Insulin Pricing

The co-chairs of the Diabetes Caucus, Congresswoman Diana DeGette (D-CO) and Congressman Tom Reed (R-NY), have conducted an inquiry to determine the causes of rising prices for insulin, a life-saving drug for millions of Americans living with diabetes. Average insulin prices have nearly doubled since 2012, and many patients are also facing high prices due to steep deductibles, coinsurance and formulary exclusions.

Taking Action

Representatives DeGette and Reed sent letters in June of 2017 requesting meetings from three key stakeholders: the Pharmaceutical Research and Manufacturers of America (PhRMA), the Pharmaceutical Care Management Association and America’s Health Insurance Plans. These are the major trade associations for the pharmaceutical industry, the pharmacy benefit managers and the health insurance industry, respectively. After meeting with top officials from these three organizations, the members released key findings summarizing what was discussed in these meetings and an additional meeting with the American Diabetes Association. These key insights served as a launching pad for further conversations and fact-finding on this complex problem. 

In November of 2017, DeGette and Reed issued a request for information on value-based contracting, an umbrella term for payment arrangements that set drug costs based on their efficacy. And In January of 2018, the Members sent letters to the heads of drug makers Novo Nordisk, Eli Lily and Sanofi requesting more information about drug discount programs, which have also been employed to reduce costs of insulin for people with diabetes. They also sent letters to the heads of America’s Health Insurance Plans and the Pharmaceutical Care Management Association to learn more about the process used to develop formularies, which determine the cost and accessibility of insulin. The Congressmembers have also met with patients, patient advocate groups such as JDRF and TD1 International, as well as provider groups including physicians, nurses, and other providers throughout this process.

The goal through these varied efforts was to collect all the information necessary to develop meaningful, bipartisan policies that will make a difference for people with diabetes and their families. On November 1, 2018, Representatives DeGette and Reed released the findings of the extensive inquiry. It highlights the need to lower prices and suggests ways to achieve this. You can read the report here.

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Letter to FDA on Barriers to Developing Biosimilar Insulins

Letter to the Endocrine Society on Insulin Prescribing Practices

Response from the Endocrine Society

Value-Based Contract RFI 

Letter to Pharmaceutical Care Management Association (PCMA) on Formularies

Letter to America's Health Insurance Plans (AHIP) on Formularies

Letter to Novo Nordisk on Drug Discount Programs

Letter to Eli Lilly on Drug Discount Programs

Letter to Sanofi on Drug Discount Programs

QFR Responses E&C Drug Supply Chain Hearing

Value-Based Contracting Key Findings

Final Report


In The News

In Bipartisan Insulin Pricing Inquiry, DeGette and Reed Explore Value-Based Contracting Options

In Ongoing Insulin Pricing Inquiry, Caucus Seeks Information on Formularies and Drug Discount Programs

DeGette, Reed Taking Next Steps in Insulin Price Inquiry

Washington Post: Lawmakers Make Bipartisan Push to Understand the Soaring Price of a Lifesaving Drug

Caucus Seeks Views on Value-Based Contracting for Insulin 

Skyrocketing Insulin Cost: Congressional Diabetes Caucus Highlights Need and Ways to Bring Prices Down