Pharma, PBMs Blame Each Other Under Intense Scrutiny from Sanders’ Health Committee
BIOMARKER
1. The cost of insulin for consumers has increased 1000-fold since 1996.
2. The CEOs of Eli Lilly, Sanofi, and Novo Nordisk and executives from three top pharmacy benefit managers represent 90% control of the global insulin market.
3. The drug companies made $100 billion in profit, while PBMs made $27 billion in profit last year.
4. The passage of the Inflation Reduction Act (IRA) forced companies to cap insulin copays at $35 per month and cap insulin expenses for seniors at $2,000 a year via Medicare.
5. Pharma indicated they would commit to lowering insulin prices.
6. People can enroll in an annual program to further discount insulin on Lilly’s website, provided their annual income is no more than $57,000 per year.
7. Lantus and an unbranded Lantus, made in the same factory with a 60% discount to the list price, was not listed on the health plans' formularies.
8. Three PBMs control 85% of the field.
9. PBMs made negotiations that were often opaque and resulted in higher consumer prices.
10. PBMs reform will likely require Congressional action to see results.