PBMs Reduce Insulin Costs
PBMs are working to improve the lives of patients living with diabetes and their families
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.
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.
When new manufacturers enter the market at a lower list price, PBMs use the competition to drive costs down.
PBMs Support Patients with Diabetes
Diabetes is the seventh leading cause of death in the U.S., affecting 37.3 million Americans, or 1 in 10 people.
IQVIA Data on Insulin
From IQVIA: The Use of Medicines in the U.S. 2023
The average final out-of-pocket costs on insulin for all patients DECREASED from $31.52 in 2018 to $21.19 in 2022.
Medicare patients paid under $35 out-of-pocket on insulin 71% of the time in 2022, while the commercially insured paid under $35 80% of the time.
All three major insulin manufacturers have announced significant list price reductions for some of their insulin products in 2023.
$19.23
Medicare average final out-of-pocket costs on insulin decreased from $30.80 to $19.23.
$22.02
Commercial average final out-of-pocket costs on insulin decreased from $30.80 to $22.02.
PCMA Press Releases & Op-Eds
- PCMA Statement on New Milliman Report on Insulin Coverage in Medicare Part D
- Pharmacy Benefit Managers: Innovations Reduce Insulin Costs, Improve Patient Access
- PCMA Praises Administration’s Action to Address Patient Out-of-Pocket Costs on Prescription Drugs
- Health Plans, Pharmacy Benefit Managers Innovate to Increase Access to Insulin
- Pharmacy Benefit Managers: Innovations Reduce Insulin Costs, Improve Patient Access
- PBMs: Applauding FDA Approval of the First Biosimilar Insulin Product
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.