DeGette, Reed Taking Next Steps in Insulin Price Inquiry

Sep 21, 2017

Washington, DC – The co-chairs of the Congressional Diabetes Caucus, Reps. Diana DeGette (D-CO) and Tom Reed (R-NY), are taking next steps in their inquiry into the rising price of insulin after meetings during the past two months with stakeholders at major trade associations and in the diabetes community.

These steps include, first, working with the Food and Drug Administration on developing lower cost, biosimilar versions of insulin. Reps. DeGette and Reed also sent a letter to the Endocrine Society seeking input from endocrinologists on insulin prescribing practices.

Reps. DeGette and Reed also released key findings from their recent meetings with top officials for the Pharmaceutical Research and Manufacturers of America (PhRMA), the Pharmaceutical Care Management Association (PCMA) and America’s Health Insurance Plans (AHIP). These are the major trade associations for the pharmaceutical industry, the pharmacy benefit managers (PBMs) and the health insurance industry, respectively. 

Their main take-aways from these meetings so far include: 

-The list price for insulin has been rising rapidly since the 1990s, and many stakeholders across the supply chain appear to gain financially from these increases. 

-Rebates are often used to help health plans lower premiums, and formulary placement is central to rebate negotiations.  However, more information is needed about the rebate negotiation process between pharmaceutical companies, PBMs, and health insurers and how those rebates are used.             

-Deductibles, coinsurance, and other issues related to formulary placement are having a significant impact on out-of-pocket cost burdens for patients.

-And while major breakthroughs have occurred in the development of insulin, in recent years many believe innovation has been incremental.  There is disagreement about the extent to which new innovation justifies  price increases. 

“The cost of insulin is a complex matter involving many points along the supply chain,” DeGette said. “Congressman Reed and I are moving deliberately and with due diligence to understand all the factors, the better to make policy decisions to help bring down insulin prices. Millions of people who rely on insulin each day, sometimes several times a day, are counting on that.”

“We know this is a complex issue and we are making an extensive effort on how to develop the best policy solutions to make insulin more affordable, added Reed.  “People rely on this drug and are struggling to keep up with the price increase. Congress must come together and develop an effective solution to this problem."

In mid-June, DeGette and Reed wrote pointed letters to these three key stakeholders to seek answers and solutions to the rising price of insulin, which millions of Americans with diabetes need in order to live. Reps. DeGette and Reed have also consulted with national patient advocacy groups, as well as with diabetics and experts on diabetes in their communities, and will continue to do so.