Price has pushed in­sulin out of reach

Boston Herald - - NEWS - By ALEXI CO­HAN

The cost of in­sulin has in­creased over 250 per­cent since 2007, ac­cord­ing to the Amer­i­can Di­a­betes As­so­ci­a­tion, and pa­tients are look­ing to law­mak­ers for re­lief.

Dr. Vikas Saini, pres­i­dent of the Lown In­sti­tute and cochair­man of the Right Care Al­liance both based in Brook­line, said a hand­ful of drug com­pa­nies cre­ate an “iron tri­an­gle” with in­sur­ance com­pa­nies and phar­macy ben­e­fit man­agers that has led to sky­rock­et­ing in­sulin prices.

“It’s a bro­ken mar­ket. It’s re­ally not work­ing,” said Saini, “They clearly have been us­ing this as a cash cow, while they say we need this to do re­search and in­no­va­tion.”

Saini said that in­sulin prices have in­creased over 1,000 per­cent in the last 25 years due in part to ris­ing list prices from man­u­fac­tur­ers and a markup over the cost of pro­duc­tion.

Saini said that al­though there have not been many new in­no­va­tions in in­sulin in the last two decades, drug com­pa­nies will slightly tweak in­sulin mol­e­cules to get new patents.

“There’s been a lot of mu­tual back scratch­ing that goes on and a lot of games­man­ship,” said Saini.

He said the sit­u­a­tion has reached a break­ing point.

“It can’t go on, young peo­ple are dy­ing it’s that bad,” Saini said. “We can’t al­low this to go on.”

At Cam­bridge-based Sanofi, one of the na­tion’s pro­duc­ers of in­sulin, spokesman Ni­co­las Kress­mann said some in­sulin drugs like Lan­tus ac­tu­ally have a lower net price to­day than in the past.

“It is our be­lief that grow­ing re­bates and de­clin­ing net prices should re­sult in lower out-of-pocket drug costs for pa­tients. Un­for­tu­nately, un­der the cur­rent sys­tem, this is gen­er­ally not the case and these sav­ings are not con­sis­tently passed through to pa­tients in the form of lower co-pays or coin­sur­ance,” said Kress­mann.

He ad­vised pa­tients to con­sider the Sanofi Pa­tient Con­nec­tion Pro­gram and the Va­lyou Sav­ings Pro­gram, both aimed at help­ing pa­tients strug­gling with drug costs.

Saini is look­ing toward law­mak­ers for reg­u­la­tory re­lief, say­ing that bulk pur­chas­ing, ne­go­ti­a­tion and dis­tri­bu­tion on a state level could of­fer a vi­able so­lu­tion. Pa­tients and ad­vo­cates are hope­ful, with three new bills filed in Congress in the last month to reg­u­late prices.

War­ren Ka­plan, as­sis­tant pro­fes­sor at the Bos­ton Uni- ver­sity School of Pub­lic Health, is also seek­ing a po­lit­i­cal so­lu­tion to ris­ing in­sulin prices. He said in­ter­na­tional agree­ments be­tween for­eign coun­tries would cre­ate more com­pe­ti­tion in the mar­ket and lower prices.

“Drug com­pa­nies are not go­ing to like it, you’ll get some push-back from the pharma in­dus­try about los­ing prof­its,” said Ka­plan. He also pointed to a lack of trans­parency in the mar­ket, which law­mak­ers could also fix.

“Some­one has to shine a light in this black hole,” said Ka­plan.

Ka­plan said in­sulin is ex­pen­sive to pro­duce, but much of the high costs are “get­ting tied up in mar­ket­ing and ad­ver­tis­ing, not re­search.”

BOS­TON HER­ALD FILE

An in­sulin pump is re­filled with in­sulin. Below, a man walks past Sanofi head­quar­ters in Paris.

AP FILE

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