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The second hearing on the insulin pricing crisis in the US, “Priced Out of a Lifesaving Drug: Getting Answers on the Rising Cost of Insulin” was held April 10, 2019 by the Oversight and Investigations Subcommittee (US Congress) in Washington, DC, but the hearings testimony offered no clarity on the rising cost of insulin. It is the second part of a hearing examining insulin affordability and the ensuing financial and health challenges on the lives of people with diabetes who are dependent on insulin. Last week, Diabetes Voice reported on the first hearing, here.

Wednesday’s hearing included testimony from the three manufacturers of insulin – Eli Lilly, Novo Nordisk and Sanofi – and the pharmacy benefit managers (PBMs), CVS Health, Express Scripts and OptumRX, which administer prescription drug programs for commercial health plans and set the formularies. PBMs are often blamed for creating incentives that lead to higher list prices.

At the heart of the hearing’s objective was to garner transparency on insulin pricing, but neither of the two factions-insulin makers or PBMs-would agree on who or what is at fault in the supply chain.

Representative Frank Pallone, D-New Jersey, Chairman of the House Committee said in his opening remarks, “When the manufacturers have been criticized for raising their prices, they point the finger at the PBMs. When the PBMs have been questioned about their practices, they often point their finger back at the manufacturer. We’re left with no accountability. For the millions of people who are suffering in this system, these back and forth arguments are frustrating and, frankly, unacceptable. Everybody seems to be coming out ahead here except for the patient.”

Unfortunately, the hearing’s testimony offered no relief as the witnesses continued to blame one another, offering no insight on how to resolve the crisis.

Rep. Diana DeGette, D-Colorado, Chair of the Subcommittee, called the current pricing a “smoke and mirrors system” where the list price is increased in an effort to negotiate the price back down.

While the hearings have not provided a solution forward so far, they have put pressure on the insulin manufacturers. Sanofi, making an announcement on the morning of the hearing, said it will sell monthly supplies of insulin for a fixed price of $99 for patients paying with cash. In March, Eli Lilly announced that it would make an authorized generic version of its Humalog insulin (insulin lispro) available in the U.S. with a 50 percent reduced price.

At the closing of the hearing, Rep. Diana DeGette was noticeably frustrated, “We are going to get together and we are going to work with all of you … to figure out how we can provide insulin to people with diabetes at a cost that they can afford,” she said. “We’re going to do that as quickly as we can. We’re prepared to talk to you now and prepared to bring you all back in July or September to talk about the progress we’ve made.”

The hearing can be viewed below.


Elizabeth Snouffer is Editor of Diabetes Voice

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