End Game?

Yesterday during a congressional hearing lawmakers gave the insulin companies and PBM’s an earful. As we expected there was plenty of finger pointing as to who is to blame for the high cost of insulin. There were also several ideas thrown as to how to solve this problem. About the only thing everyone seemed to agree on was insulin cost too much and something should be done about it. This as they say is the good news for as Momma Kliff used to say the first step in solving a problem is to acknowledge there is a problem.

Now comes the hard part coming up with a solution that works, and this won’t be so easy. Even if the Congress instituted price controls, something we think is a very bad idea, that does not solve a problem that no one is talking about. What would this do for patients who either do not have health insurance or those patients who have high deductible plans?

Anyone who has been following this story has seen the horrible stories of patients rationing insulin or worse patients dying because they could not afford the medication that keeps them alive. A common thread here is these patients either did not have health insurance or were in high deductible plans and could not afford their insulin. As we have noted on many occasions for patients who fall into these categories the retail cost of insulin is crazy expensive.

So let’s say that Congress does institute price controls how does this help patients who do not have insurance or those with high deductible plans? Each time we write about this subject we receive lots of feedback much of which points the finger at insulin companies. The insulin companies lead by Lilly and now followed by Sanofi are starting to respond by offering lower cost insulin. Yet these efforts still aren’t making people happy either.

Some of the feedback we have received notes that even at these lower price points patients still cannot afford their insulin.

Now we hate to point out the obvious here or note those pesky facts again but Congress, the insulin companies and PBM’s can only do so much. Although no one will dare mention this, but the patient does bear some responsibility here. Reading through many of the horror stories reported about insulin rationing or deaths most people ignored the role the patient played. In some cases the patients chose NOT to get insurance or had options available that they did not pursue.

The real problem here really isn’t what insulin costs, but economic inequality combined with our current healthcare system. Problems which are getting lots of attention by the many Presidential candidates yet problems that have been around` since the last election. Frankly we aren’t sure that any solution for the high cost of insulin will help under these conditions. Listen if a patient cannot afford insurance does it really matter what insulin costs?

From the start we have noted that our biggest concern here is that the people who need help won’t get help. That for those patients who through no fault of their own cannot afford insulin there would no relief. As we have noted often unless insulin was given away for free, these patients due to their economic circumstances would still struggle to afford the drug that keeps them alive. We are thankfully making progress on this issue; will it be enough only time will tell. However until we address the bigger issues our gut tells the people who need the help the most will continue to struggle.