offering $99 multipacks of its insulin pens and vials as well as discounts on its authorized generic insulins.
The program is a follow-up to the company’s September 2019 announcement of these new half-priced insulins.
“We know some people still struggle to afford their insulin and we want to help. We’ve talked to people, including those who have been critical of us, and it’s clear there is no one solution that will work for everyone, and people need options,” said Doug Langa, executive vice president of North America operations and president of Novo Nordisk Inc., in a press release. “That’s why today, we have made available additional options recognizing the different situations that make insulin unaffordable or inaccessible.”
Nordisk is the latest of the major insulin manufacturers to announce expanded affordability options for insulin.
In December, Eli Lilly and Company promised to cap insulin costs at $95 a month for both commercially insured and uninsured people, according to a LinkedIn post from Lilly CEO David Ricks.
The company also promised to offer free insulin to eligible Americans as well as emergency access to insulin for those rationing it.
“You should not have to ration your treatment and you should not have to choose between insulin and putting food on the table,” Ricks wrote in his post. “Your health is too important.”
In April, Sanofi, the other one of “big three” manufacturers, announced its own $99 a month insulin program for qualified insurance holders.
These moves will certainly be welcome for the many people with diabetes who struggle to pay for their insulin.
But it does raise the question: Should drug manufacturers get credit for solving a problem they had a hand in creating?
“The rising cost of insulin in the United States can be attributed primarily to two phenomena. First, U.S. law allows pharmaceutical manufacturers to price their products at whatever level they believe the market will bear and to raise prices over time without limit [and] second, direct competition in the insulin market is lacking,” Dr. Michael Fralick and Dr. Aaron S. Kesselheim, JD, MPH, wrote in the New England Journal of Medicine in November.
“The most effective form of price competition for prescription drugs in the United States comes from interchangeable generic drugs… but such products have been blocked from entering the insulin market because many current insulin products are protected by recently obtained patents covering aspects of the drug’s formulation or its delivery device,” they wrote.
In other words, drug companies have protected their monopolies and their profits.
That perfect storm has created a crisis in which insulin prices nearly tripled from 2002 to 2013, resulting in the deaths of some Americans who were forced to ration their insulin and prompting others to drive across the border to Canada to buy their medications for a fraction of the price.
“The bigger picture here is that some insulin makers have been engaging in ‘product-hopping’ to prevent entry of generics,” said Yali Friedman, PhD, publisher of DrugPatentWatch.com, a Washington, D.C.-based business intelligence firm tracking pharmaceutical trends.
Product-hopping is a practice whereby drug manufacturers make minor changes to a drug’s formulation to make it more difficult for companies wanting to make generic brands to obtain the approval rating they need to manufacture the drug.
“So, while these affordability options are a step in the right direction, they may also serve to take the pressure off regulators to stop product-hopping, ultimately limiting healthy levels of competition,” Friedman told Healthline.
International organizations, such as the World Health Organization, are attempting to broaden the market for insulin by smoothing the way for manufacturers and companies to create their own generic insulins — a framework called “prequalification” that was successful in lowering costs of HIV drugs worldwide.
In the end, it may be that nothing short of systemic change can permanently alter the landscape that allowed insulin prices to run rampant.
“Pharmaceutical companies are profit-making entities. We cannot expect them to act against their own self-interest,” Robin Feldman, JD, director of the Center for Innovation at University of California Hastings and author of the book “Drugs, Money, and Secret Handshakes: The Unstoppable Growth of Prescription Drug Prices,” told Healthline.
“Insulin products are classic examples of drugs that have extended their protections. According to my research, all of the top-selling insulin drugs have increased their protection by at least 20 years. Each of the top-selling drugs piled on dozens of protections — as many as 55,” Feldman said.
“As long as the system leaves room for strategic behaviors, prices will continue to soar,” she said.