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New insulin price won't top $25 a month out-of-pocket, Cigna says

Health insurer Cigna is launching a program that will cap out-of-pocket expenses at $25 for a 30-day supply of insulin, the company...

Posted: Apr 3, 2019 7:42 PM

Health insurer Cigna is launching a program that will cap out-of-pocket expenses at $25 for a 30-day supply of insulin, the company said Wednesday. Last year, patients paid an average of $41.50 a month out of pocket, including deductibles, copays or coinsurance, for the lifesaving diabetes drug, the company said.

The Patient Assurance Program will be available to members of participating non-government-funded pharmacy plans managed by Express Scripts, including Cigna and other plans. Cigna acquired Express Scripts, the largest US pharmacy benefit management company, in December.

"In most cases, people who use insulin will see lower out-of-pocket costs without any increased cost to the plan," the company said.

The move follows the US Food and Drug Administration's announcement Tuesday that it intends to bring competition to the insulin market as a way to lower prices. Commissioner Dr. Scott Gottlieb said the FDA would change how insulin is regulated in order to enable products that are biosimilar to (or interchangeable with) insulin to come to market.

Biologics are typically isolated from a natural source and may be produced through biotechnology and other cutting-edge technologies, Gottlieb explained: "Once an interchangeable insulin product is approved and available on the market, it can then be substituted for the reference product at the pharmacy, potentially leading to increased access and lower costs for patients."

People with diabetes are prescribed insulin because their bodies either do not produce it (as with Type 1 diabetes) or do not use it properly (as with Type 2 diabetes). There are more than 20 types of insulin sold in the United States, according to the American Diabetes Association.

About 31% of American adults with diabetes reported taking insulin in 2011, according to the US Centers for Disease Control and Prevention, while the diabetes association reported that 23.1 million Americans had been diagnosed with diabetes in 2015.

A report from the Health Care Cost Institute, an independent research group funded by four health insurance companies, found that individuals with Type 1 diabetes spent, on average, $5,705 per person on insulin in 2016, an increase of $2,841 since 2012. "The price of all types of insulin and insulin products increased, with point-of-sale prices roughly doubling on average between 2012 and 2016," said the institute, which holds data on over 50 million commercially insured individuals per year.

Between 2010 and 2015, the cost of Humulin R U-500, an Eli Lilly product, experienced the largest price increase (380%), jumping from $15 to $72, according to Kaiser Family Foundation, a nonprofit news service focused on health-care policy.

Eli Lilly did not respond to requests for comment on Cigna's announcement but said last month that it had created insulin lispro, a generic version of a faster-acting and more expensive product called Humalog U-100, "to provide a more affordable option for certain Americans in high-deductible health insurance plans, the uninsured and seniors that hit the coverage gap in their Medicare Part D plans."

The generic would sell for half the price of Humalog U-100, which costs $135 per month for patients who take an average amount, according to the company.

Insulin pricing in the United States is driven by a supply chain consisting of manufacturers, wholesalers, pharmacy benefit managers, insurers and pharmacies, according to the American Diabetes Association: "In much of Europe, insulin costs about a sixth of what it does in the United States."

At a US House of Representatives subcommittee hearing on insulin pricing Tuesday, Aaron Kowalski, chief mission officer of JDRF, a nonprofit diabetes research funding organization, called for the elimination of rebates -- which make up more than 70% of the list price of insulin -- from the drug reimbursement system.

"In the current system, companies give discounts to pharmacy benefit managers and health plans while increasing prices at the pharmacy counter," he said. He also believes that manufacturers need to lower list prices and restrict increases to "no more than the consumer price index."

"If this occurs, we believe that strong competition among insulin manufacturers will quickly push them to lower prices to net levels, which will greatly benefit patients who need this drug to survive," Kowalski said.

Cigna's new pricing scheme is "a step in the right direction," added Cynthia Rice, a senior vice president at the nonprofit, in an email.

