[throwitaway6512]

Read up on the matter. The culprits are pharmacy benefits managers who push producers to increase list prices while demanding obscene rebates that are never passed on to the consumers. Most producers don’t disclaim the rebates, but Lars Fruegaard (Novos CEO) is on record saying that it increased from 64% to 67% last year. So pharmacy benefits managers are pushing up the list price but less and less is getting through to the producers. The American system is rigged by the middlemen who approach consumers with ownership of “cheap drugs” because of the rebates, while they approach the producers with ownership of the consumers. As an alternative to that system Novo Nordisk is releasing cheaper insulin through a partnership with Walmart where it goes directly to the consumers.

Openness around rebates will be a great first step to help lower prices, but the PBMs have gotten the industry into a reverse price war where everyone is overbidding each other on price in order to provide the larges rebate to PBMs. Something big has to change to revert that cause.

Disclaimer: I work for Novo Nordisk.

[sithlord]

Although I appreciate the $25/vial insulin sold at walmart, its unfortunate that its such an old-school version that that it makes it almost dangerous to try and manage diabetes with it *obviously better than nothing though.

I know, before insurance, it costs around $240 a vial, and I know personally I go through roughly 3 vials a month. I would guess I use a lot less insulin than a lot of others too.

So I know the manufacturer isn't the only one to blame, and maybe its unfair to completely blame them, but as much as the manufacturers are donating to politicians I cant imagine they are doing a lot to fight it either.

[sdfj3423]

>Read up on the matter.

Slightly off-topic, but could you talk about what pharmacy benefits managers are supposed to do and actually do, for insulin especially, and their effect on the market?

I Googled this term but can't make of sense of your comment based on what I've read. (The definitions of pharmacy benefits managers that I found have nothing to do with what you wrote.)

[tokai]

There is a paragraph in the wikipedia article on PBM[0] full of sources on this.

[0] https://en.wikipedia.org/wiki/Pharmacy_benefit_management#Co...

[phkahler]

Can they just sell direct to consumers? Cut out the pharmacy and the insurance companies. You guys could earn more while the patient pays less.

[throwitaway6512]

90% of diabetics are insured. If we stop selling to insurance and try to sell directly to these patients we would end up being more expensive than competitors and lose those customers. I mean you could argue that if they are paying their own insurence they could cancel and perhaps have a net saving on the insulin, but that seem very risky considering potential comorbidities of diabetes, and you’d lose all other coverage.

[peter303]

Each level in the system INCLUDING PHYSICIANS gets a cut.Thein entice is to keep raising prices.