Generic Humalog Insulin: A new alternative, "Not a panacea": Shots

Eli Lilly and Company, based in Indianapolis, roll out a half-price version of insulin Humalog that will be sold as a generic.

Darron Cummings / AP

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Darron Cummings / AP

Eli Lilly and Company, based in Indianapolis, roll out a half-price version of insulin Humalog that will be sold as a generic.

Darron Cummings / AP

When Erin Gilmore filled her insulin recipe in a Denver area Walgreens in January, she paid $ 8.50. US taxpayers paid another $ 280.51.

She believes that the price of insulin is too high. "It eats me to know that taxpayer's money is wasted," said Gilmer, who was diagnosed with Type 1 diabetes while he was a sister of the University of Colorado in 2002.

The diagnosis meant that for the rest of her life it requires daily insulin shots to stay alive. But the price of that insulin is skyrocketing.

Between 2009 and 2017, the wholesale price of a single vial of Humalog, Eli Lilly and Company-produced insulin Gilmer, nearly tripled – from $ 92.70 to $ 274.70, according to data from IBM Watson Health.

Six years ago, Gilmer was eligible for Social Security – and hence Medicare – due to a number of health problems. At that time, the insulin she needed cost $ 167.70 per vial, according to IBM Watson Health.

"When it's taxpayer's money paying for medication for someone like me, it makes it a national problem, not just a diabetic issue," Gilmer says.

Stories of people with type 1 diabetes who die when they could not afford insulin have made headlines. The patient argues that Gilmer has protested high prices outside Lilly's headquarters in Indianapolis.

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In October, in Minnesota, Advocate General Lori Swanson sued insulin manufacturers for price smoothing. Pharmaceutical leaders were grilled on high drug prices at the Senate Finance Committee on February 26.

This is the reason why Lilly says it rolls out a half-price, generic version of Humalog called "insulin lispro". List Price: $ 137.35 per vial.

"Patients, doctors and politicians demand lower list prices for drugs and lower patient costs at the pharmacist," said David Ricks, Eli Lilly, in a blog post about the move. "You may be surprised to hear that we agree – it's time for change in our system and for consumer prices to come down."

No Panacea

When Lilly Humalog, the first short-acting insulin, came to market in 1996, the list price was about $ 21 per vial. The price did not reach $ 275 overnight, but annual price increases increased.

In February 2009, for example, the wholesale price was $ 92.70, according to IBM Watson Health. It rose to $ 99.65 in December 2009, then to $ 107.60 in September 2010, $ 115.70 in May 2011, and so on.

"There is no reason why prices should continue to increase by an average of 10 percent every year," says Inmaculada Hernandez of the University of Pittsburgh School of Pharmacy, who headed a January report in Health Affairs skyrocketing cost of prescription drugs for accumulated annual price increases.

"The public perception we have in general is that the substances are so expensive because we have to pay for research and development, and that's true," says Hernandez. "However, research and development is usually paid in the early years of a drug."

At $ 137.35 per bottle, Lilly generic insulin is priced at about the same level as Humalog was in 2012, 16 years after it came to market.

"We will recognize that this is not a paradise," spokesman for the company, company spokesman Greg Kueterman, "This is an option we hope can help people in the current system we work with."

There is nothing worth Humalog's fast-acting insulin, but it is just one of the two Types of insulin most people with Type 1 diabetes use every day The other type is prolonged, Lilly does one called Basaglar, the most popular long-term insulin is Lantus, produced by Sanofi, nor is it a cheap alternative.

Nevertheless, Li Lly's movement at Humalog put pressure on the two other major makers of insulin to act.

Novo Nordisk called Lilly cheaper generic insulin "an important development" in an e-mail statement.

"Providing affordable insulin to the market requires ideas from all stakeholders," said Novo Nordisk's Ken Inchausti in an email, which also mentioned the steps the company has taken, such as a patient assistance program. The statement did not say whether Novo Nordisk is considering offering a cheaper version of its popular insulin Novolog, a competitor of Humalog.

A statement by Sanofi, the third major insulin producer, also did not say whether the company Sanofi supports all actions that increase access to insulin for reasonable living patients, Ashleigh Koss spokesman Ashleigh Koss said. The company's patient assistant program

Another kind of generic

A twist in this story is that Lilly's new insulin is just a repackaged version of Humalog, minus the brand name. It's called an "authorized generic."

"Whoever came up with the term," authorized generic "?" Dr. Vincent Rajkumar says laughs. Rajkumar is a hematologist at the Mayo Clinic in Rochester, Minn.

"It's the same exact substance" as the brand name, he continues.

Usually, Rajkumar says that authorized generics are introduced by brand name fabric makers to compete with generic versions of their medications made by competing companies.

But when it comes to Humalog and other insulins, there are no generics made by competitors, such as cholesterol drug Lipitor or other diabetes drugs, such as medformin.

So when Lilly's authorized generic comes on the market, the company will have both Humalog insulin and the authorized generic version of that drug on the market.

Rajkumar says it's a PR move.

"There is rebellion over the price of insulin being discussed in Congress and elsewhere. And then the company basically says," Hey, we want to make the same product available at half price. "On the surface that sounds good, Rajkumar says.

" But you look at the problems, and you think, "OK, how crazy is it that someone is actually going to buy the brand?" "

In fact, it is possible that Lilly may make the same or even more profit from its authorized generic than it does from the name-brand Humalog, according to the University of Pittsburgh's Hernandez.

The profit margin will depend on discounts paid by the company to insurance companies and pharmacy managers. days as a factor in rising drug prices, they are usually not disclosed and increase as a medical price increase that gives incentives to someone

"Making an authorized generic is nothing but giving the insurers two options," says Hernandez: Pay the entire list price for a brand name and get a higher discount, or pay lower price for authorized generic and receive a presumably less discount.

"What we really need to bring down insulin prices are getting generic into the market and we need more than one, "Hernandez says, adding that previous research has shown that prices are starting to decline when two or three generics compete in the market.

Nevertheless, Lillly's Kueterman says the authorized generic insulin "will hopefully move the system towards a more sustainable model."

"I can guarantee you the reason we do this to help people," says Kueterman and notes that the company's Diabetes Solution Center has also helped "10,000 people pay monthly monthly for their insulin" since it opened in August 2018.

For Erin Gilmer, the news of a Lilly authorized generic insulin has left her mildly encouraged.

"It sounds really good and it will help some people who are great," said Gilmer. "It is Eli Lilly and pharma who are beginning to understand that Greek activism must be taken seriously and we are on a betting point." [19659008] This story is part of NPR's reporting partnership with Kaiser Health News. Freelance journalist Bram Sable-Smith can be found on Twitter: @besables .