November 16, 2020

(Washington, D.C.) — In recognition of National Diabetes Month, the Pharmaceutical Care Management Association (PCMA) is outlining how pharmacy benefit managers, PBMs, are working to lower insulin costs and creating programs to support people with diabetes and improve health outcomes.

“PBMs have been able to moderate insulin costs for most people with insurance,” said PCMA President and CEO JC Scott. “However, we understand that for too many people with diabetes insulin costs are increasingly unaffordable. That’s why PBMs are innovating clinical care programs that provide targeted services to help people with diabetes stay healthy as well as creating programs to lower out-of-pocket costs for insulin.”

Read JC Scott’s most recent op-ed for more information on how PBMs are addressing high insulin prices.

This month PCMA’s podcast, The Pharmacy Benefit, released a new episode featuring Amy Bricker, Senior Vice President, Health Services Supply Chain for Express Scripts.  Ms. Bricker explained how Express Scripts is increasing access to affordable diabetes medications through a combination of discounts and clinical programs.

Listen to “How PBMs Reduce Insulin Costs” on PCMA’s The Pharmacy Benefit podcast.

In addition, a recent Visante analysis, “Insulins: Managing Costs with Increasing Manufacturer Prices,” highlights how insulin list prices have escalated dramatically over the past decade largely due to limited competition caused by an oligopoly of three drug manufacturers, a lack of alternative generic and biosimilar insulins, and drug manufacturers’ overuse of patent extensions. As a result of rising list prices, total gross sales for insulins increased from $22 billion in 2012 to $54 billion in 2019.

The report shows that PBMs have held net insulin costs flat. Total net sales of all insulins were the same in 2012 as in 2019, at $13 billion respectively. Visit PCMA’s website for more information on the Visante analysis and how PBMs are addressing insulin costs.  

Tomorrow, November 17th at 2 pm EST., PCMA is offering a webinar on diabetes patient care management. Several PBM company executives will join a discussion on the future of diabetes care coordination. To register, please click here.

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PCMA is the national association representing America’s pharmacy benefit managers (PBMs).  PBMs administer prescription drug plans for more than 266 million Americans who have health insurance from a variety of sponsors including:  commercial health plans, self-insured employer plans, union plans, Medicare Part D plans, the Federal Employees Health Benefits Program (FEHBP), state government employee plans, Medicaid plans, and others.