Harris County sues insulin manufacturers, alleging price-gouging scheme

[Elderberry]

Houston Chronicle by  Zach Despart Nov. 22, 2019

Harris County filed suit against three insulin manufacturers this week, accusing the firms of colluding to set artificially high prices for the medicine and other diabetic treatments.

The suit estimates the alleged 15-year scheme costs the county millions of dollars annually through higher health care costs for employees, their dependents and inmates in the Harris County Jail.

Ryan accused the manufacturers of raising prices to curry favor with the benefits providers, who in turn will generate more lucrative profits from selling the drugs.

Insulin that sold for $20 per vial in the late 1990s now retails for $300 to $700, Ryan said. As a result, Ryan said Harris County now spends more treating diabetes than on medications related to any other disease. From 2014 to 2015, he said the amount the county spent on diabetes spiked by more than 60 percent.

More: https://www.houstonchronicle.com/news/houston-texas/houston/article/Harris-County-sues-insulin-manufacturers-14856121.php

[PeteS in CA]

Insulin that sold for $20 per vial in the late 1990s now retails for $300 to $700, Ryan said.

That is a false statement. The prices may be correct, but what is sold for "$300 to $700" is not the same "insulin" that was being sold for "$20".

https://www.goodrx.com/blog/heres-why-insulin-is-so-expensive-and-what-you-can-do-about-it/

[Elderberry]

Insulin Price Gouging Lawsuit / Novo Nordisk, Lilly, Sanofi Must Face Insulin Drug Pricing Suit

http://www.natap.org/2019/newsUpdates/022719_01.htm

People with type 1 and type 2 diabetes pay the price in more ways than one
 
The cost of a vial of the short-acting insulin lispro (Humalog) increased 585% (from $35 to $234) between 2001 and 2015. By January of 2017, it reached $270, according to the drug-price website GoodRx.com.5 During the same time, the price of a vial of human insulin rose 555%, from $20 to $131, according to endocrinologist Irl B. Hirsch, MD, a professor of medicine at the University of Washington. And by January 2017, it hit $147 according to GoodRx.com.6
 
Between 1987 and 2014, the wholesale price of a 20-ml vial of Humulin U500-a concentrated form of long-acting insulin that more and more people with diabetes are using to control blood sugar-rose from $170 to $1,200, according to Truven Health Analytics.3 By January of 2017, the list price was $1,400.7
 
Many manufacturers, however, offer discounts and sponsor savings programs but they generally are only useful if you have insurance. GoodRx recently reported on the savings programs currently being offered for long-acting Basaglar insulin. Medicare/Medicaid patients are also generally left out of sponsored price-cutting programs. "Copay or savings cards cannot be used with Medicare/Medicaid," notes Fischl-Hess, "but can be used by people who are uninsured."
 
Several factors are fueling the price hikes. Insulin makers have continually adjusted formulations, creating insulin "analogs" that are easier to use and less likely to trigger dangerous low blood sugar episodes-but that cost millions of dollars to develop, Johns Hopkins University researchers noted in a 2015 report in the New England Journal of Medicine.5 This practice, which the researchers call "evergreening," keeps pricey brands under patent protection so other drug makers can't copy formulas and offer lower-cost versions. That's one reason there's no low-cost "generic" insulin in the US. Another reason: Insulin is a biologic drug produced in living bacteria or yeast cells and is more difficult to copy into a generic form.

[bigheadfred]

That is a false statement. The prices may be correct, but what is sold for "$300 to $700" is not the same "insulin" that was being sold for "$20".

https://www.goodrx.com/blog/heres-why-insulin-is-so-expensive-and-what-you-can-do-about-it/

Right. Analog insulin and synthetic human insulin. You left out the best part, IMO. From your link:

Due to the added convenience and benefits of analog insulin, 96% of insulin prescriptions in the U.S. are now for analogs. However, a growing body of research suggests that synthetic human insulin is just as effective for managing diabetes. (bolding mine)

It is like many items. Laundry soap or TP. Advertised as "new and improved" when all they did was change the package it comes in and raised the price.