President Donald Trump campaigned on a promise to lower drug prices and posted his blueprint for doing so in May. One of the primary intentions of the plan is to increase competition while allowing the federal government to negotiate Medicare drug prices directly.

Minnesota Coronavirus Cases

Data is updated nightly.

Cases: 915942

Reported Deaths: 9606
CountyCasesDeaths
Hennepin1786832038
Ramsey739711046
Dakota67683587
Anoka64112577
Washington40545359
Stearns33631279
St. Louis29591409
Scott25994186
Wright25957217
Olmsted22339130
Sherburne19000127
Carver1670669
Clay12104105
Blue Earth1147970
Rice11451138
Crow Wing11213123
Chisago995379
Kandiyohi9815108
Otter Tail9813127
Benton9033125
Beltrami816997
Goodhue811798
Douglas7875101
Itasca772299
Mower733449
McLeod713084
Winona710258
Isanti700783
Steele685731
Morrison672879
Becker628574
Polk603187
Freeborn561246
Carlton546974
Mille Lacs532479
Lyon528461
Nobles525054
Nicollet522460
Pine515043
Cass501253
Todd492843
Brown470759
Le Sueur459734
Meeker433458
Martin386544
Wabasha375510
Waseca374333
Dodge361112
Hubbard355249
Roseau316231
Fillmore305315
Wadena302940
Redwood281445
Houston272017
Renville268451
Faribault258233
Sibley252317
Pennington252130
Kanabec250136
Cottonwood230132
Aitkin222450
Chippewa220542
Pope207410
Watonwan198020
Yellow Medicine188023
Rock177729
Koochiching176725
Swift173123
Stevens167511
Jackson161016
Clearwater158020
Marshall153522
Murray151811
Pipestone149729
Lake132924
Lac qui Parle123025
Wilkin121116
Mahnomen106014
Norman10509
Grant101510
Big Stone9485
Lincoln8805
Kittson73223
Red Lake71410
Traverse6056
Unassigned545124
Lake of the Woods5265
Cook3071

Iowa Coronavirus Cases

Data is updated nightly.

Cases: 525758

Reported Deaths: 7379
CountyCasesDeaths
Polk81677809
Linn32838430
Scott27126295
Black Hawk22334382
Woodbury20736263
Johnson20150108
Dubuque18996243
Pottawattamie16215214
Dallas15573115
Story1398059
Warren8637107
Cerro Gordo8141125
Clinton7928115
Webster7419124
Des Moines7153106
Marshall675494
Muscatine6717117
Wapello6546145
Jasper630591
Sioux622477
Lee5977106
Marion567697
Buena Vista503449
Plymouth493388
Henry427155
Benton414760
Jones413564
Bremer403873
Boone397042
Washington395464
Carroll373355
Mahaska372366
Crawford355647
Jackson324047
Dickinson317555
Buchanan312743
Delaware303255
Clay297636
Kossuth293477
Fayette290356
Hardin289253
Tama282878
Page276133
Wright270050
Cedar269527
Winneshiek267744
Hamilton262757
Floyd261049
Clayton252360
Poweshiek242043
Harrison240979
Madison237425
Butler237346
Cass235667
Iowa234336
Jefferson228544
Mills225330
Hancock222840
Winnebago222339
Cherokee217347
Appanoose210157
Lyon209842
Allamakee209456
Calhoun199519
Shelby199542
Union197141
Humboldt188231
Franklin188031
Grundy186137
Chickasaw184522
Mitchell184343
Emmet180146
Louisa178653
Sac175626
Guthrie169338
Clarke163629
Montgomery163146
Keokuk152639
Palo Alto152332
Howard150624
Monroe144340
Ida134141
Greene128818
Davis126825
Lucas126127
Monona124940
Worth12309
Pocahontas122125
Adair118239
Osceola105718
Decatur104813
Taylor100914
Fremont98913
Van Buren95922
Wayne86125
Ringgold78429
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Adams5869
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