Insulin is Too Expensive

#Insulin is too expensive for many of my patients. It doesn’t have to be.

By David M. Tridgell Washington Post, June 22 at 11:43 AM
David M. Tridgell is a board-certified endocrinologist. He practices just outside Minneapolis.

At age 15, I developed an unquenchable thirst and frequent urination, and lost 20 pounds. I had developed Type 1 diabetes, an autoimmune disease that destroyed my body’s ability to produce insulin. Without insulin, I would have eventually developed a condition called diabetic ketoacidosis, which is lethal without (and even sometimes with) treatment.

Years later, I’m a practicing endocrinologist. I could never have imagined back when I first started taking insulin that one day I would have so many patients who could not afford the medication because of skyrocketing prices. When the drug was discovered in 1921, the original patent was sold to the University of Toronto for $1 so that no one else could patent it and “secure a profitable monopoly.”


He makes excellent points. A tl;dr might read as such:

If Congress was serious about fixing drug pricing, start by doing the following:

  1. Eliminate tax write-offs for direct marketing of pharmaceuticals to patients;
  2. Eliminate direct marketing of pharmaceuticals to patients;
  3. Investigate price raising behavior from PBMs and pharmaceutical companies;
  4. Investigate rebates provided by pharmaceutical companies to PBMs;
  5. And allow Medicare and Medicaid to negotiate prices on behalf of taxpayers.

That would definitely be a good place to start, and wouldn’t require completely reworking the system as it is now (although I personally think the system should be completely reworked).

I’ve often thought of it from a different perspective: threaten to allow Medicare to negotiate prices on behalf of taxpayers unless the drug industry reigns itself in and brings prices into line. The threat would carry significant weight, I think.

Unfortunately, Dr. Tridgell offers relatively few solutions aside from telling Congress to fix it. I agree prices are too high, but there are some proposals that make sense at least in the near term,

  1. Thas is correct; allow Medicare and Medicaid to negotiate prices.
  2. Force transparency in PBM practices,
  3. Reduce obstacles to biosimilar entry into the market.

Oh yeah, one more thing, make insulin obsolete by encouraging cure innovation.

I was interviewed for an NBC series of reports regarding skyrocketing Rx prices. I looked at reeipts at the retail price for 3 vials of Humulog (I wear a pump,so I don’t need Lantus) went from$270 in 2012 to $1,250+ in 2016. I had a few moments before the interview so I went on the Eli Lilly website and click on the info for investors.I figured I’d get to see their financials. Yep, a big chunk - more than for R & D - went to admin and marketing. Why even market to the general public anyway? The ads during prime time cost a fortune, and since D meds are Rx’s why advertise anyway. Yeah, I can understand ads in he Forecast and other public publications as well as to Endo journals. And I do think the PBM’s do need to be looked into. I don’t understand why health plans can’t do their own negotiating and share the benefits of the negotiated prices with their policy holders. I can’t remember which PBM- CVS or another - admitted to increasing the retail price prior to the haggling process (kinda like what would happen when we went to Baja California and haggled on Avenida Revolucion). The problem is,that pre-negotiation price remained the retai prices so people without coverage or with high deductibles paid even more!

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