Eli Lilly drops insulin prices

March 1, 2023 9:08 AM

Eli Lilly is slashing prices of commonly prescribed insulin drugs by 70 percent while capping related out-of-pocket costs at $35 a month Link is to a Washington Post gift article.
posted by PussKillian (36 comments total)

The cost of some medications more than doubled between 2007 and 2018, according to the medical journal Lancet, with some people paying more than $1,000 when higher doses are required.

“Insulin belongs to the world, not to me.” - Frederick Banting
posted by mandolin conspiracy at 9:14 AM on March 1, 2023 [14 favorites]

Its non-branded insulin, Insulin Lispro Injection, will drop from $82.41 to $25 per vial, making it the lowest-priced mealtime insulin available, according to the company. Humalog, its most commonly prescribed insulin, will drop 70 percent from its current price of $530.40 for a five-pack of insulin pens to roughly $160.

Costs about two bucks to make a vial of this stuff, and they expect gratitude for marking it up by only 1150% instead of 4000%?

Nationalize insulin production now.
posted by flabdablet at 9:15 AM on March 1, 2023 [111 favorites]

Really good to see this. Hopefully it results in pressure on other manufacturers to do the same.
posted by learning from frequent failure at 9:16 AM on March 1, 2023 [4 favorites]

Great news, and a testament to years of activism and messaging around bringing down insulin prices from healthcare activists to elected progressives to the current administration.

But also, really annoying to see that yes - the prices of these drugs *don't* have to be as high as they are, and can be lowered with the snap of a finger. We should not have to be dependent on the "goodwill" of pharma companies to do this stuff.
posted by windbox at 9:17 AM on March 1, 2023 [18 favorites]

Hey, Twitter Blue was worth it after all.
posted by rouftop at 9:20 AM on March 1, 2023 [54 favorites]

I've been saying for years that the states should undercut these companies by standing up a production lab and selling generic pharmaceuticals for, let's say, 125% of the cost of production. They could be built out of the state universities and return a small but reliable profit to the general fund while saving people a ton of money.
posted by gauche at 9:31 AM on March 1, 2023 [40 favorites]

It's the maximum price allowed by the feds in Medicare:

The change, which Eli Lilly said takes effect immediately, puts the drugmaker in line with a provision in the Inflation Reduction Act, which in January imposed a $35 monthly cap on the out-of-pocket cost of insulin for seniors enrolled in Medicare.

(from a different article)

Technically they didn't have to do this for all patients but it seems they saw the writing on the wall here. As hippybear says, they see the price dropping to the new local maximum over time and want to move in and collect before locally produced generics drive the price down to under $10.

Edit to add: But still, it's good news!
posted by BlackLeotardFront at 9:51 AM on March 1, 2023 [16 favorites]

We have to regulate these essential medicine manufacturers like utilities and end this monopoly pricing.
posted by interogative mood at 9:53 AM on March 1, 2023 [7 favorites]

we know that 7 out of 10 Americans don't use Lilly insulin

Oh, probably a bit more than that.

More seriously, are there actually any countries that nationalize insulin production? (Or is it unnecessary in most rich countries because national health care regulates prices?)
posted by trig at 9:53 AM on March 1, 2023 [1 favorite]

This fucking sucks. We just have to rely on the whims and largesse of billionaires literally for survival. Total failed state.

Kudos to the activists who forced Lilly to do this, but shame on the lawmakers who let this industry run wild and shame on the lawmakers for not providing healthcare to all as one of the state's core functions.
posted by latkes at 9:53 AM on March 1, 2023 [8 favorites]

From Eli Lilly to cut insulin prices, cap costs at $35 for many people with diabetes, Jen Christensen and Betsy Klein, CNN:

This year’s Inflation Reduction Act capped insulin costs for seniors who get their health coverage through Medicare Part D at $35 a month. Congressional Democrats pushed to extend that price cap to people covered by private insurance, but Republicans stripped that measure from the bill.

...

Some states have taken matters into their own hands. Twenty-two states and the District of Columbia have price caps ranging from $25 to $100 for insulin as well as diabetes supplies and devices – but that’s only for people covered by insurance plans regulated by those states.

