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MARCH 1, 2023
Kuttner on TAP
A Small Victory Over Big Pharma
Eli Lilly announces insulin price caps, but keep an eye on the footnotes.
The pharmaceutical giant Eli Lilly announced today that it is capping out-of-pocket patient costs for its two most popular insulin drugs at $35 a month. By some strange coincidence, that is the same $35 insulin price cap included last year for Medicare in the Inflation Reduction Act, and the one President Biden demanded in his State of the Union address to be expanded beyond Medicare to include every diabetes patient.

Funny how a progressive president using both the bully pulpit and the legislative agenda can alter indefensible corporate behavior.

Lilly also announced that it was cutting list prices by 70 percent for two of its most popular branded insulin drugs, Humalog and Humulin. But watch out for the fine print.

First of all, those price cuts are not scheduled to be implemented until October, giving Lilly seven more months of high prices even as they are lauded for their corporate responsibility.

Second, patients who have commercial insurance can get the $35-per-month cap on out-of-pocket costs. And patients with no insurance can get a Lilly “savings card” to get insulin for the same $35.

But the Lilly press release adds in a footnote, “Government restrictions exclude people enrolled in federal government insurance programs from Lilly’s $35 solutions.”

Say what? The federally mandated $35 cap already covers Medicare Part D. Is Lilly saying that people on Medicaid, who include the lowest-income Americans, will have to pay sticker prices for their insulin?

And since Lilly caps out-of-pocket costs to patients but not necessarily prices charged insurance companies, the result could be cost-shifting and higher insurance premiums.

Lilly is out to limit reputational damage and head off more direct government regulation. For a decade, the strategy of the three major insulin makers, Lilly, Sanofi, and Novo Nordisk, has been to jack up the price of insulin as much as the market will bear. The current list price of Humalog is $530 for five injection pens.

Lilly’s strategy is also to compensate for the hit to profits by increasing market share. It is planning to introduce yet another insulin variant, called Rezvoglar, a copycat knockoff of a Sanofi product.

We are all for greater price and product competition, but basic insulin, synthesized in 1921, has been in the public domain for more than a century and should cost no more than aspirin.

If embarrassed drugmakers are cutting prices thanks to government action, that’s the time for government to redouble regulatory requirements and not to trust corporate public relations and voluntary gestures. Better yet, produce and sell generic insulin socially, at cost.
~ ROBERT KUTTNER
Will the Supreme Court Block Student Debt Relief?
The justices may have trouble confirming that the plaintiffs have the right to sue. BY MILES MOGULESCU
Julie Su Will Soon Be Running the Labor Department
As deputy secretary, she’ll take the role of acting head of the Cabinet agency. That will help her win confirmation to lead it. BY DAVID DAYEN
Calling Deficit Squawks’ Bluff on Environmental Enforcement
Deregulatory zeal and government spending cuts are surefire ways to preserve corporate impunity, at the public’s peril. BY HANNAH STORY BROWN
 
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