Congress pushing insulin price cuts

Desiree Burns
April 5, 2019

Cigna is one of a group of PBMs that are scheduled to come up against the influential Senate Committee on Finance in a hearing on 9 April that will focus on drug pricing - and claims that PBMs are pocketing medicine discounts instead of passing them on to patients.

The country's largest pharmacy benefit manager - itself acquired previous year by one of the country's biggest health insurers - is introducing a program to cap out-of-pocket costs for diabetes patients who rely on insulin.

U.S. lawmakers have pulled up healthcare companies over rising costs of medicine, with powerful committees in Congress holding hearings in January on insulin affordability.

The program is only available to members who participate in non-government-funded pharmacy plans managed by Express Scripts, including Cigna and other plans.

People with Type 1 diabetes don't produce it naturally in their body, and need it to regulate their blood sugar levels.

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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. For one thing, a huge number of Americans live with diabetes; of the 30 million Americans with the illness, 7.4 million rely on insulin.

"For people with diabetes, insulin can be as essential as air", Dr. For patients, the average annual out-of-pocket spending for insulin jumped from $2,864 to $5,705 in that same time frame, according to the study. "This is what I would say is the latest in a string of things we've been doing to try to support better care for patients generally and people with diabetes specifically".

In 2018, users of insulin plans by Cigna and Express Cripts were paying an average out-of-pocket cost of $41.50 for a 30-day supply.

President Donald Trump campaigned on a promise to lower drug prices and posted his blueprint for doing so in May. He also believes that manufacturers need to lower list prices and restrict increases to "no more than the consumer price index".

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