Voting matters. Voting for state government matters.
posted by kristi at 9:55 AM on March 1, 2023 [27 favorites]

the Inflation Reduction Act, which in January imposed a $35 monthly cap on the out-of-pocket cost of insulin for seniors enrolled in Medicare.

Also, I hope Biden and Democrats take very vocal credit for this; the one smart thing about Trump was that he incessantly took credit for everything, and made headlines doing it.
posted by trig at 9:55 AM on March 1, 2023 [12 favorites]

states should undercut these companies by standing up a production lab and selling generic pharmaceuticals for, let's say, 125% of the cost of production

Michigan had been exploring it. Apparently the state used to have its own factory for manufacturing vaccines which was sold off in the 90s.
posted by BungaDunga at 9:59 AM on March 1, 2023 [6 favorites]

Nationalize insulin production now.
...
I've been saying for years that the states should undercut these companies by standing up a production lab and selling generic pharmaceuticals for, let's say, 125% of the cost of production.

California's on it.
posted by Halloween Jack at 10:22 AM on March 1, 2023 [8 favorites]

are there actually any countries that nationalize insulin production?

We used to. Then the Nineties happened and the government sold it out from underneath us, which was the style at the time.
posted by flabdablet at 10:45 AM on March 1, 2023 [18 favorites]

I'm not sure existing generic manufacturers have less than a 25% profit margin, you can find stats suggesting it's more like 12% and decreasing. Undercutting existing generics factories might be pretty hard.
posted by BungaDunga at 11:04 AM on March 1, 2023

Reading that more clearly, they're doing a price drop as a market grab.

So, capitalism? Isn't this how it's supposed to work, but rarely does because the companies use monopolies and legal moats to prevent competition?
posted by meowzilla at 11:09 AM on March 1, 2023 [2 favorites]

> Isn't this how it's supposed to work

Yes, meowzilla, that was my reaction. Yes, it's awful it costs so much. Yes, it should be nationalized or somehow a low cost should be imposed. Yes, I'm very happy Lilly has done this and hope it will prod its competitors into doing the same.

I'm a type 2 diabetic, and don't need insulin. Yet. The current situation is far from ideal. But we should celebrate the victories we get.
posted by lhauser at 11:26 AM on March 1, 2023 [2 favorites]

Thanks to the prankster who sent that fake tweet in which "Eli Lilly" declared insulin would be free for helping make this happen. And, also, surprisingly, thanks to Elon Musk for the fuckup/money grab with the blue checks that made that prank possible.

Which lifesaving medicine can we do next?
posted by gentlyepigrams at 11:35 AM on March 1, 2023 [12 favorites]

I'll never understand why the U.S. healthcare system hasn't radicalized the country so far to the left that Bernie Sanders would seem Republican. Once you encounter this system and actually have need of care and/or medications, I don't understand how people can think it should continue.
posted by jzb at 11:49 AM on March 1, 2023 [22 favorites]

I'd say a large part of that is because vanishingly few Americans have ever experienced anything different than the current system, i.e. living in a foreign country. That + fear of change = "this is how it's aways been here in the best country on earth, so it must be right."
posted by gottabefunky at 11:52 AM on March 1, 2023 [7 favorites]

That, and members of Congress don't have to live (or die) with that system any more, and the health insurance industry -- which adds no value save for extracting profits -- spends a lot of money on lobbying and Fear, Uncertainty, and Doubt.
posted by Gelatin at 11:55 AM on March 1, 2023 [4 favorites]

So, capitalism? Isn't this how it's supposed to work, but rarely does because the companies use monopolies and legal moats to prevent competition?

What are the chances that they were facing a price-fixing investigation and the administration quietly-but-firmly suggested that they go for the PR win instead?
posted by clawsoon at 12:00 PM on March 1, 2023 [3 favorites]

That + fear of change

+ fear that the "undeserving" (read: poor people, immigrants, and Black/Indigenous people) will get uppity.