[PeteS in CA]

Right. Analog insulin and synthetic human insulin. You left out the best part, IMO. From your link:

Due to the added convenience and benefits of analog insulin, 96% of insulin prescriptions in the U.S. are now for analogs. However, a growing body of research suggests that synthetic human insulin is just as effective for managing diabetes. (bolding mine)

It is like many items. Laundry soap or TP. Advertised as "new and improved" when all they did was change the package it comes in and raised the price.

I didn't quote from the article at all.

Today there are two major categories of insulin. Synthetic “human” insulin was introduced in the early 1980s and appears under brand names like Humulin R and Novolin 70/30. Genetically modified “analog” insulin was developed in the 1990s to provide several benefits over human insulin. Analog insulins take effect more quickly, their effects are more consistent and predictable, and they reduce the frequency of low and high blood sugar. Popular analog insulins are Lantus, Humalog, and Novolog. The prices for both types of insulin have risen over the years, but analog insulin is often much more expensive (compare $25 for Novolin 70/30 versus $323 for Humalog 50/50).

So, prices:

https://www.drugs.com/price-guide/humulin-r

This Humulin R price guide is based on using the Drugs.com discount card which is accepted at most U.S. pharmacies. The cost for Humulin R injectable solution (human recombinant 100 units/mL) is around $56 for a supply of 3 milliliters, depending on the pharmacy you visit. Prices are for cash paying customers only and are not valid with insurance plans.

https://www.goodrx.com/novolin-70-30

Walmart1 vial (10ml) of Novolin 70/30 100 units/ml

Discount Price $24.88
1. Get the discount using the button on the right.
2. Present the discount to your pharmacist.
3. Pay the discount price of $24.88

As I said, the Harris County attorney (whatever his/her title is) Ryan made a false statement. The insulin that was $20 in the 1990s is still available for a similar price, ~$25 at Walmart, and ~$28 at Walgreens, Ralphs, Safeway, Vons, Rite Aid, CVS, Target, Costco, and Albertsons (Sav-on), all net of the free discount.

[Elderberry]

To Drive Down Insulin Prices, W.H.O. Will Certify Generic Versions

NY Times By Donald G. McNeil Jr. 11/13/2019

https://www.nytimes.com/2019/11/13/health/insulin-prices-generic-who.html

About 80 million people with diabetes around the world need the hormone, and half of them can’t afford it. Creating competition could help, the agency said.

With insulin prices skyrocketing and substantial shortages developing in poorer countries, the World Health Organization said on Wednesday that it would begin testing and approving generic versions of the drug.

Agency officials said they hoped to drive down insulin prices by encouraging makers of generic drugs to enter the market, increasing competition. At the moment, the world’s insulin market is dominated by three companies — Eli Lilly, Novo Nordisk and Sanofi — and they have steadily pushed up prices for two decades.

The approval process, which the W.H.O. calls “prequalification,” will permit United Nations agencies and medical charities like Doctors Without Borders to buy approved generic versions of insulin.

Still, Americans are increasingly aware that virtually every country in the world pays less for medicine, a realization that has set off congressional hearings and become a rallying cry for Presidential candidates.

In July, for example, Bernie Sanders took a group of Americans with diabetes to Canada to buy insulin, saying that corporate greed had made the price in this country almost 10 times higher than the price in Canada.

President Trump has said he will lower drug prices, though a plan to do so has not yet been enacted.

The director of the Affordable Insulin Now campaign, Rosemary Enobakhare, on Wednesday called the W.H.O. announcement “a good first step toward affordable insulin for all around the world,” but said it would not help the 30 million people with diabetes in the United States.

Any measure to lower American prices “must require Congress to grant Medicare the power to negotiate drug prices,” she added.

[Elderberry]

https://www.statnews.com/2019/02/19/no-generic-insulin-who-is-to-blame/

‘Everyone is at fault’: With insulin prices skyrocketing, there’s plenty of blame to go around

Fifteen years ago, a patient with diabetes might have paid $175.57 for a 20-milliliter vial of the long-acting insulin Humulin R U-500.

