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A Senate hearing on high insulin costs billed as a blockbuster showdown with drugmakers and middlemen turned out to be a familiar case of political theater that appeared to satisfy no one.

The nation’s three biggest insulin makers, Eli Lilly, Novo Nordisk, and Sanofi, and the trio of middlemen known as pharmacy benefit managers, Express Scripts, OptumRx and CVS Health, testified Wednesday in a three-hour hearing before the Senate Health, Education, Labor, and Pensions Committee. The hearing sets up a debate by the same committee Thursday over a package of bills aimed at PBM reform.


However it provided little clarity on how to contain costs that have been rising for years. All the executives’ arguments — and senators’ counterpoints — mirrored those advanced during a House subcommittee hearing on insulin prices four years ago that saw leaders from the same six companies testify with nearly verbatim remarks.

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