Why is insulin so expensive in the US and how much do patients pay per month?
The cost of the four most popular insulin medications have trebled in the past decade being the posterchild for America’s broken healthcare ‘system’.
It is a simple fact that what is passed as a healthcare ‘system’ in the US is fundamentally broken. Of the world’s major economies, it stands alone as the only one without a public healthcare system, leaving individuals in the hands of private insurers to stay alive. These insurers have made a serious amount of money from the venture with some estimates believing the industry to be worth nearly 3 trillion dollars in 2020.
An aspect of this which has come to the forefront in recent years are drug prices, specifically insulin. Insulin is the drug for diabetics which regulates the amount of insulin for patients. Without it, they will die. The prices have always been outrageous, but that could be changing.
But this has been of little concern for drug companies which have been pumping up the price of the life-saving drug over the last thirty years. Average prices have grown by 15 percent each year since 2012. It can cost between $175 and $300 for a vial of which most need at least three a month. This isn’t some experimental or niche drug; 35 million Americans need it.
While seniors were partly protected from these prices by the Trump administration with adaptations to Medicare plans, the majority are still hung out to dry.
The latest effort to cap the price of insulin was defeated by Republicans this week. In the Inflation Reduction Act, Democrats had sought to cap the price of insulin at $35 a month. However, the Senate parliamentarian decreed this would need 60 votes to pass in the Senate but the legislation was three votes short of this figure. Seven Republicans voted for the price cap.
Now it seems that Eli Lilly has decided to cap its insulin prices at $35 a month for patients. It isn’t clear if competitors will follow suit, but now they really don’t have a choice.
Why are the prices so high for insulin?
The lack of government control for drug prices has allowed companies to push the boundaries in terms of pricing. Joe Biden has tried to change that and it looks like public pressure and White House insistence is beginning to work.
One way that this has happened is the role of Medicare, or lack thereof. In the UK, the National Health Service controls the pricing of all drugs for the service by offering a maximum bid which, if not taken up by the companies, is final. If the drug companies do not accept then they cannot sell their drugs in the country.
In contrast, Medicare is actually barred from negotiating drugs prices. This leaves the system to be exploited as private insurers battle against each other for prices with Medicare to be left the scraps. So why do drug companies court death with these extortionate prices?
“They are doing it because they can,” Jing Luo, a researcher at Brigham and Women’s Hospital, told Vox, “and it’s scary because it happens in all kinds of different drugs and drug classes.”
It looks like insulin prices will finally be lowered in the US after many years of out-of-control prices by big pharma companies.