Insulin prices soaring; lawmakers open probe

Soaring costs for crucial product are getting scrutiny from diabetes patients, physicians and politicians.

Profit opportunities along supply chain are driving up price for modified hormone commonly used by diabetes patients.

More than 7 million Americans with diabetes need insulin to control their blood sugar and stave off dangerous com- plications. The average price of insulin tripled between 2002 and 2013, according to the American Medical Asso- ciation. The group recently called on regulators to monitor competition among the three drugmakers that control the market.

Meanwhile, several congres- sional lawmakers are probing the multibillion-dollar insulin market.

We spoke with diabetes specialist Dr. Robert Lash, an executive with the Endocrine Society, about insulin prices.

How long has insulin been used to treat diabetes?

Purification of insulin was a major historical event, and it happened about 100 years ago. Initially, it came from animals. And then in the 1990s, recombinant DNA technology was available so we could make and purify human insulin in bacteria, and that became the source of insulin.

Then people realized they could make insulins with different properties by making small genetic alterations — insulins that act more quickly or more slowly. Those are the insulins that are now the subject of the price increases we’re seeing.

If you look at what’s called regular insulin, you can get that at a pharmacy for $25 to $30 per vial. And if you look at the same insulin with one tiny amino acid change, that insulin is $300 a vial.

What accounts for that price difference?

You have asked the ques- tion that everyone keeps asking. These insulins have been around for 20 years; they’re made pretty much the exact same way in the exact same factories. What other manufactured product do you know that shows no economies of scale and no price drop in 20 years? TVs, phones, cars get cheaper — but insulin never does.

And the reason it doesn’t is that it’s a medicine that everybody needs, and it has an incredibly complicated supply chain where every player is trying to maximize their own profit.

How do these prices impact patients?

When patients don’t have insurance and can’t afford their insulin, bad things can happen. They may use less insulin than they should, and their glucose isn’t well-controlled, so they are more likely to have complications of diabetes.

How are doctors responding?

There is a movement among some endocrinologists to go back to older forms of insulin because they are so much cheaper. They wouldn’t be for everybody, but there are probably a lot of people who could use the older insulins. The trouble is that these newer insulins have been around so long that we have multiple generations of physicians who have never used the older insulins before.

REED SAXON / ASSOCIATED PRESS 2012 Insulin’s average price tripled from 2002 to 2013, the American Medical Association says. It urged regulators to monitor drug firms controlling the market.