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**MARCH 1, 2023**
Kuttner on TAP
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**** A Small Victory Over Big Pharma
Eli Lilly announces insulin price caps, but keep an eye on the
footnotes.
The pharmaceutical giant Eli Lilly announced today that it is capping
out-of-pocket patient costs for its two most popular insulin drugs at
$35 a month. By some strange coincidence, that is the same $35 insulin
price cap included last year for Medicare in the Inflation Reduction
Act, and the one President Biden demanded in his State of the Union
address to be expanded beyond Medicare
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to include every diabetes patient.
Funny how a progressive president using both the bully pulpit and the
legislative agenda can alter indefensible corporate behavior.
Lilly also announced that it was cutting list prices by 70 percent for
two of its most popular branded insulin drugs, Humalog and Humulin. But
watch out for the fine print.
First of all, those price cuts are not scheduled to be implemented until
October, giving Lilly seven more months of high prices even as they are
lauded for their corporate responsibility.
Second, patients who have commercial insurance can get the $35-per-month
cap on out-of-pocket costs. And patients with no insurance can get a
Lilly "savings card" to get insulin for the same $35.
But the Lilly press release adds in a footnote, "Government restrictions
exclude people enrolled in federal government insurance programs from
Lilly's $35 solutions."
Say what? The federally mandated $35 cap already covers Medicare Part D.
Is Lilly saying that people on Medicaid, who include the lowest-income
Americans, will have to pay sticker prices for their insulin?
And since Lilly caps out-of-pocket costs to patients but not necessarily
prices charged insurance companies, the result could be cost-shifting
and higher insurance premiums.
Lilly is out to limit reputational damage and head off more direct
government regulation. For a decade, the strategy of the three major
insulin makers, Lilly, Sanofi, and Novo Nordisk, has been to jack up the
price of insulin as much as the market will bear. The current list price
of Humalog is $530 for five injection pens
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Lilly's strategy is also to compensate for the hit to profits by
increasing market share. It is planning to introduce yet another insulin
variant, called Rezvoglar, a copycat knockoff of a Sanofi product.
We are all for greater price and product competition, but basic insulin,
synthesized in 1921, has been in the public domain for more than a
century and should cost no more than aspirin.
If embarrassed drugmakers are cutting prices thanks to government
action, that's the time for government to redouble regulatory
requirements and not to trust corporate public relations and voluntary
gestures. Better yet, produce and sell generic insulin socially, at
cost.
~ ROBERT KUTTNER
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