Zion Research has published a new report titled “Human Insulin Market”  in the report they state that Global Human Insulin market accounted for USD 27.00 billion in 2015 and is expected to reach USD 43.6 billion by 2021, growing at a rate of around 8.3% between 2016 and 2021.

The price of insulin has tripled in the past decade, some individuals are paying $400-$500 a month for their insulin.  A physician who has tracked the cost of insulin states that the wholesale price in 2001 was $45. In 2015 it has jumped 3000 percent to $1447.  How has this happened, as stated in the article about biosimilar insulin in this newsletter there are only three companies that have the patents for insulin.  Pharmaceutical companies defend the cost as justified to cover the funding of new types of insulin. 

According to the Zion report, even if biosimilars are developed the increased numbers of individuals with diabetes is growing; the number of individuals requiring insulin is growing; the technological advances in insulin delivery devices; and favorable medical reimbursements are all fueling the growth.

In 2015, North America had the largest share in the global insulin market.  This growth is attributed to the high prevalence of diabetes, the technological advances and government support. European countries are also seeing growth of revenue as the incidence of type 1 diabetes is increasing and the use of insulin therapy has been influenced by the Diabetes Control and Complications Trial and the United Kingdom Prospective Diabetes Study (UKPDS), both of which showed the importance of tight metabolic control in patients with diabetes.

Attention is being drawn to this problem as recent reports about the rising cost of EpiPens received a significant amount of press.  Health care professionals and diabetes organizations are looking at these issues and bringing them to the attention of legislators.  It is important that we raise awareness. As an individual you must make your voice heard.  Contact DRWF with your story, contact your legislators and let them know that they need to look at this problem. 

Health insurances are asking more of their insurers to bear the burden and as a result individuals are experiencing hard choices – do they take the insulin they need to live or do they try to stretch their supply? 

Download the card or the DRWF Drug Discount App. *This card cannot be used with insurance.

Published in the Diabetes Wellnes Newsletter November, 2016 issue

Boston Scientists make quantum leap in diabetes treatment 

In April of this year Medscape Diabetes and Endocrinology published an article by Mark Harmel, MPH, CDE and Irl B. Hirsh, MD.  Dr. Hirsh is an endocrinologist who also happens to have Type 1 diabetes.  He raises questions about insulin pricing whenever he has the opportunity.

Dr. Hirsh states that his patients are yelling at him, because they cannot afford their insulin.  Patients on Medicare who have not been on insulin long, find that due to the cost of insulin they quickly fall into the doughnut-hole and have to pay for their insulin out of pocket.  The newly insured who did not understand the high deductible are now forced to pay full price for their insulin, and co-pays for insulin have increased so dramatically that individuals with insurance can no longer pay for their insulin.  As we stated in the July newsletter, the cost of insulin has risen almost 200 percent between 2002 and 2013 and the burden is now too great.

In order to make insulin last longer many individuals will cut back their dose or skip doses.  This is a big problem considering those with diabetes need insulin to stay healthy.  For those with Type 1 diabetes it becomes much more serious, as they can’t live without taking insulin.

So how is insulin priced?

The picture has changed dramatically in recent years.  Insulin prices are set by the three big insulin companies – Novo Nordisk, Eli Lilly, and Sanofi.  However, the new players are the PBMs – Pharmacy Benefit Managers.  PBMs are a third-party administrator of prescription drug programs for commercial health plans, self-insured employer plans, Medicare Part D plans, the Federal Employees Health Benefits Program, and state government employee plans.  As of 2016, PBMs manage pharmacy benefits for 266 million Americans. They operate inside of integrated healthcare systems (e.g., Kaiser or VA), as part of retail pharmacies (e.g.,CVS Pharmacy or Rite-Aid), and as part of insurance companies (e.g.,UnitedHealth Group). There are fewer than 30 major companies in this category in the US.  The three major PBMs comprise 78 percent of the market, and cover 180 million enrollees.

PBMs make money by charging health plans fees for processing the payments of the prescription benefits, in addition they make large profits by “marking up” prescription drug benefit claims and billing your health plan more than your local pharmacist charges.  These companies also receive payments from the pharmaceutical companies based on their ability to promise to increase the sales of a costly brand-name medication.  These savings do not get passed on to the health plans.

These companies are now the middleman and are direct competitors to community pharmacists.  They are the main reason why prescription medications have increased so dramatically in recent years.

Because of rebates given to healthcare plans, the pharmaceutical companies are then forced to increase the amount of money they charge—further causing prices to rise.  DRWF is interested in hearing about your experiences with trying to afford your medications.  Email us your story at diabeteswellness@diabeteswellness.net, or call the helpline at 800-941-4635. 

DRWF is happy to report many highlights from the 2016 AADE Annual Conference in San Diego, CA. Our diabetes educator, Kathy Gold attended the meeting and the expo.

• What a wonderful meeting over 3,600 Diabetes Educators attended the annual meeting in San Diego.  A wide variety of topics were covered on technology. With the development of a wide variety of apps for those living with diabetes -  Molly McElwee-Malloy did a great presentation giving guidance on how to choose appropriate APP’s for patients and how to evaluate their value. There are 84 APPs available for diabetes  It is important for educators to know what Apps their patients are using and how they can access the information.

• The artificial pancreas was another hot topic as the first closed loop system should be available in 2017.  A great presentation by JDRF shared the status of the closed loop system.

• Lots of new insulins are now available, a number of presentations offered guidance on how these insulin may be used in practice. 

• Is the A1C the gold standard in Diabetes Outcomes?  Presently A1C levels are used to evaluate all products and medications, discussions are presently underway to identify other measures such as rate of hypoglycemia, quality of life measures that may be of value. 

More highlights and resources to come.  Check back.