[Ip-health] Planned Diabetes Patient Protest Puts Heat on Eli Lilly Insulin Pricing

Fran Quigley fwquigley at gmail.com
Sat Aug 26 06:00:35 PDT 2017

A September 9th protest in front of Eli Lilly international headquarters--co-sponsored by T1International, People of Faith for Access to Medicines, Public Citizen, and Patients for Affordable Drugs--has spurred a lengthy and critical article in Lilly's hometown Indianapolis Business Journal: 


The Business Journal is an important publication for Lilly, and one that has traditionally given it almost universally positive coverage. 


Over the past 20 years, while the price of a gallon of milk climbed 23 percent and the sticker on a Dodge Caravan minivan rose 21 percent, the list price of the insulin Humalog, made by Eli Lilly and Co., shot up 1,157 percent.

Other Lilly insulins saw hefty price increases, too, including Humulin, on the market since 1982. It has seen price increases totaling nearly 800 percent over the last two decades.

The soaring prices at Indianapolis-based Lilly—and two other insulin makers, whose prices are climbing at similar rates—are sending sticker shock through the diabetes community. In recent months, patients have filed lawsuits and called for congressional investigations, and now they’re planning a demonstration next month in front of Lilly’s headquarters on South Delaware Street.

Already, some physicians say high insulin prices across the industry are causing financially strapped patients to ration or discontinue their medicines, which could lead to serious medical problems.

“It’s an everyday thing,” said Dr. Michael Hancock, an endocrinologist with Franciscan Health. “It comes up in at least 15 to 20 percent of office visits, patients saying they can’t afford insulin.”

Sometimes, he said, patients don’t bother telling him until much later, when their blood-sugar levels get out of control.

If left untreated, diabetes can lead to heart disease, kidney disease, foot ulcers and eye damage. About 30.3 million Americans, or 9.4 percent of the population, have diabetes, up from 29.1 million in 2014.

Lilly launched Humalog in 1996 with a list price of $21 a vial—about a month’s supply for many patients. Over the next two decades, the company increased the list price more than 30 times, including an 8 percent price bump this spring. The vial now has a list price of $274.70.

he trend toward high-deductible insurance plans means more patients are feeling the bite of drug costs, including insulins.

Earlier this year, a group of patients filed a lawsuit in federal court in Massachusetts, accusing the three major insulin makers of violating federal racketeering laws by systemically increasing the prices.

The lawsuit claimed that the drugmakers have been increasing prices, nearly in lockstep, in order to expand discounts and rebates to pharmacy-benefits managers. The practical effect, according to the lawsuit, was to saddle patients with “crushing out-of-pocket expenses.”

Lilly and the other drugmakers say the suit is without merit and plan to fight it.

Physicians say patients most vulnerable to price increases are those without insurance, those with high-deductible plans, and those on Medicare, who have a coverage gap known as a “doughnut hole.”


In the meantime, Lilly—and its competitors—must deal with a rising tide of anger. The American Diabetes Association is circulating a petition calling for more transparency, affordability and access to insulin.

It is also asking Congress to hold hearings with all the players in the insulin supply chain—including drugmakers, insurers, pharmacy-benefit managers and pharmacy chains—“to ensure that all people who use insulin have affordable access” to the life-saving medicine. So far, more than 225,000 people have signed the petition.

Last year, Sen. Bernie Sanders asked the Department of Justice and the Federal Trade Commission to investigate insulin makers for possible price collusion. In a letter to the agencies, he pointed to 13 instances in which the prices of Lilly, Sanofi and Novo Nordisk insulin brands rose in lockstep, a practice known as shadow pricing.

“The original insulin patent expired 75 years ago,” Sanders’ letter said. “Instead of falling prices, as one might expect after decades of competition, three drugmakers who make different versions of insulin have continuously raised prices on this life-saving medication.”

Next month, critics will take their complaint to Lilly’s doorstep. From 1 p.m. to 3 p.m. on Sept. 9, two patient groups plan to demonstrate at the company’s headquarters. Their goal: to “stop price-gouging” of people with diabetes, according to a flier circulating on the internet.

The main organizer is Elizabeth Rowley, who was diagnosed with Type 1 diabetes at age 4. She grew up in Illinois but now lives in England.

In an email exchange with IBJ, she said she could not move back to the United States for fear that the cost of diabetes would bankrupt her or force her to make “incredibly dangerous choices.”

“The insulin makers like to point to the ‘complex system’ to avoid blame for the insulin pricing crisis,” she wrote. “While the system is certainly broken, at the end of the day, these companies are the ones who set the prices.”

Fran Quigley
PFAM: People of Faith for Access to Medicines, www.pfamrx.org, (317) 750-4891
Also: Clinical Professor, Health & Human Rights Clinic, Indiana University McKinney School of Law

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