Lawmakers
are asking what took them so long.
By Cynthia Koons
and Anna Edney | April 10, 2019 at 07:33 PM
Decisions by two of the world’s biggest insulin
producers to offer bigger discounts on drugs used by millions of diabetics are
raising questions from Congress about whether the companies could have done so
sooner.
On Wednesday, French drugmaker Sanofi said it
would increase discounts on insulin for some patients. The move follows recent
efforts by Cigna Corp., which runs a major drug plan, and Eli Lilly & Co.,
another major insulin producer, to lower patients’ out-of-pocket costs for the
drugs.
The actions by the companies, which have come
in the middle of a series of hearings in the House and Senate on drug costs,
have raised questions from lawmakers about why it took a drumbeat of public
pressure before the companies altered their programs.
“It shouldn’t take months of bad press,
persistent public outcry and increasing congressional scrutiny to get a company
to charge a fair price,” Senator Chuck Grassley, the Iowa Republican who is
leading hearings in the Senate, said of Sanofi’s announcement. “That’s not how
a functioning marketplace works.”
Sanofi is expanding its “Valyou” discount
program. Under the enhanced discounts, some patients would pay $99 a month for
what should amount to a month’s supply of Sanofi’s Lantus, Toujeo and Admelog
insulins. It’s an improvement from the existing program, which charged patients
more for less insulin.
In March, Lilly said it would begin selling a
lower-priced version of its top-selling insulin, Humalog, and Cigna this month
agreed to cap patient’s out-of-pocket costs for the drugs.
House Hearing
At a House Energy and Commerce subcommittee
hearing Wednesday, Rep. Joseph Kennedy III, a Massachusetts Democrat,
referenced the Eli Lilly price reduction, expressing frustration.
“It took 15 years and global outcry on this to
do it,” Kennedy said.
Rep. Diana DeGette, a Colorado Democrat, said
the discount offerings weren’t a permanent solution. “It’s just a temporary
Band-Aid,” DeGette said.
Representatives from insulin manufacturers
blamed a system that requires them to pay higher and higher rebates to
pharmacy-benefit managers to gain access to the patients whose prescriptions
the PBMs manage.
“There’s a significant demand for rebates,”
said Doug Langa, executive vice president of North American operations at Novo
Nordisk A/S.
Lawmakers were frustrated by the
finger-pointing that continued throughout the hearing, which featured the three
biggest insulin makers and the three PBMs that dominate the market.
“The PBMs blame the companies, the companies
blame the PBMs and our constituents say, ‘They’re all no good. Just get rid of
the system,”’ said House Energy and Commerce Committee Chairman Frank Pallone,
a New Jersey Democrat.
For Sanofi’s expanded program, only
cash-paying patients or people who have private insurance are eligible.
Medicare and Medicaid bar patients from using drugmaker-funded discount
programs, which can be a way for companies to steer patients toward expensive
drugs by covering their out-of-pocket costs.
Grassley questioned the lack of a discount for
patients in government health programs, saying, “If Sanofi can reduce the price
to patients for insulin while still making a profit, I can’t imagine a
legitimate reason taxpayers shouldn’t be charged the same price.”
Sanofi said program was designed initially to
help patients when their insurance lapsed. The company said that about 10% of
its insulin patients pay in cash. Drugs like Lantus, a popular long-acting
insulin, have a list price of $290 for five pens, according to GoodRx, which
tracks drug prices.
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