Memorandum
The public and political frustration with high insulin and other medication prices continues and has moved from patient discontent to a high level government inquiry. US lawmakers Senator Bernie Sanders and Representative Elijah Cummings as of this morning are calling for an investigation into possible collusion among diabetes companies over rising insulin and other diabetes drug prices. Specifically, they’re charging that drug makers (Sanofi, Novo Nordisk, Eli Lilly, and Merck) have introduced matching price hikes 13 times since 2009. Allegations of price fixing aside, this level of inquiry and controversy begs obvious questions: who is responsible, what can be done ... and how did we get here?
First, we hope that drug makers invest more in better understanding and appreciating patients’ needs and financial realities. That can mean many things - lower therapy prices (can the cost of R&D be lowered and quality maintained or increased?), much greater transparency and overall awareness and growth of assistance programs, and/or acknowledgement that US patients' worlds have changed due to employers that want more expense shifted to patients. Second, the US healthcare system remains unbelievably complex and non-transparent; the litany of middlemen is not helping and we need to do more to show we're actually listening, full stop. Patients are sympathetic about PBMs only to an extent - many barely understand the abbreviation but recognize that there was less complaining about PBMs when payers covered much more. Third, we'd like to see less finger-pointing from all sides (“It’s the PBMs’ fault!" "It’s pharma’s fault!" "It’s payers’ fault!”) and more public, united, action-oriented dialogue and action. And, more movement toward less waste. In a world where people with diabetes are rationing the very therapies they need to survive, we hope we can all come together to better figure out what needs to change to improve access for people with diabetes.
We're extremely chastened that what started with patient complaining has moved into high level government inquiry. There is only more coming our way. I've now had diabetes exactly 30 years (nearly to the day) and I actually personally feel there is tremendous value with the $800 spent on insulin each month for me; I'd die without it, so of course I like the ROI. But I'm not behind a broom every day, I don't have three jobs, I'm relatively okay with Aetna (thanks Mr. Bertolini!) pushing more costs my way, for me, and for a dozen employees at Close Concerns and The diaTribe Foundation. But given how much diabetes hits, disproportionately, the very poor, it's not nearly as easy for most patients to say this. Please. Act.
Thank you in advance for the gatherings that have already been planned, for the ways in which you have reached out to our Foundation and other patient groups, for coming to our office to see us to discuss (one of you!), and for the ways that you have (and plan to) listen to renowned healthcare providers. Show us what you've got.