Eli Lilly guarantees insulin costs will not go up; Novo Nordisk, Sanofi hedge

An Eli Lilly & Co. logo is featured on a box of insulin medications in this arranged photo of a pharmacy in Princeton, Illinois.

Daniel Acker | Bloomberg | Getty Images

Eli Lilli CEO Dave Ricks vowed Wednesday not to raise prices again on the company’s existing insulin products — the only executive to do so ahead of a Senate Health Committee hearing on the affordability of the life-saving diabetes drug.

Sen. Bernie Sanders, the committee chair, asked Ricks and the CEOs of Novo Nordisk And Sanofi to commit “never again to increasing the price of an insulin drug”. The three companies control over 90% of the global insulin market.

Ricks was the only executive who wholeheartedly agreed with Sanders’ request — at least for Eli Lilly’s existing insulin products.

“We will leave our prices for the insulins on the market today as they are,” Ricks told the Vermont Senator. “In fact, we cut them.”

Meanwhile, Lars Fruergaard Jørgensen, CEO of Novo Nordisk, said the Danish company has committed to limiting price increases to “single digits”.

Sanofi CEO Paul Hudson responded that the company has a “responsible pricing policy.”

He also noted that the net prices for Sanofi’s insulin products are actually falling. Net price refers to the amount insurers pay for an insulin drug after discounts and rebates. It is usually lower than the price a product is listed for.

All three companies have been under political pressure for years to make insulin more affordable for people with diabetes.

In March, they each announced that they would reduce the prices of their most commonly used insulin products.

Lilly announced that the price of the Lispro injection will be $25 per vial starting May 1, and the price of the Humalog and Humulin injections will be reduced by 70% starting in the fourth quarter.

The company also announced that it would limit the deductible for individuals with personal insurance at participating retail pharmacies to $35 per month.

Novo Nordisk announced that it will reduce the list price of its NovoLog insulin by 75% and the prices of Levemir and Novolin by 65% ​​starting next year.

Sanofi said it plans to cut the price of its most popular insulin drug, Lantus, by 78% and the list price of its short-acting insulin, Apidra, by 70%.

At the hearing, Sanders called these actions “good news” and a result of public pressure.

But the senator said the committee plans to hold a hearing next year to make sure those price cuts “actually happen.”

“We just don’t want words. We want action,” Sanders said in his opening speech.

“We need to make sure price cuts are effective enough to ensure that every American with diabetes gets the insulin they need at an affordable price,” Sanders added.

CVS, Express Scripts, Optum Rx

The hearing also brought together other key players in the insulin industry: top executives from three of the largest pharma-benefits executives.

Those executives were David Joyner, President of CVS Health pharmacy services; Adam Kautzner, President of Express Scripts; and Heather Cianfrocco, CEO of Optum Rx.

PBMs are the middlemen who negotiate drug prices with manufacturers on behalf of health insurance companies. They are often criticized for allegedly inflating drug prices and not passing on all the rebates and rebates they negotiate to consumers.

Joyner pointed out that CVS Health passes on more than 98% of all discounts to customers.

“We’ve always prioritized making really transparent offers to the market,” he said during the hearing.

But Senator Roger Marshall, R-Kan, stressed that 84 cents of every dollar goes to the PBMs.

Sen. Susan Collins, R-Maine, also highlighted a colossal gap between list and net prices of insulin from 2012 and 2021.

Collins asked Ricks to explain “who gets this money” because “I can tell you it’s not going to the consumer at the pharmacy counter.”

Ricks urged her to ask the PBMs “how this money is being redistributed.”

government caps

About 37 million people in the United States have diabetes, according to the Centers for Disease Control and Prevention. About 8.4 million diabetes patients are dependent on insulin.

High prices have forced many Americans to ration insulin or reduce their use of the drug. A 2021 study in the Annals of Internal Medicine found that nearly 1 in 5 US adults either skipped, delayed, or used less insulin to save money.

The Inflation Reduction Act, the Democratic plan Biden signed into law last year, capped the monthly cost of insulin for Medicare beneficiaries to a $35 monthly prescription but offered no protection for diabetes patients who have private insurance.

More than 2 million patients with diabetes who take insulin are privately insured, according to the Department of Health and Human Services. Another 150,000 patients who take insulin are uninsured, HHS says.

Last month, Sens. Jeanne Shaheen, DN.H., and Collins introduced bipartisan legislation that would require private health insurers to cap the price of any insulin type and dosage form to $35 a month.

These types of insulin include fast-acting, short-acting, medium-acting, long-acting, and pre-mixed. Dosage forms include vials, pens, and inhalers.

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