PBM reduces co-payment of insulin as lawmakers clash

Express Scripts has announced a plan to reduce the co-payment of insulin-based drugs by patients by $ 25 a month before price competition with US politicians next week.

This cap is part of a "Patient Insurance Program" initiated by the Pharmacy Benefits Officer (LPM) for members of participating drug plans funded by the government-run, managed by Express Scripts, according to its parent company Cigna.

Cigna is part of a group of PBMs that are due to confront the April 9th ​​Senate Standing Committee on Finance at a hearing centered on the price of drugs. They claim that PBMs pocket drug discounts instead of transferring them to patients.

Cigna Vice President Steve Miller and other PBM executives – including CVS Health, Humana, OptumRx and Prime Therapeutics – will be joined by Senators led by Republican Chuck Grbadley and Democrat Ron Wyden. Third hearing of this type, which will follow the committee hearing testimony from major pharmaceutical manufacturers and groups of patient representatives.

"We have heard from pharmaceutical companies and it is fair that the committee has the opportunity to ask questions of other players in the healthcare supply chain," Grbadley and Wyden said in a joint statement.

"Every industry sector has a role to play in reducing prescription drug prices. The witnesses of these companies must be ready to provide real information and to discuss real solutions. "

The day after the hearing of the Senate Finance Committee (April 10), the three companies manufacturing insulin in the United States – Eli Lilly, Novo Nordisk and Sanofi – as well as the three largest PBM, should testify before House Energy and Commerce. sub-committee, according to a report TheHill.com. This committee heard from the patient representatives yesterday.

Insulin has become a focal point for lawmakers, giving rise to bipartite inquiries on drug prices that have risen sharply, according to Frank Pallone (Democrat), chairman of the Energy and Trade Council. Prices of the most commonly prescribed insulins have increased by more than 700% over the last 20 years, taking into account inflation.

"We need to find viable solutions to support the development of high-quality drugs and insulin-related innovations, while ensuring that people with diabetes are never forced to risk their lives in isolation. rationing their insulin because they can not afford it, "he said. meeting of yesterday.

A recent study conducted at Yale has highlighted the effects of this problem, showing that one in four diabetic patients who use insulin admitted to having reduced their use of the drug because of its cost.

Cigna's Miller pointed out in a statement highlighting the co-pay plan: "We need to make sure that these people feel safe in their ability to fully afford not to miss a dose, which can be dangerous for their health."

The company insists that, for users of insulin programs managed by Cigna and Express Scripts, the average cost of insulin was $ 41.50 for a 30-day supply in 2018.

Last month, Lilly responded to critics of high insulin prices in the United States by launching a low-cost version of its Humalog brand, which was hotly criticized after its price dropped from $ 35 to $ 234 a barrel. bottle between 2001 and 2015.