Advocating for Fair Drug Pricing

Patients with diabetes who have prescription coverage provided by Express Scripts might finally see some additional benefits coming from their insurer very soon. Last week, it was announced that a new plan could limit out-of-pocket costs for insulin to only $25 a month.

With the price of insulin skyrocketing — for really unclear reasons other than profit — and now out-of-pocket costs reaching more than $450 a month for some patients, how can we as CEOs and physicians facilitate and promote this type of fair pricing — and compassionate pricing — for patients with diabetes and other chronic diseases?

Welcome to The Clinical Divide. I’m Dr. Kevin Campbell, a Duke-trained cardiologist and CEO of the health data startup PaceMate. Every week, this Inside Digital Health™ video series examines healthcare technology and medicine’s top news. I bring the views that help physicians and healthcare executives bridge the clinical divide.

Patients with Type 1 diabetes must have daily insulin in order to live. But with the prices of the drug continuing to surge every year, some patients are unable to buy it and resort to rationing their insulin — with sometimes deadly consequences.

Under pressure from both lawmakers and consumers alike, both Cigna and Express Scripts have finally begun to recognize that this is in an alarming and potentially life-threatening problem. It appears — thus far — that these insurers may actually — at long last — be doing something about it. Under a new plan, reported in the New York Times last week, employers who cover their workers through the insurer can opt into the program and the average monthly savings would be almost $16.

The extra costs will be picked up by the three drug makers that sell insulin, Eli Lilly, Novo Nordisk and Sanofi. Many of us — particularly me — remain skeptical as these are the same drug makers who have sued other companies to prevent the development of generic insulin competition. It’s hard to wrap my head around this one.

But people deserve to feel secure about their ability to afford the medication that they need to live. No longer is it acceptable for drug developers and insurance companies to overcharge for these — just because they can. We as CEOs and physicians must continue to speak up about the outrageous drug pricing and advocate for our patients. We have got to have more stringent regulations and our government must hold these drug makers accountable. We must support the companies and developers who do things like this — who are working hard to improve access and reduce costs, like this potential drug savings program may provide.

Thank you for joining me for this episode of The Clinical Divide. Until next week, I’m Dr. Kevin Campbell, for Inside Digital Health™.

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