MedPage Today announced a new surge in prices for a specific brand of highly concentrated insulin. Now a single bottle of the drug Humulin U-500 insulin, created by Eli Lilly, costs $1,200 wholesale—more than five times the $220 it cost in 2007. A bottle of U-500 lasts a diabetic patient about one month, making the total cost a whopping $14,400 a year.
"I've had patients with a $2,500 deductible who can't put down $1,200 for a bottle of insulin," Amber Taylor, MD, director of The Diabetes Center in Baltimore, told MedPage Today. "For them, it's pay the mortgage or buy my insulin—what do you want me to do?"
Even though insulin is nearly a century old, prices have steadily increased throughout the entire market. But recently there has been a significant rise in Eli Lilly highly concentrated insulin prices that is difficult to ignore.
U-500 used to be inexpensive and essentially out of the market, but in the past 5 years doctors have increased their prescriptions for the drug. Many diabetics are becoming insulin-resistant and need to inject more than 200 units of insulin per day—a practice that can result in insulin depot formation, a lumpy forming of insulin under the skin, and even more dwindling efficacy. The more highly concentrated form of insulin helps patients avoid these side effects.
With this spike in demand, Eli Lilly is raising prices on the drug simply because it can. Unfortunately, there are no regulatory laws to stop pharmaceutical companies from arbitrarily raising prices and U-500 is the only highly-concentrated insulin offered in the U.S.—Eli Lilly has the monopoly on this medical niche.
Some of this drug’s costs are covered by insurance providers, but that only adds a small pile of dirt into the wide hole that is treatment costs for diabetics. In addition, Eli Lilly has set up a coupon program that can cover some U-500 costs, but doctors have expressed concern that some of their patients who need the drug will not qualify.
Doctors and diabetics alike are hoping that the monopoly may diminish as new highly concentrated insulin products are introduced to the market. Sanofi is updating a version of their best-selling Lantus, which will come off patent in 2015 and will be offered in a U-300 concentration. There may not be a 80% decrease in prices, but a 30 to 40% decrease is possible.
Taylor says she remains optimistic: "It's so frustrating that it's so expensive," she said, "but we hope with more products, the competition will decrease the costs."
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