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NPR 2019-03-11

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How Much Difference Will Eli Lilly's Half-Price Insulin Make?

LULU GARCIA-NAVARRO, HOST:

Drugmaker Eli Lilly has announced it will be offering a cheaper version of Humalog, its insulin drug. Humalog is one of the most widely sold insulin drugs in the United States. Between 2009 and 2017, the wholesale price of a single vial tripled - according to data from IBM Watson Health - to $274.70. So what does the availability of a cheaper version mean? That's what we'll ask health reporter Bram Sable-Smith, who's based in Madison, Wis.

Thanks for joining us.

BRAM SABLE-SMITH, BYLINE: Thank you, Lulu.

GARCIA-NAVARRO: So Bram, tell us what kind of insulin we're talking about here because someone who needs insulin can need a combination of different kinds, right?

SABLE-SMITH: That's exactly right. So what we're talking about is a fast-acting insulin. So for most patients, that's about half the insulin that they use. The other half is going to be - we call it basal insulin. That's just to keep your blood sugar at a normal rate. This fast-acting insulin - this is what you use when you're eating carbohydrates. And how much you use depends on how many carbohydrates you eat. So you need less when you're eating a small salad than you do for when you eat a big bowl of pasta, like I did last night.

GARCIA-NAVARRO: OK. So they're promising a discount on one of the kinds of insulin somebody with diabetes needs. So is it actually a break financially?

SABLE-SMITH: Well, for some consumers, yes, it will be. So insulin will be potentially a little bit cheaper for them. Most patients use one or two vials of insulin per month. And this new insulin is priced at just under $138 per vial. Now, because of insurance, most patients - about 95 percent - are already paying less than $100 per vial. So the impact of this new insulin is really aimed at people who are exposed to the high list prices. And those are people with high-deductible health plans as well as the uninsured. And for them, the cost of a vial could drop in half, from $280 to $138. But remember. This is only one of the two types of insulin that they probably need.

GARCIA-NAVARRO: Why is the company doing it?

SABLE-SMITH: Well, they say they're doing it to help people. But the context for this timing here - the timing of this announcement is that there've been a lot of stories about people who've suffered and even died because they couldn't afford their insulin. Drug companies recently got grilled by the U.S. Senate. And it was a bipartisan grilling. In Minnesota, last October, the outgoing state attorney general actually sued the three big insulin makers, alleging price gouging. So there's a lot of pressure here. There's lots of bad press. And this is almost a low-stakes way for them to say that they're offering a cheaper product.

GARCIA-NAVARRO: All right. Last question - you've written a lot about insulin and diabetes because you were actually diagnosed with Type 1 diabetes in your 20s. What kind of reaction have you seen among not only activists on this issue but also just people living with this condition?

SABLE-SMITH: Yeah. There's a lot of conversation on what I like to call diabetes Twitter as well. I'd say it's been met with a lot of ambivalence and a fair amount of frustration. So buying insulin - it's not a choice for people with Type 1 diabetes. You either take it, and you live or you don't take it, and you die. Those are the stakes for being able to afford insulin. So one thing to remember is that Humalog entered the market in 1996 at about $21 per vial. So this generic version of Humalog at $138 - it's still six times more expensive than that original price. And a little bit more context - an independent analysis last year estimated each vial only costs the company about $6 to make. So there's still a ton of profit here and advocates are frustrated with that.

GARCIA-NAVARRO: That's health reporter Bram Sable-Smith. He's part of NPR's reporting partnership with Kaiser Health News. Bram, thanks so much.

SABLE-SMITH: Thank you, Lulu.


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