PBMs Reduce Insulin Costs

The INSULIN Act will increase insulin costs while giving drug manufacturers another way to game the system to maximize profits.

Insulin prices are high because there are only a few insulin manufacturers, shielded from competition, and those companies set and raise prices. PBMs, on the other hand, are the only entity in the prescription drug supply and payment chain dedicated to reducing drug costs. On average, PBMs reduce patient drug costs by nearly $1,000 every year. 

Component 6 – 1

PBMs are creating innovative programs that limit consumer out-of-pocket insulin costs to promote affordable access, as well as clinical programs that improve care and patient outcomes.

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When new manufacturers enter the market at a lower list price, PBMs use the competition to drive costs down.

 

THE PHARMACY BENEFIT PODCAST

A new ad campaign from PCMA highlights that the INSULIN Act won’t lower insulin costs, it gives Big Pharma companies another way to game the system to maximize profits.

IQVIA Data on Insulin

From IQVIA: The Use of Medicines in the U.S. 2022

The average final out-of-pocket costs on insulin for all patients DECREASED from $31.52 in 2018 to $22.88 in 2021.

Medicare patients paid under $35 out-of-pocket on insulin 74% of the time in 2021, while the commercially insured pay under $35 88% of the time.

Total out-of-pocket costs by patients with insulin prescriptions fell by $500 million since 2018.

$21.02

Medicare average final out-of-pocket costs on insulin decreased from $30.80 to $21.02.

$23.19

Commercial average final out-of-pocket costs on insulin decreased from $29.36 to $23.19.

Young woman injecting insulin with insulin pen.Home office during pandemic concept
Insulin (1)

PBMs Reduce Insulin Costs for Patients

RESEARCH SHOWS US

$54 B

Total gross sales for drug manufacturers increased from $22 billion in 2012 to $54 billion in 2019.

$13 B

Despite climbing gross drug costs, PBMs held total net sales to $13 billion in 2012 and 2019.

Study: Artificial Manufacturer Barriers to Competition Lead to High Insulin Prices