Today, he’d shell out $1,487 for the same tiny vial, according to wholesale acquisition cost data from Elsevier’s Gold Standard Drug Database.

       GoodRX Humulin+r-20ml

[catfish1957]

https://www.statnews.com/2019/02/19/no-generic-insulin-who-is-to-blame/
       GoodRX Humulin+r-20ml

Your GoodRx links show alternatives as low as $230.  Not a MD, but from what I read why would one specify such a costly singular choice?

[Elderberry]

Donno. Not an ailment I'm knowledgeable about.

[catfish1957]

Donno. Not an ailment I'm knowledgeable about.

So shouldn't the tax payers sue Harris County for their inability to find lower case alternatives, or negotiate a favorable rate?

[Elderberry]

So shouldn't the tax payers sue Harris County for their inability to find lower case alternatives, or negotiate a favorable rate?

Sue the Govt for wasting your hard earned taxpayer dollars? You'd be hard put to find a court that would give you "Standing". Anyway that's what governments do, waste tax payer's dollars.

[PeteS in CA]

I'm not a diabetic, and thus have no experience with buying insulin. But I saw a meme on FB claiming Big Pharma had jacked up the price on the same insulin that used to cost $10 or $20. The same claim that Harris County is making. So I resorted to DDG and learned:

1. The high-priced insulin is not the same as what used to be low- cost;

2. What used to be low-cost is still available and is still relatively low-cost (within the US).

[LadyLiberty]

I would love to know how goodrx works and what's in it for them.

Hubby takes ezetimibe (generic Zetia) but it's not covered by his insurance.  They have a "negotiated" price with the pharmacy, however, of $89.99 for a 90 day supply.  No big deal, we can afford it, but normally when a drug goes generic there is a price drop, but this has not happened in this case.

Last week he needed a refill and I printed out the Goodrx coupon for $23.88.  He took it to the same pharmacy and they honored the price without blinking an eye.  How can Goodrx get it so much cheaper?  And with not so much as asking us to sign up for an account or even asking for an email address?

[Elderberry]

https://www.healthline.com/diabetesmine/history-of-insulin-costs#6

[bigheadfred]

I'm not a diabetic, and thus have no experience with buying insulin. But I saw a meme on FB claiming Big Pharma had jacked up the price on the same insulin that used to cost $10 or $20. The same claim that Harris County is making. So I resorted to DDG and learned:

1. The high-priced insulin is not the same as what used to be low- cost;

2. What used to be low-cost is still available and is still relatively low-cost (within the US).

Thanks for your reply and clarification.

My point, that I made poorly, is that the older lower priced insulin is (apparently) as effective as the newer version(s).

While there seem to be lies being told by prosecutors etal I think the main problem is that the medical professionals may not be as professional as peoplle are led to believe.

Meaning there may be MDs who simply aren't aware of the possibilities for treatment available. There are many new drugs coming out for just about any illness. Doctors may be trying to stay up with these new treatments and just aren't that good at their jobs.

The entire medical structure, between big pharma, insurance companies, government meddling, and helathcare providers it is a huge mess. The goal seems to me to be that money, and not affordable healthcare is the priority.

That insurance companies don't cover medications is no surprise @LadyLiberty.

The whole cabal is an uncontrollable monster currently. A monopoly that needs to be broken up.

In 2016, when my mds told me that without treatment, my hep c would kill me within a year, my only thought was great, I have a year or less to live. There is a cure. In my case, Sovaldi. The only problem was that the 12 week course cost $84,000. One $1000 pill a day for 84 days. After about six months I was so sick I was ready to die. Through the work of my wife and doctors they got me through the approval process for free treatment through the manufacturer. Could I put a price on my life? Yes. There was no guarantee the meds would work. My main bitch was the cost of the medication. The profit margin for Gilead was over 5,000%.

Maybe lawsuits like this by the boatload will break the camels back. I hope so.

To be a little clearer I was diagnosed in 2002. I went to a specialist. When he found out my economic situation he told me the treatment available was too expensive and he wouldn't help me. But, on the bright side, as he was showing me the door, was that hep c was a slow killer and I might live for another 20 years.