October 26, 2022 – Trapper Haskins, a 45-year-old musician with type 1 diabetes, says the price of insulin is a constant stressor in his life. The Nashville resident takes two types of insulin daily and sometimes has to ration the drug because his insurance plan limits how much of the expensive drug he can get each month. Insulin “is not like a high blood pressure drug,” he says. “Some days you need more, and at the end of the month you’re afraid you’ll run out.”
Studies show that about one in four people with type 1 and type 2 diabetes have to ration their supplies to save money. In general, most people with diabetes need two or three vials of insulin per month. Each vial can cost hundreds of dollars, meaning the cost to patients can easily reach $1,000 a month.
“Insulin prices have tripled in the last 10 years, causing a national crisis,” said Lizheng Shi, PhD, professor of health policy at Tulane University in New Orleans. .
In the US there are 1.5 million people with type 1 diabetes who cannot buy theirs possess insulin and rely entirely on keeping their blood sugar within a safe range. The vast majority of people with diabetes, approximately 37 million, have type 2 diabetes, which usually leads to the use of blood-sugar-lowering drugs until later insulin is given because the body is no longer responding to itself.
The high cost of insulin is largely due to a lack of competition and too few manufacturers of current products, Shi says. One of the biggest hopes for more affordable insulin is to increase competition in the market and lower prices by introducing so-called biosimilars, which are very similar versions of the original biologic drugs — and typically far cheaper.
create competition in the market
In July 2021 the FDA approved the first biosimilar product that could be used iinterchangeabley with current insulin products. Called semgleeit is a long-acting insulin analogue and the generic form of Lantus, the world’s leading basal insulin, whose patent expired in 2016. Semglee, manufactured by pharmaceutical company Mylan, is now available under some 2022 insurance plans and approved for patients with type 1 and type 2 diabetes. But Semglee isn’t cheap — it’s roughly $133 per vial without insurance. Some versions of Lantus cost more than $300.
The introduction of insulin biosimilars won’t bring big price cuts any time soon, he says , MD, Assistant Professor of Medicine at the University of Pittsburgh. One reason, he says, is that it takes years for drugmakers to develop the expertise and capacity to scale up production of biosimilars. Still, Luo is optimistic that we’ll be able to do it in the next 2-3 years, and if we can, it could mean that insulin would cost 10 times less.
Luo cites the work of the nonprofit Civica Rx. In March, the organization announced it would mass-produce generic insulin to reduce costs.
The company will manufacture three forms of insulin to be used interchangeabley with Lantus, Humalog and Novolog. The products are sold for no more than $30 per vial. They have already started construction Production facility in Petersburg, VA and will have products available for purchase through 2024, pending FDA approval.
In addition, the state of California plans to produce its own generic insulin. The state is investing $50 million to manufacture biosimilar insulin products and another $50 million to build a manufacturing facility.
Not soon enough
But for many, price drops aren’t happening fast enough. Allison Bailey of Ames, IA, who has type 1 diabetes, says finding a way to pay can be daunting at times, but she couldn’t survive without the life-saving drugs. It has sometimes cost her as much as $500 to fill out her prescription. Bailey was eventually able to switch her prescription to a cheaper insulin, but the 35-year-old graphic designer says her insurance coverage still accounts for a significant chunk of her monthly expenses.
The introduction of biosimilars hasn’t driven the price of insulin down fast enough for patients like Bailey, Bailey says ccalled sScience and medical officer with the American Diabetes Association. For this reason, the association is pushing for legislation to lower insulin prices. It has worked hard to establish a $35 per month Medicare Price cap that will come into effect in 2023. Now it’s focusing its efforts on extending the cap to private insurers, a move opposed by Congressional Republicans as part of the Inflation Reduction Act.
“We would like to see some transparency in pricing; Right now, everyone is just pointing fingers at each other and we don’t know who’s to blame,” says Gabbay.
But people with diabetes like Haskins and Bailey agree that competition from biosimilars and price caps could help drive down what they see as exorbitant prices for the drugs they need. “I’m lucky to have insurance, but for those who don’t, it’s often a life and death situation,” says Haskins