Last week, Lilly Diabetes hosted a workshop to talk about insulin pricing and access with a handful of respected diabetes advocates. Diabetes Mine has a really good summary of the event.
@Mila was there and was representing Diabetes Hands Foundation and the TuDiabetes community. I’d be interested in hearing her perspective.
I know there has been some intense scrutiny expressed on social media about this event. The general criticism I have seen is something like, “pharmaceutical companies created the problem, so why would they help us solve it?” I don’t think it is irrational to be skeptical of pharmaceutical companies, but as the Diabetes Mine recap points out, the problem is really complex.
Part of the discussion, according to Diabetes Mine, was about employer-focused reform. The fix would be to get employers to use their power over Pharmacy Benefit Managers to make some changes to improve the system in the US. Here’s a few of Lilly’s ideas on this (from the article):
- Manufacturers must take more responsibility in pushing for point-of-sale benefits from rebates. More work needs to be done to pass along these insider “rebates” to consumers/patients.
- Free Insulin to clinics: An idea that Lilly mentioned as still being in development, and not finalized by any means, is an effort to work with non-profit groups over the next year to get insulin into free health clinics in select places nationally. Interestingly, not all free clinics are equipped to handle donations for free insulin, and so this is all in the works. Hopefully we all hear more soon.
- First dollar obligations before deductibles. Employers can contribute to health savings or reimbursement accounts on Jan. 1, rather than gradually paying into those accounts throughout the year. This could help employees pay for insulin from the first day of the year. Again, not addressing the true pricing problem, but it’s something that could help.
- Exempt insulin from deductibles: This is something Lilly’s already been doing as a large employer, but it wants to encourage more employers to adopt: insulin could/should be categorized as one of the essential, life-or-death meds that isn’t subject to a high-deductible, but rather just a flat co-pay. Wells said the high-deductible plan system was setup to drive people to cheaper generics, and to go to primary care doctors instead of higher-cost ERs. “But with insulin, it doesn’t make sense. Insulin should be treated differently.”
The Diabetes Mine article goes on to point out how stigma and discrimination in the workplace will make employer-focused reform difficult. How many of us are willing to tell HR we have diabetes…and then how many of that group are willing to advocate for company-wide insurance changes for our own benefit?
This complicated issue is…still complicated.
What do you think?