Seriously, Dying of Whiteness was an eye-opening read into the ways in which American oligarchs (and yes, using that word intentionally) manipulated generations into racial resentment instead of class solidarity.
posted by basalganglia at 12:35 PM on March 1, 2023 [6 favorites]

Humalog, its most commonly prescribed insulin, will drop 70 percent from its price of $530.40 for a five-pack of insulin pens to roughly $160.

Interesting. When I refilled mine a few days ago I had a $95 copay, and if I'm reading the receipt right, they either billed my insurance for $873.68 or that is the uninsured price. But then, maybe that price was for 100units/mL rather than 200.

Anyway... this is a start. Hopefully Novo Nordisk sees which way the wind is blowing too -- my insulin degludec copay would be something like $450, but instead I'm pretending to be uninsured so I can use their discount card to get it for $99. That tells me they have a lot of room to drop prices.

(And then there's the various diabetes meds that aren't an insulin and have no generic... the copay on one of those I'm on is slightly larger than my mortgage payment until the deductible is met.)
posted by Foosnark at 12:52 PM on March 1, 2023 [4 favorites]

What are the chances that they were facing a price-fixing investigation and the administration quietly-but-firmly suggested that they go for the PR win instead?

Is it too soon to call this a PR win?

The undercurrent I get from personal anecdata is that people who need insulin get the kinds that are not affected by this price change, e.g. insulin pen, and so their personal costs remain largely unchanged. I wonder if this will "backfire" and ultimately highlight problems with how we do drug coverage for a lot of people/voters.

At the very least, kudos to Bernie Sanders for putting a spotlight on this, which caused stock prices to drop and probably did much to get changes rolling.
posted by They sucked his brains out! at 1:04 PM on March 1, 2023 [1 favorite]

Ask your doctor if Grotesque, Insurmountable Profit Margins™ are right for you.

Note: Side effects of Grotesque, Insurmountable Profit Margins™ may include widespread, needless suffering up to and including death.
posted by BigHeartedGuy at 1:05 PM on March 1, 2023 [16 favorites]

I have to get my insulin at Wal-Mart because

1. my doctor is being a jackass and not giving me a proper prescription for one my insurance covers, but for one he thinks is "better" (I want the Eli Lilly, he wants the Novo Nordisk, and I see a bunch of Novo stuff in the office, so I scent a kickback or five hundred)
2. it's actually cheaper at Wal-Mart, albeit not as effective, than what my insurance would cover
3. you don't need a prescription at Wal-mart, just rock on up and ask them for it

so if you were wondering, this is what it is like to be insanely fucked over. And because of the insurance, I can't just go to someone else as a PCP. However, as a trans person as well as a diabetic, I'm trying to get an endocrinologist so I can get things properly covered.

(before you ask, the insurance company has a "what we cover for trans people" list and it's a pretty slim list but at least has my HRT.)
posted by mephron at 1:25 PM on March 1, 2023 [14 favorites]

Walmarts price is probably closer to a fair market price than the $35 plus whatever the manufacturer they can wrangle from your insurance company.
posted by interogative mood at 3:16 PM on March 1, 2023

> I'll never understand why the U.S. healthcare system hasn't radicalized the country so far to the left that Bernie Sanders would seem Republican.

Because millions of Americans never see how much any of this stuff costs.

I just checked how HumaLOG would cost me, and it's $10 a month. Not a generic, the brand. It costs my health insurance company (according to them) $784.21 a month, but I personally only pay $10. The KiwkPen version of the HumaLog costs me a bit more at $30 a month.

The Eli Lilly brand version of what this article is discussing isn't covered, but the generic: $10 a month.

Every form of insulin I choose either costs $10 or $30 a month.

So, my insurance might be paying too much, but I personally would have no idea.
posted by Back At It Again At Krispy Kreme at 3:23 PM on March 1, 2023 [4 favorites]

My wife and her dad (retired Lilly executive) had it out ovr texts today about this. He brought it up as an example of the wonderfulness of Eli Lilly, and she slapped him down by pointing out that generic insulin, CA working on making their own insulin, and bad PR has pushed them into this.

