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The Journal Gazette

Thursday, April 04, 2019 1:00 am

Congress pushing insulin price cuts

Major insurers vow to limit price for its customers

Washington Post

WASHINGTON – Congress is pouring pressure on drugmakers and pharmacy middlemen to ease steep insulin prices for patients with diabetes. And there's a sign their scrutiny is starting to prompt action.

Major health insurer Cigna and Express Scripts, its recently acquired pharmacy benefit manager, announced Wednesday morning it will ensure patients in its commercial plans will have to pay no more than $25 for a 30-day supply of insulin, even before meeting their annual deductible. The discounts could potentially affect around 700,000 of its patients – mostly people with employer-sponsored coverage – who had an insulin claim last year, a spokeswoman told Health 202.

“For people with diabetes, insulin can be as essential as air,” said Steve Miller, Cigna's chief clinical officer. “We need to ensure these individuals feel secure in their ability to afford every fill so they don't miss one dose.”

The company expects to roll out the program later this year for insurance plans that work with Express Scripts and in 2020 for Cigna plans. Miller told me the company has struck agreements with the country's three insulin manufacturers – Eli Lilly, Novo Nordisk and Sanofi – for discounts on the insulin so the insurance company won't have to eat all the costs.

Miller insisted the company's announcement isn't tied to recent scrutiny by lawmakers on Capitol Hill, who have been holding hearings in the House and Senate on drug prices, and have specifically fixated on insulin prices.

“We've been at this for a little while,” he said. “This is what I would say is the latest in a string of things we've been doing to try to support better care for patients generally and people with diabetes specifically.”

Insulin is a particularly striking case study as lawmakers go after the problem of impossibly expensive prescription drugs in the United States. For one thing, a huge number of Americans live with diabetes; of the 30 million Americans with the illness, 7.4 million rely on insulin.

Plus, insulin is a hormone every single person needs to stay alive. For patients with Type 1 diabetes whose bodies don't produce any insulin (including your Health 202 author), access to insulin is quite literally a matter of life or death.

“American families are suffering from the ongoing and staggering price hikes of insulin,” Energy and Commerce Chairman Frank Pallone, D-N.J., said at Tuesday's hearing.