Washington, DC—The Endocrine Society is making a big push to reduce insulin prices, arguing that inability to pay for their treatment is adversely affecting many diabetes patients.

In an updated position statement published in The Journal of Clinical Endocrinology & Metabolism, the advocacy group is calling for government negotiation and other efforts to reduce insulin prices. The document points out that the cost of insulin has nearly tripled in the past 15 years, and a lack of transparency in the drug supply chain has made it challenging to identify and address the causes of soaring costs.

As it stands now, federal law prohibits Medicare, which accounts for a third of all drug spending, from negotiating directly with pharmaceutical companies over drug prices. The society suggests that new legislation allowing the government to negotiate lower insulin prices could save billions and provide more benefits to Medicare beneficiaries.

“Inventors Frederick Banting and Charles Best sold the insulin patent for a mere $1 in the 1920s because they wanted their discovery to save lives and for insulin to be affordable and accessible to everyone who needed it,” explained Endocrine Society President-Elect Carol Wysham, MD, of the Rockwood/MultiCare Health Systems in Spokane, Washington. “People with diabetes without full insurance are often paying increasing out-of-pocket costs for insulin resulting in many rationing their medication or skipping lifesaving doses altogether.”

Especially facing problems with rising insulin costs are those with low incomes; those on high-deductible healthcare plans; Medicare beneficiaries; and young people who, at age 26 years, lose their parents’ health insurance, according to the statement.

In addition to government action, The Endocrine Society calls for more inclusive and accessible Patient Assistance Programs—rebate programs from employers to reduce patients’ out-of-pocket costs and health-insurance premiums.

Here are some of the recommendations:
• Allowing government negotiation of drug prices
• Creating greater transparency across the supply chain to understand rising insulin costs
• Limiting future list-price increases to the rate of inflation
• Limiting out-of-pocket costs through one or more of the following policies, without increasing premiums or deductibles: limiting cost-sharing to a copay of no more than $35; providing first-dollar coverage; capping costs at no more than $100 per month
• Eliminating rebates, or passing savings from rebates along to consumers without increasing premiums or deductibles
• Expediting the approval of insulin biosimilars to create competition in the marketplace
• Including real-time benefit information on medication costs in electronic medical records
• Developing a payment model for Medicare Part B beneficiaries in addition to Part D that lowers their out-of-pocket copay

While the society urges action along the supply chain, they specifically recommend that pharmacists learn about and share information with patients about lower-cost options offered by manufacturers. Physicians and hospital administrators should train healthcare providers to use lower-cost human insulins (NPH and regular), which should be available at no cost to patients, and provide access to real-time benefit information to help prescribe the lowest cost insulin when clinically appropriate, the statement notes.

“Given the complex nature of diabetes, it is essential that patients adhere to their medication regimens to reduce or avoid unnecessary complications and hospitalizations,” according to the article. “For people with type 1 diabetes and people with type 2 diabetes who are dependent on insulin, taking the appropriate dose or doses of insulin each day is required to avoid complications, including death. However, adherence can be difficult as people with diabetes often have comorbidities that require them to take multiple, costly medications or they may be unable to make sustained lifestyle changes that could improve outcomes.”

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