I prefer to believe it was the Insulin is now free account on Twitter.
posted by COD at 4:28 PM on March 1, 2023 [10 favorites]

@[e-mail]

❌ Eli Lilly lowers the cost of insulin in U.S.
✅ Eli Lilly reluctantly complies with Democratic law that caps out-of-pocket cost of insulin
posted by bjrubble at 6:39 PM on March 1, 2023 [2 favorites]

✅ Eli Lilly reluctantly complies with Democratic law that caps out-of-pocket cost of insulin

The IRA only caps it for Medicare Part D beneficiaries. Lilly making it the price across the board isn’t just spinning their compliance with the law.
posted by Etrigan at 9:04 PM on March 1, 2023 [3 favorites]

The IRA only caps it for Medicare Part D beneficiaries. Lilly making it the price across the board isn’t just spinning their compliance with the law.

So it’s just a coincidence that this coincides with the Medicare cap?

I give Lilly (very tepid) credit for doing more than is absolutely required by law, but it seems clear what instigated this change.
posted by bjrubble at 10:16 PM on March 1, 2023 [3 favorites]

The undercurrent I get from personal anecdata is that people who need insulin get the kinds that are not affected by this price change, e.g. insulin pen, and so their personal costs remain largely unchanged.

Humalog (insulin lispro) is the most common prescribed rapid-acting insulin pen, and they're lowering its price by 70% too.

Some diabetics need a combination of rapid-acting and long-acting insulin. A lot of treatment plans also include some non-insulin drugs, of which Metformin is generic and cheap (discovered in 1922), but the newer GLP-1 inhibitors and SGLT-2 inhibitors are decidedly expensive.

I'm hoping that this price change precipitates lower prices at least on the long-acting insulin. I can't see Ozempic/Wegovy/Rybelsus etc. getting any cheaper anytime soon though because of the extremely profitable connection with weight loss.
posted by Foosnark at 6:49 AM on March 2, 2023 [1 favorite]

So couple comments from my work-for-pharma, though not biologics and not manufacturing, perspective:

I'm not sure existing generic manufacturers have less than a 25% profit margin, you can find stats suggesting it's more like 12% and decreasing. Undercutting existing generics factories might be pretty hard.

The problem is generic factories aren't really making insulin. The generics are very good competing on price, but it's almost exclusively small molecule drugs.

Insulin is a biologic, which is harder to make and has a much higher regulatory barrier to compete. There's not a functioning generic market for them.

So, capitalism? Isn't this how it's supposed to work, but rarely does because the companies use monopolies and legal moats to prevent competition?

You absolutely want companies competing on price. If they did prices would be going down to that "reasonable profit" level.

In this case it's not just "legal moats" but a high cost of entry. It's a sort of textbook oligopoly (or even monopoly) situation without patent protection. The issue is plants are expensive (hundreds of millions) and take a long time to build (4+ years), and when you are done you are competing with people better and more flexible than you, so they can lower the price to maintain market share, and you will go under. (It's what's behind some of the off-patent stuff, like Shkreli's HIV medication gouging, and contributes to the epipen pricing too.)

For this reason, government run plants will not make a profit. However, they almost certainly can drive the price down, as long as they stay open while taking a loss. That's a win. Unless you have pitched this investment as "efficient" and "profitable." (I have a pet peeve about the BCG/McKinsley style analysis, which will suggest selling off assets, which returns us to monopoly or oligopoly problems we started with.)

You, as the energetic government official working to prevent oligopoly pricing, could also handle this by guaranteeing large purchases at set prices from multiple suppliers, ensuring they stay viable and leaving them to compete on price on the consumer market. (This is essentially how industry guarantees raw material supply.) It's again vital for this to work to not be efficient in McKinsey terms: If you are worried about news stories saying you are "overpaying" for drugs you aren't going to be guaranteeing the oversupply of capital investment you want.

What are the chances that they were facing a price-fixing investigation and the administration quietly-but-firmly suggested that they go for the PR win instead?

Honestly, I'd put the odds at around zero percent. The reasons above are part of why you can get big markups, combined with the f*cked up US pricing system.
posted by mark k at 5:30 PM on March 2, 2023 [1 favorite]