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Why is insulin so expensive and the cost so difficult to cap? – Portland, Oregon

Portland, Oregon 2022-08-05 06:13:11 –

WASHINGTON (AP) — Curbing rising insulin prices has been elusive in Congress so far, but Democrats say they’ll try again. An economic package with a focus on health and climate.

The price of a 100-year-old drug has more than tripled over the past 20 years, leaving the nation’s diabetics to pay thousands of dollars a year for life-saving drugs. Democrats are considering capping the price of at least some drugs, but it’s unclear what the final proposal will look like and how many insulin users will get the price cuts. .

Here’s a look at how insulin has become so expensive and why it’s been so hard to bring down the price of the drug.

How many people in the US use insulin for what?

About 8.4 million Americans use insulin, according to the American Diabetes Association. Not everyone with diabetes needs insulin, but it is an important drug for those who do. Her more than one million people with type 1 diabetes require regular access to medicine and will die without it.

“People need insulin. It’s not an option. You don’t have to decide between life-sustaining medicine or food or rent,” said Robert Gavey, chief scientific and medical officer of the American Diabetes Association. says Dr.

Insulin also helps control blood sugar levels in people with other forms of diabetes. Some insulin users ration the drug because of the cost and risk many health complications as a result.

How expensive is insulin?

Prices vary.

Some people with private insurance pay hundreds of dollars each month for medicine. For most Medicare beneficiaries, the average out-of-pocket cost per insulin prescription in 2020 was $54, a nearly 40% increase since 2007. Research published last month Discovered by the Kaiser Family Foundation. Others live in one of the 22 states that limit out-of-pocket costs to $25 to $100 for 30-day supplies.

Because of the cost, some people use less insulin than their doctor prescribes or postpone other medical bills.

Why is insulin so expensive?

Only three manufacturers—Eli Lilly, Novo Nordisk, and Sanofi—manufacture insulin, and these companies control most of the market.

Dr. Jing Luo, professor of medicine at the University of Pittsburgh, said: “There hasn’t been a lot of pressure on the price.”

Luo also added that making insulin generics is not easy and that new manufacturers will have to clear regulatory hurdles and questions about how generics should be classified. Generic His insulin is expected to hit the market in 2024 at under $30 per vial, which could bring down some of the prices.

How Will Democrats Plan to Limit Insulin Prices?

I don’t know yet.

Senate Majority Leader Chuck Schumer said language would be added to limit the price of insulin. economic billbut it’s not clear what that price point will be, and who will be protected by that price cap.

Democrats had proposed a $35 monthly cap for those who get their drugs through Medicare or private insurance companies as part of a larger package that was derailed in the Senate. Excluded from the package.

Why is it so hard to cap the cost of insulin?

Putting a cap on the price of insulin would make it very expensive.

Not only is insulin getting more expensive, but more and more people are using it.

A bipartisan bill to limit the price of insulin, proposed earlier this year, could cost about $23 billion over the next decade, according to estimates from the Congressional Budget Office. According to the firm’s analysis, the bill would cut insulin costs for many consumers, but would increase government costs and premiums charged by Medicare and private insurers.

This is one of the reasons price caps are controversial.

“If your health insurance company voluntarily says that no one who buys insulin on our plan has to pay more than $25, the question is who will pay the rest.” Luo said. “It means their costs go up, which means they raise premiums for everyone.”

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