mcloudyn.png
Thursday August 11th, 2022 11:07PM

EXPLAINER: Why is insulin so expensive and difficult to cap?

By The Associated Press
Related Articles
  Contact Editor

Washington (AP) — Reining in the soaring prices of insulin has thus far been elusive in Congress, although Democrats say they'll try again — as part of their economic package that focuses on health and climate.

The price of the 100-year-old drug has more than tripled in the last two decades, forcing the nation's diabetics to pay thousands of dollars a year for the life-saving medication. Democrats are considering capping the cost of that drug for at least some, although it’s unclear what the final proposal will look like and how many insulin users will get a price break.

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

HOW MANY PEOPLE IN THE U.S. USE INSULIN AND FOR WHAT?

Roughly 8.4 million Americans use insulin, according to the American Diabetes Association. Not everyone who has diabetes needs insulin, but for those who do, it's an important medication. For more than 1 million of those people with type 1 diabetes, regular access to the medication is a necessity and they will die without it.

"People require insulin, it’s not an option and nobody should have to decide between life-sustaining medication or food and rent," said Dr. Robert Gabbay, the chief scientific and medical officer for the American Diabetes Association.

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

HOW EXPENSIVE IS INSULIN?

The price varies.

Some people on private insurance pay hundreds of dollars monthly for the drug. For most Medicare beneficiaries, the average out-of-pocket cost per insulin prescription was $54 in 2020 — an increase of nearly 40% since 2007, a study released last month by the Kaiser Family Foundation found. Others live in one of 22 states where the copay for a 30-day supply has been capped between $25 to $100.

The cost has led some to use less insulin than their doctor prescribes or postpone paying for other medical care.

WHY IS INSULIN SO EXPENSIVE?

Only three manufacturers — Eli Lilly, Novo Nordisk and Sanofi — produce insulin, allowing those companies to control much of the market.

“They’ve been historically raising their list prices for their respective products in lockstep with one another,” Dr. Jing Luo, a professor of medicine at the University of Pittsburgh, said. “There hasn’t been a lot of pricing pressure.”

And making a generic drug for insulin hasn't been easy, with new manufacturers having to clear regulatory hurdles and questions over how a generic drug should be categorized, Luo added. A generic insulin is slated to come on the market in 2024 at no more than $30 a vial, which could drive down some of the price.

A biosimilar insulin product the Food and Drug Administration approved last year, however, has been more expensive than advocates had hoped, Gabbay said.

HOW DO DEMOCRATS PLAN TO CAP THE PRICE OF INSULIN?

That remains to be seen.

Senate Majority Leader Chuck Schumer has said some language that limits the price of insulin will be added to the economic bill, but it's not clear what that price point will be and who all will be protected by that price cap.

Democrats had proposed a $35 monthly cap for those who get the drug through Medicare or private insurers as part of a bigger package that was derailed in the Senate. But it was left out of the scaled down package now headed for a congressional vote.

WHY IS THE COST OF INSULIN SO DIFFICULT TO CAP?

Capping the price of insulin will 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 that would cap 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 drive up government costs and premiums charged by Medicare and private insurers, according to the office's analysis.

And that's one of the reasons why price caps can be controversial.

“If your health insurance company says, voluntarily, nobody who buys insulin in our plan will have to pay more than $25, the question is who is paying the balance of that?” Luo said. “That then means their cost will go up, which means they’ll raise premiums on everyone.”

