The rising cost of drugs to treat diabetes—among other conditions—has come under fire over the past two years. As a result, some pharmaceutical manufacturers and PBMs are establishing programs to help reduce the cost of diabetes medications. But the American Diabetes Association (ADA) is taking a somber view of one discount program.
For example, Sanofi committed to not increasing the price of its existing drugs in the United States, including the blockbuster insulin glargine injection (Lantus) for diabetes. In its new pricing policy, Sanofi said, “Should we take a list price increase on one of our medicines, our guiding principle will be to limit the total annual increase to a level at or below the rate of medical inflation for the year.”
Its benchmark will be the growth rate of the U.S. National Health Expenditure (NHE), published annually by the Centers for Medicare and Medicaid Services. The NHE, which is projected to be 5.4% in 2017, measures health inflation retrospectively and prospectively.
“Should we take a price increase above the NHE growth rate for a given medicine, we will provide our rationale, highlighting clinical value, real world evidence, regulatory changes, new data, or other circumstances that support our decision,” Sanofi said in the policy.
Last year, Novo Nordisk and Allergan, which both manufacture diabetes drugs, committed to limits of single-digit drug price increases.
In early May, Express Scripts launched a program intended to save uninsured people or those with high out-of-pocket costs 34% on scripts for diabetes and other conditions.
Inside Rx is a partially owned subsidiary that applies Express Scripts' purchasing power to expand affordable access to brand and generic medications for patients in need. Patients can visit www.goodrx.com/brand or download the GoodRx mobile app to access savings on more than 40 popular brand name drugs that treat diabetes, asthma, heart disease, depression, gastrointestinal disorders, gout, and other common illnesses, Express Scripts said in a statement.
There is no fee to obtain the prescription savings. Eligible patients present the discount card or mobile app at participating pharmacies. The benefits are available at CVS, Walgreens, the Kroger Family of Pharmacies, and other pharmacies nationwide. A complete list of available medications and participating pharmacies is available at www.insiderx.com.
However, the ADA expressed concerns about the new program. InsideRx is only available to a limited number of Americans living with diabetes, “because only individuals who are uninsured or have commercial health insurance can use this program,” ADA said. “It cannot be used by people enrolled in government health-care programs, such as Medicare and Medicaid.”
In addition, the money spent on drugs in this program does not go toward an individual’s annual deductible, which must be met before insurance coverage begin, ADA said. “For people living with diabetes, who require ongoing care and have high-deductible health plans, this could result in greater overall out-of-pocket expenses.”
“The American Diabetes Association remains committed to working with all stakeholders in the complex supply chain to create a long-term solution—lowering the price of life-saving insulin, the cost of which has nearly tripled in the last decade. While the announcement of this program demonstrates the need to address prescription drug costs, it does not create a long-term, sustainable path to lower prices for Americans living with diabetes,” ADA stated.