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Eli Lilly, a pharmaceutical giant that has become virtually synonymous with the sky-high cost of insulin in the United States, pledged Wednesday to cut the list prices for its most widely used insulin products by 70%, a move that advocates and experts met with deep skepticism even as they welcomed its potentially significant benefits for some people with diabetes.

“Eli Lilly’s price cut will help people,” said David Mitchell, the founder of Patients for Affordable Drugs. “But it’s the result of years of relentless pressure by diabetes advocates in this country and around the world.”

In addition to cutting the list prices of commonly prescribed insulin products such as Humalog—which currently has a price tag of $274.70 per vial—Eli Lilly said it would impose a $35 cap on out-of-pocket insulin costs for people with private insurance who use participating retail pharmacies.

Eli Lilly, one of the three companies that dominate the U.S. insulin market, directed those without health insurance to a company website offering a $35-per-month “insulin savings card.”

The company also pledged to slash the price of Lispro, Eli Lilly’s generic insulin, to $25 a vial—years after lawmakers chastised the drugmaker for failing to make the lower-cost product widely accessible.

The changes are set to take effect in the coming weeks.

“This decision for affordable insulin shows the power of grassroots advocacy and organizing,” Elizabeth Pfiester, executive director of T1International and a person living with Type 1 diabetes, said in a statement. “The T1International community has been taking action and asking insulin manufacturers to put patients over profits for years. In October, T1International and people with diabetes demonstrated outside of Eli Lilly in Indianapolis, and shared a petition with thousands of signatures asking them to lower their list price of insulin.”

“Countless patients and families have fought for decades for lower insulin costs and some have even lost loved ones because of the relentless price gouging that fueled profits for corporations like Eli Lilly.”

The company’s announcement comes nearly two months after a $35-a-month insulin copayment cap took effect for Medicare recipients, a change authorized by the Inflation Reduction Act that congressional Democrats passed and President Joe Biden signed into law last year.

On the surface, Eli Lilly’s 70% price cut for many of its insulin products appears substantial, but expert observers stressed that patients—excepting the uninsured and those with high-deductible plans—often don’t pay the full list price for prescription medicines, making it easy to overestimate the boldness of the company’s move.

“This will be helpful to some consumers,” Stacie Dusetzina, a professor at Vanderbilt University School of Medicine, toldSTAT. “It’s not clear to me how much of this is real cutting of the amount that Lilly makes on their insulins versus lowering the list price.”

Kristen Whitney Daniels, co-leader of T1International’s federal working group, also highlighted the possibility of Eli Lilly reneging on its commitments, something the company has been accused of in the past.

“Insulin manufacturers have shown time and time again that they will put their CEO’s profits over patients’ lives,” said Daniels, who is living with Type 1 diabetes. “Eli Lilly can roll back this new price structure for Lispro at any time, or put in place other practices to limit its use. That’s why the government also needs to regulate insulin manufacturers to hold them accountable to ensuring the human right to insulin.”

Others echoed that warning and urged lawmakers to continue pushing for broader reforms to bring down prices for insulin and other medications.

“My take? It’s a brilliant PR move to halt federal and state legislation, advocacy efforts, negative press, and all the heat pharma has been getting,” tweeted Hilary Koch, a public health advocate. “Once that goes away, price of insulin will go back up.”

“Any states and advocates currently working on legislation should plow forward,” Koch added. “Do NOT let this stop you.”

The obscene price of insulin in the U.S. relative to other rich nations has long been a source of outrage among progressive campaigners and lawmakers.

In 2019, Sen. Bernie Sanders of Vermont led a caravan of people with diabetes across the border into Canada to spotlight what he called the “unbelievable greed” of U.S. insulin manufacturers.

Last April, Human Rights Watch published a report showing that Eli Lilly has hiked the list price of Humalog by an inflation-adjusted 680% since 1996, when it first began selling the product.

In November, Eli Lilly’s stock price fell sharply after a parody account tweeted that “insulin is free now”—a spoof that brought greater public attention to the company’s history of profiteering.

Eli Lilly, Novo Nordisk, and Sanofi are currently facing lawsuits from California, Arkansas, Kansas, and Mississippi that accuse the companies of unlawfully using their dominance of the U.S. insulin market to drive up prices for patients, forcing many to ration the lifesaving drug.

“There’s much more to do. Novo Nordisk and Sanofi should follow suit with price reductions immediately,” Peter Maybarduk, director of the Access to Medicines program at Public Citizen, said following Eli Lilly’s announcement.

“Eli Lilly’s overdue price cut is an acknowledgment that insulin prices are a deadly outrage, and is a direct result of #insulin4all activists raising their voices, organizing, and fighting for their lives,” Maybarduk continued. “Meanwhile, our government must go far beyond guaranteeing $35 per month insulin on Medicare, to ensure that all insulin products are affordable for everyone who needs them, regardless of age, or insurance type or status.”

Margarida Jorge, the head of Lower Drug Prices Now, agreed, saying in a statement Wednesday that while Eli Lilly’s voluntary price cut is positive news, “the tens of millions of Americans who can not afford their prescription medication should not have to depend on the goodwill of greedy corporations who have repeatedly shown they care about profits more than people to bring them relief from skyrocketing prescription costs.”

“Countless patients and families have fought for decades for lower insulin costs and some have even lost loved ones because of the relentless price gouging that fueled profits for corporations like Eli Lilly,” Jorge said. “Congress, not greedy corporations trying to redeem their tarnished reputations, should be leading the way on reforms that put patients ahead of pharmaceutical profits and that guarantee millions of Americans get affordable medicines they need to take care of themselves and their families.”

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