Express Scripts is taking action to reduce the price of insulin for patients

While the pressure is mounting on drug manufacturers who determine the price of insulin and on health insurance and the intermediaries that determine the price to be paid by patients, one company – Cigna's Express Scripts – Wednesday announced that it would take action by the end of the year to help limit the drug. cost to consumers.

Express Scripts, which manages the drug coverage of more than 80 million people, launches a "Patient Insurance Program" which, explains Steve Miller, director of Cigna's clinics, "caps a patient's copayment. $ 25 a month for insulin – no matter what. "

Express Scripts comes as legislators focus on high drug prices and listen to stories about patients who can not afford their medications.

Insulin has become a major goal. A Minnesota man died last year, according to his mother, while he was trying to ration his insulin because he could not pay the $ 1,300 monthly.

Although the drug has been used for more than a century, its price in the United States is 10 times higher than it was 20 years ago, according to a report from the House of Representatives released last week.

"What we hope is that more diabetics are taking more insulin, [fewer] complications for these patients and, hopefully, lower health care costs, "Miller told Shots.

Express Scripts covers 1.4 million people on insulin, says Miller.

As part of the reduction program, patients who do not respect their deductible and should normally pay the retail price of their insulin pay $ 25. The same is true for those whose normal share is a percentage of this retail price. According to Miller, patients pay an average of about $ 40 a month for the insulin contribution, but the price can vary significantly from month to month, depending on the structure of the patient's prescription drug plan.

The announcement of Express Scripts, one of the largest pharmacy benefit managers, comes one day after a House subcommittee hearing on the high cost of insulin.

Gail DeVore is a patient rights advocate who testified at the hearing.

"Every day, I get emails from people who ask me," How do I pay for insulin? "" DeVore told members of the Subcommittee on Monitoring and Surveys on Energy and Trade. "Every day, and every day, I have to help them find a way to find insulin."

DeVore. who has been relying on insulin to control her diabetes for 47 years, she says, now works as a patient advocate. She says the total retail price of her insulin is $ 1,400 a month.

DeVore says that she has good insurance, so the cost of this medicine is reasonable. But her insurance does not cover a second fast-acting insulin that she sometimes needs, so she adds that she dilutes it to extend its duration.

A recent study by Yale researchers found that about a quarter of diabetics skip doses to save money or use fewer medications than those prescribed.

"Patients who rationed insulin were more likely to have poor blood glucose control," said Dr. Kasia Lipska, endocrinologist and badistant professor at Yale, during her hearing. She said that patients who do not control their blood sugar well are at risk of amputation, blindness and other complications of diabetes.

Lipska told lawmakers that pharmaceutical companies are raising prices for no apparent reason.

She urged committee members to focus on current drug prices set by pharmaceutical companies, rather than worrying about discounts and rebates.

"In the end, drug prices are set by drug manufacturers," she told lawmakers. "The current price of insulin has increased dramatically – and that's the price that many patients pay.It's what needs to go down .It's as simple as that."

The Express Scripts program does not do that, Miller acknowledges.

"It does not lower the price of the drug," says Miller. "We think there is a whole other problem, namely:" What is the price of pharmaceuticals in the United States? "It does not solve the problem, it's really about relieving the pain felt by the patients at the counter."

Last month, Eli Lilly & Co. announced that it would start selling an "Authorized Generic" version of one of its insulin-based products at a price corresponding to half of its Retail price.

According to Express Scripts, its $ 25 co-payment agreement will be available by the end of this year for patients who are not covered by a government insurance program (such as Medicare or Medicaid).

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