  • Associated Categories: Associated Press (AP), AP National News, AP Online National News, Top General short headlines, AP Online Headlines - Washington, AP Online Congress News, AP Health, AP Business, AP Business - Corporate News, AP Business - Economy, AP Business - Industries, AP Business - Financial Services
© Copyright 2022 AccessWDUN.com
All rights reserved. This material may not be published, broadcast, rewritten, or redistributed without permission.
EXPLAINER: Why is insulin so expensive and difficult to cap?
Reining in the soaring prices of insulin has thus far been elusive in Congress, although Democrats say they’ll try again — as part of their economic package that focuses on health and climate
12:40AM ( 8 minutes ago )
China summons European diplomats over statement on Taiwan
China says it summoned European diplomats in the country to protest statements issued by the Group of Seven nations and the European Union criticizing threatening Chinese military exercises surrounding Taiwan
12:37AM ( 10 minutes ago )
Washington town evacuated, some homes burned in wildfire
A small town in Washington state was evacuated due to a fast-moving fire that burned a half-dozen homes as crews in California made progress  against the state’s deadliest and largest wildfire of the year
12:21AM ( 27 minutes ago )
Associated Press (AP)
Biden, Republicans spar over impact of Dems' economic plan
Democrats call it the “Inflation Reduction Act.”
11:47PM ( 1 hour ago )
Democrats say they've reached agreement on economic package
Senate Democrats say they have reached an accord on changes to their marquee economic legislation, clearing the major hurdle to pushing one of President Joe Biden’s leading election-year priorities through the chamber in coming days
11:43PM ( 1 hour ago )
Pelosi: China cannot stop US officials from visiting Taiwan
U.S. House Speaker Nancy Pelosi says that China will not isolate Taiwan by preventing U.S. officials from traveling there
11:41PM ( 1 hour ago )
AP Online Headlines - Washington
GOP eyes Nashville seat for flip; Dems vie to face governor
Tennessee Republicans are set to settle a nine-way primary in a reconfigured congressional district in Nashville they are hoping to flip
7:21PM ( 5 hours ago )
Surprise Senate vote would overturn Biden environmental rule
In a surprise victory for Republicans, the Senate on Thursday voted to overturn a Biden administration rule requiring rigorous environmental review of major infrastructure projects such as highways, pipelines and oil wells — a victory enabled in part by Democratic Sen. Joe Manchin of West Virginia
7:01PM ( 5 hours ago )
Louisiana abortion providers file appeal, hope to block ban
Access to abortion in Louisiana has been back-and-forth for weeks — with the state’s three clinics relying on rulings and temporary restraining orders to continue operations
6:47PM ( 6 hours ago )
AP Online Congress News
Asian stock markets rise ahead of US jobs data
Asian stock markets are higher ahead of an update on the health of the U.S. jobs market while the Federal Reserve weighs whether more rate hikes are needed to cool surging inflation
11:50PM ( 58 minutes ago )
US, Russia, China take part in talks with SE Asian nations
U.S. Secretary of State Antony Blinken has joined the foreign ministers of Russia and China at a meeting with top diplomats from Southeast Asia, which comes at a time of increased tensions
11:38PM ( 1 hour ago )
China conducts 'precision missile strikes' in Taiwan Strait
China says it has conducted “precision missile strikes" in the Taiwan Strait as part of military exercises by its navy, air force and other departments in six zones surrounding the island
10:46PM ( 2 hours ago )
AP Business
DoorDash sees record orders in Q2 as it combines with Wolt
DoorDash has reported that it received a record number of customer orders in the second quarter, boosted by resilient demand and its acquisition of Finnish delivery service Wolt Enterprises
7:29PM ( 5 hours ago )
US stocks end mixed amid earnings, economic updates
Stocks closed mixed on Wall Street Thursday as investors continued to review the latest updates on the economy and corporate earnings
4:55PM ( 7 hours ago )
US stocks mixed amid earnings, economic updates
Stocks were mixed in afternoon trading on Wall Street Thursday as investors continued to review the latest updates on the economy and corporate earnings
1:40PM ( 11 hours ago )
AP Business - Economy
Beyond Meat announces layoffs after lower Q2 sales
Plant-based meat maker Beyond Meat says it’s laying off 4% of its workforce
7:15PM ( 5 hours ago )
Efforts intensify to reach 10 trapped coal miners in Mexico
Efforts to rescue 10 miners trapped in a collapsed and flooded coal mine in northern Mexico have intensified with hundreds of people involved in the operation
3:39PM ( 9 hours ago )
Russians shell city near Europe's largest nuclear plant
Russian forces shelled a city close to Europe’s biggest nuclear power plant Thursday, reinforcing the U_N_ nuclear chief’s fears that the situation around the facility is “grave and dangerous.”
1:07PM ( 11 hours ago )
AP Business - Industries
Bank of England likely to raise interest rates — maybe a lot
The Bank of England is likely to announce its biggest interest rate increase in more than 27 years as it seeks to rein in accelerating inflation driven by the fallout from Russia’s invasion of Ukraine
4:29AM ( 20 hours ago )
US stocks rise following solid earnings reports
Stocks are closing higher on Wall Street Wednesday as investors reviewed a mostly encouraging batch of earnings from big companies
4:43PM ( 1 day ago )
Growing prescriptions help push CVS past Q2 expectations
CVS Health thumped second-quarter expectations and hiked its full-year forecast as growing prescription claims helped balance a drop in vaccinations
10:59AM ( 1 day ago )
AP Business - Financial Services
Washington town evacuated, some homes burned in wildfire
A small town in Washington state was evacuated due to a fast-moving fire that burned a half-dozen homes as crews in California made progress  against the state’s deadliest and largest wildfire of the year
12:21AM ( 28 minutes ago )
Tougher IRS enforcement central to Dem economic package
One of Washington’s favorite punching bags, the Internal Revenue Service, may finally get the resources it’s been asking Congress for if Democrats get their economic package focused on energy and health care over the finish line
12:18AM ( 30 minutes ago )
Democrats could strip Iowa of opening spot in 2024 campaign
Democrats may be moving toward shaking up their presidential nominating process starting in 2024
12:13AM ( 36 minutes ago )
Trump ally takes on Walker protégé in Wis. governor's race
Republican hopes to reclaim a crucial governor’s seat in swing-state Wisconsin this year long appeared to rest on Rebecca Kleefisch
12:08AM ( 41 minutes ago )
Ogles wins House race; Tennessee Dem gov bid still too early
Maury County Mayor Andy Ogles has won Tennessee’s bruising nine-candidate Republican primary for an open congressional seat in Nashville
12:07AM ( 41 minutes ago )