“Disproportional”

“Disproportional”

“In the end, those of us whose lives rely on insulin (and countless other medications) are left holding the bag here, while insurers, drug manufacturers, and PBMs simply say “we’re working on it” and continue raking in disproportional profits.”  This passage comes from a post on the Diabetesmine blog (the full post can read at http://www.healthline.com/diabetesmine/high-insulin-price-response#1).

As we predicted this furor over the “rising” cost of insulin won’t go away anytime soon and also as we predicted not much will get done expect lots of finger pointing. Judging by the reaction this has received on Facebook one just might think that the insulin manufacturers are a bunch of heartless robber barons who care nothing about patients and only want to fatten profits. That the executives who run these heartless publicly traded companies could care less about what a patient pays out of pocket for their insulin and all they want to do is fatten their already inflated compensation packages.

While there is a ring of truth to some of this; this anger directed at insulin companies misses the point. Now people can judge for themselves the quality of the responses given by the insulin companies and we applaud Diabetesmine for reaching out to these companies and giving them a chance to tell their side of the story. Diabetesmine may not have liked what they got from these companies which quite frankly is a little naïve.

There is no way on earth that the companies would come back and say; “We share your concern over the “rising” out of pocket cost of insulin. We do understand that for certain patients this cost places an undo financial burden. Yes, it’s true we have been raising the “list” price of insulin so that after discounts and rebates we can maintain some sort of reasonable margins.  But as much as you may not like to hear this being a publicly traded company our first responsibility is to our stakeholders. Stakeholders who expect us to make a profit.

Keep in mind that it cost us billions to develop new and better insulin’s. That if you want better drugs we must spend this money. The money we make funds this research.

Yes, we know that any patient impacted by the out of pocket cost of insulin feels betrayed. However, as much as we feel their pain we are a for-profit business and not a charity. This is after all a business and our first responsibility is to our stakeholders. Now if you can convince our stakeholders to allow us to lower our list price, to allow us to make less money be our guest. Again you won’t like to hear this but that’s who we answer to.”

We’d also like to know exactly what disproportional means. There was a time when Diabetesmine was an independent company which was then acquired by Healthline. Now we have no idea what the terms of this deal where but would imagine the stakeholders in Diabetesmine wanted the highest possible price. And they had every right to do so for the last time we looked this is America a capitalist country and as far as we know stakeholders are entitled to make as much on their investment as they possibly can.

Listen we know this is a complex problem with multiple moving parts. We also know that truth be told all the players involved really don’t want to solve the problem, that they have competing interests and objectives. Insulin companies are looking to make as much money as possible. PBM’s, payors want lower list prices so they can make more money and insurers also want to make money. This is why each blames the other for the high cost of insulin.

The fact is the only way this is going to change is if the government steps in, something quite frankly we hope does not happen. Anyone who disputes this need look no further than competitive bidding for diabetes testing supplies. Mark our words if the government does get involved, issues price controls or some other “solution” and takes away the ability to make a profit then say goodbye to innovation. Say goodbye to new and better insulin’s.

Frankly we haven’t a clue as to how this “problem” will be solved. But as Momma Kliff used to say; “Perhaps a problem isn’t being solved because no one really wants to solve it. Sure there will lots of pontificating, finger pointing and even outrage but what they really want is no change at all. Change brings in the unknown factor, change is hard and quite frankly most don’t like dealing with change.”