For diabetics and drug consumers, lingering questions on decision

Eli Lilly, one of the world’s top three insulin producers, is slashing the price of its most widely prescribed insulin by 70 percent. That’s welcome news for the roughly 7 million Americans who use insulin daily to treat diabetes, including some who have had to ration their dosage because of the cost and inadequate insurance coverage.

The company’s announcement Wednesday comes as the Biden administration has pressed the industry to rein in prices, which have skyrocketed in recent years and weighed on lower- and middle-income people with diabetes. Congress authorized a $35-per-month cap for some seniors with Medicare coverage, but that does not help those with private insurance struggling to afford the lifesaving medication.

Here are some key questions about the decision and what it means for consumers.

Why is Eli Lilly lowering insulin prices?

The Indianapolis-based pharmaceutical giant said Wednesday that the price reductions would make insulin access easier, especially for Americans who have trouble navigating the nation’s “complex health care system.”

Prices of the four most popular types of insulin have tripled in the past decade, according to the American Diabetes Association. A November study published in the Annals of Internal Medicine found that 1.3 million adults with diabetes, or 16.5 percent of those who use insulin to manage the disease, rationed use in 2021. A 2022 Yale University study found that 1 in 7 Americans who use insulin daily spent roughly 40 percent of their income, after food and housing, on the medicine.

Which medications are affected, and how much will they cost?

Lilly’s most affordable insulin — its non-branded lispro injection — will run $25 per vile starting May 1, compared with $82.41 now.

Humalog, its most commonly prescribed insulin, will drop 70 percent from $530.40 for a five-pack of insulin pens to roughly $160. That price will be effective in the fourth quarter of 2023.

Lilly is also launching an insulin product called Rezvoglar, which the company says is interchangeable with medication by competitor Sanofi but costs 78 percent less. It will be available April 1.

Could other companies follow suit?

It’s unclear. But the American Diabetes Association issued a statement lauding Lilly and called on other insulin producers to follow the new pricing model.

Sanofi has previously said that it supported a universal price cap and already offered insulin at affordable prices through a savings program, CNBC reported. In a statement to The Washington Post, the Paris-based company said that it has programs to lower the price of the medicine, including a co-pay assistance program in which privately insured patients are “eligible” for a supply of insulin that costs $15 or less. Uninsured individuals are eligible for a $35-permonth insulin supply.

Novo Nordisk, based in Denmark, said in a statement that it also has programs to make insulin affordable, including a product at Walmart for $25 per vial.

Why aren’t prices on all drugs being lowered?

In recent years, there’s been political jousting over insulin prices and how to lower them. Last year, congressional Democrats attempted to impose a sweeping $35-per-month price cap for both Medicare patients and those with private insurance. But the provision, included in the Inflation Reduction Act, was limited after Republicans successfully jettisoned the part of the proposal that applied to privately insured patients.

In his State of the Union address last month, President Biden called on Congress to pass a provision that would cap insulin prices in the private insurance market.

After the speech, an Eli Lilly spokeswoman told CNBC that the company supported extending a $35-per-month price cap to privately insured patients.

More than 20 states and D.C. have passed price caps ranging from $25 to $100 per month.

Why has insulin cost so much?

The researchers who discovered insulin in 1921 sold their patent to the University of Toronto for $3, and for decades the price per vial remained as affordable as any household item. Ads published in The Post in the 1960s advertised insulin for as little as 84 cents a vial, less than a bottle of shampoo.

But in recent decades, as producers have made improvements to the medicine and generated new patents, companies have raised prices.

The cost of some insulin products swelled by over 200 percent between 2007 and 2018, according to the medical journal Lancet. For someone with little to no health-insurance coverage, the pharmacy bill could push past $1,000 a month when higher doses are required.

What does insulin do?

Insulin is a hormone produced by the pancreas. It helps body control blood sugar levels and transform food into energy.

For diabetics, the body either doesn’t make enough insulin ( Type 1 diabetes) or it is not used correctly ( Type 2). People with Type 1 need a daily dose of insulin to live, while those with Type 2 can be prescribed insulin, known as “human insulin,” to manage blood sugar levels.

About 37 million Americans have diabetes, according to the latest data from the U.S. Centers for Disease Control and Prevention, though some use other methods to control their blood sugar.

How do people use insulin?

The hormone is typically injected using a needle, pen or pump. In some cases, it’s consumed via an inhalable powder.