When drugmaker Eli Lilly it will slash the list price for some of its insulin products following years of criticism from lawmakers and activists that the price of the lifesaving hormone had become unaffordable, the news raised questions about what will happen to other efforts to provide low-cost insulin.
, a nonprofit drugmaker based in Utah, for example, has said it plans to begin selling biosimilar insulin for roughly $30 per vial by 2024 鈥 $5 more than the new price of Eli Lilly鈥檚 generic insulin.
In December, billionaire entrepreneur Mark Cuban said his new company, the Mark Cuban Cost Plus Drug Co., . And California is poised to launch an ambitious program to manufacture its own brand of the hormone, as well as generics of other high-priced prescription drugs.
Drug pricing experts welcomed the Eli Lilly news, predicting the move won鈥檛 undercut those efforts. And these other initiatives to bring lower-cost insulin to market, in turn, would put pressure on Eli Lilly to keep its prices down. Together these will help, not hamper, what could become a race to the bottom on insulin prices.
鈥淭he more competition, the more stable this solution will be so that five to 10 years from now the prices won’t go up again,鈥 said , a Mayo Clinic oncologist who has been a .
The pressure could cause further ripples. Following Eli Lilly鈥檚 news, Sen. Bernie Sanders (I-Vt.) sent letters to the two other major insulin makers, and calling on them to follow suit.
People with diabetes, especially those with Type 1 who need the drug to survive, will benefit. Yet even while some of Eli Lilly鈥檚 , they noted work remains to make insulin widely affordable.
鈥淎dditional competition and other accountability moves are still incredibly necessary because the companies can raise their list price again at any time,鈥 said Elizabeth Pfiester, founder of , a nonprofit that advocates for people with diabetes. 鈥淭hat鈥檚 why the government also needs to regulate insulin manufacturers to hold them accountable.鈥
Cuban鈥檚 company did not respond to requests for comment on how the Eli Lilly cuts might affect its efforts. But Civica鈥檚 plan remains unchanged following the news, said spokesperson Debbi Ford.
鈥淔rom the beginning, we have said we are not entering medicine markets for market share,鈥 Ford said. 鈥淲e are participating for market impact.鈥
Democratic California Gov. Wednesday that 鈥渟ky high prices for insulin have put it out of reach for too many鈥 and his state will manufacture its 鈥淥WN insulin and ensure all who need access to this medicine鈥 can afford it.
鈥淣ow, Eli Lilly is lowering their cost,鈥 Newsom wrote. 鈥淟et鈥檚 keep it up.鈥
Last year, California lawmakers approved $100 million for the state to contract for cheaper insulin and make the lifesaving drug, cutting out drugmakers and go-between companies that add to the price consumers pay. Newsom has said that would be available 鈥渁t a cheaper price, close to at cost.鈥 Officials haven鈥檛 said when the state鈥檚 insulin will be available, though, or exactly how much it will cost.
鈥淐alifornia’s goal was to get competition into the market however they can manage it,鈥 said , a professor at the University of California College of the Law-San Francisco who studies the insulin market. 鈥淚f California’s entry results in bringing prices down from other manufacturers, that will be a good thing.鈥
Eli Lilly鈥檚 price cuts apply to what it described as its 鈥渕ost commonly prescribed鈥 insulins, but Feldman noted those are older insulin products. Although California officials haven鈥檛 released details about which insulin products would be included in its program, Feldman said she expects the state will offer a variety to cover the market.
鈥淚t’s not aimed at any one company or any one drug,鈥 she said. 鈥淚t’s aimed at making affordable insulin available to market and putting pressure on other companies.鈥
Washington and Maine are also exploring ways to bring cheap insulin to consumers, and pledged millions in an agreement with Civica to manufacture cheaper insulin.
The cadre of newcomers aim to break open the insulin market because three pharmaceutical companies 鈥 Eli Lilly and Co., Sanofi, and Novo Nordisk 鈥 have long dominated the U.S. insulin supply and allowed their prices to escalate. The price of one of Eli Lilly鈥檚 products, for example, rose from between 1996 and 2016.
St. Louis University law professor said Eli Lilly may have seen a threat from the discount insulin initiatives.
鈥淭his might be a response to some of those initiatives and the looming threat of really steep losses in terms of market share,鈥 Sinha said.
University of California-San Diego pharmaceutical professor offered another possible reason for the price cut: changes to .
Beginning in 2024, Hern谩ndez said, drugmakers could be on the hook to pay fees, known as rebates, to Medicaid for drugs like insulin that have had steep price hikes. By lowering the list price of insulin, Eli Lilly could avoid those costs, Hern谩ndez said.
Hern谩ndez said that understanding the incentives behind Eli Lilly鈥檚 decision to cut list prices could help lower the price of other drugs that patients have trouble affording. If the makers of those other drugs also slash their list prices ahead of 2024, it could show the effectiveness of the new federal policy. If they don鈥檛, it might underscore the importance of factors unique to insulin like public pressure by politicians and activists or market competition from initiatives like California鈥檚.
This story was produced by , which publishes , an editorially independent service of the .
