I

n his latest attack on the pharmaceutical industry, Senator Bernie Sanders has asked the Department of Justice and the Federal Trade Commission to investigate three insulin makers for price collusion.

In a letter sent Thursday, Sanders and Representative Elijah Cummings (D-Md.) referred to a pattern in which prices for insulin sold by Eli Lilly, Sanofi, and Novo Nordisk often rose in tandem over several years. The lawmakers expressed concern that the drug companies may have been coordinating their pricing and, as a result, driving up the cost for millions of Americans, including both patients and taxpayers.

Their letter cited a recent analysis that found the cost of insulin more than tripled — from $231 to $736 a year per patient — between 2002 and 2013. Meanwhile, since 2009, the lawmakers pointed to 13 instances in which the prices of Sanofi and Novo Nordisk insulin brands rose in lockstep. They said Lilly did the same. The practice is known as shadow pricing and was first reported by Bloomberg News.

advertisement

“The original insulin patent expired 75 years ago. Instead of falling prices, as one might expect after decades of competition, three drug makers who make different versions of insulin have continuously raised prices on this life-saving medication,” the lawmakers wrote. “In numerous instances, price increases have reportedly mirrored one another precisely.”

Their missive reflects concerns that competition is failing to lower prices. Drug makers in general argue that they have to raise prices in order to give substantial rebates to pharmacy benefit managers, which are the middleman that negotiate with health plans.

The insulin makers, not surprisingly, took exception to the concerns expressed by Sanders and Cummings.

“We strongly disagree with the accusations in the letter. The insulin market in the US is highly competitive,” wrote a spokesman for Lilly, which sells Humalog and Humilin. He maintained the net price has not increased since 2009 and pointed to the “complex reimbursement designs,” which place “an unfair burden on people with diabetes.” The spokesman said Lilly complies with the law.

A spokesman for Novo Nordisk, which markets Levemir and Novolin, wrote us that “we set price for these life-saving medicines independently and then negotiate with payers and PBMs to ensure patients have access to them. We stand by our business practices.”

And a spokeswoman for Sanofi, which sells Lantus, said the company “sets the prices of our treatments independently.”

“To me, [the lawmakers’ allegation is] far-fetched because it doesn’t take into account the way insulin is priced in the real world.” said David Kliff of Diabetic Investor. “Yes, if you go through the data, it’s true they’re raising their prices in lockstep, but their list prices have only a minor impact on what it costs a patient out of pocket. And don’t forget, these guys are archrivals.”

The letter to the feds was sent as Bloomberg News reported that the Justice Department is conducting a wide-ranging investigation into possible price fixing among generic drug makers. Among the companies that received subpoenas are Mylan Pharmaceuticals, Teva Pharmaceuticals, Sun Pharmaceuticals, and Endo International.

Sanders has caused a stir among drug makers and investors in recent weeks with a series of tweets criticizing different companies — including Valeant Pharmaceuticals and Ariad Pharmaceuticals — for their price hikes. And he and Cummings have teamed up before to probe price hikes taken by various generic drug makers.

Newsletters

Sign up for our Pharmalot newsletter

Please enter a valid email address.

Leave a Comment

Please enter your name.
Please enter a comment.

  • Hopefully Bernie can blow the whistle loud enough to matter.
    Big Pharma is out of control.
    And below is more proof…
    MANNKIND CORPORATION (MNKD) was founded by Alfred Mann, (Google his name) was a genius of a scientist and a world class philanthropist.
    MANNKIND CORP has a new mealtime inhaleable insulin that is superior to current injectable treatments
    called AFREZZA.
    MANNKIND CORP received two CRL’s while trying to achieve FDA Approval of AFREZZA, costing MANNKIND millions of dollars and it has been an uphill battle since. There was suspicion of corruption back then because MARTIN SHKRELI had some involvement with MARGRET HAMBURG which many believe caused one of the two CRL’s.
    MANNKIND’s stock price is suffering greatly, and there are approximately 100 million shares held short, and if you are to watch the way market manipulators control the price by playing with the bid and the ask throughout the trading day, I am surprised that the SEC has not cracked down on them.

    MANNKIND partnered with SANOFI and it appears that SANOFI either tried to bury AFREZZA or just gave up on it. However, SANOFI did have to pay millions of dollars to MANNKINDdue to the way things went down.
    Use your own judgement.

    MANNKIND CORP is in a joint collaboration with the JDRF for pediatric use of AFREZZA.
    In addition, The head of the JDRF actually uses AFREZZA and said that AFREZZA was life changing or words to that effect.

    IMHO, Due to the power and corruption of Big Pharmaceutical companies trying to protect their own stronghold on the insulin market. They are purposely holding back a REVOLUTIONARY, life saving treatment
    for Diabetes, that if successful, will swing the billion dollar profits from the Big Three Phamaceutical companies Bernie Sanders has exposed, to a little biotech company called MANNKIND CORPORATION.
    Not to mention that billions of people that currently suffer from Diabetes will benefit greatly by switching
    to AFREZZA so that they can enjoy a reasonably normal, healthy, long life.

    All of the above is my own opinion based on my experience of owning MNKD stock for the last 7 years or so.
    Do your own DD and see what you come up with!
    GLTY!

    AFREZZA mimics the function of a healthy human pancreas better than ANY other insulin treatment.
    AFREZZA is the ONLY monomer insulin.
    AFREZZA is human insulin.
    AFREZZA combined with TRISIBA is actually giving many Diabetics non diabetic A1C readings, enabling
    Diabetics to regain a quality of life that they thought was impossible.
    AFREZZA with TRISIBA also keeps a Diabetics Time in Range (Acceptable Blood Glucose readings)
    Which translates to less damage to the human body, blindness and amputations that many Diabetics have to ultimately deal with are eliminated with the use of AFREZZA.
    AFREZZA is a game changer!
    That is, unless BIG PHARMA does not bury AFREZZA first.

  • How much kickback is paid to Doctors for prescribing medicines? Why so much TV advertising now being seen for prescription drugs? Is the latter being implemented to justify the increased cost that
    the pharmas are complaining about?

  • Pharmaceutical company customers are third party payers, not patients. Prices are not set by normal market forces. Those out-of-pocket payers caught outside the system are stuck. Bernie and his friends should look in the mirror for the culprit since it is federal government policy that is largely responsible for this problem.

  • I am a insulin user. If Sanofi and Nordisk, didn’t have programs that help. I wouldn’t be able to afford my insulin. At least not while in the dough nut hole. I appreciate the help, both of these companies give, low income people. I am just thankful, they have such programs…

  • Type 2 diabetics don’t get off cheap either. I take Victoza, which costs $249/month and I’m not even at the highest dose. That’s ok, my first psoriasis injection costs me $3000 and once I crept out of the donut hole the next shot only cost me $898.00.

  • I use to get five boxes of Novo Nordisk Flex Pens and five vials of Lantus per shipment from the V.A., but now I get two boxes of Flex Pens and three vials of Lantus because of the price increase.

  • Dear Sen. Sanders, I am 68 years old with Medicare and the only drugs I use are metformin and insulin [Lantus in a vile]. Apparently, I am underinsured because, although 9 months of the year I can afford the insulin [$120/90days] the cost for the same amount of insulin in the last quarter is over $700 which I cannot afford. WTF?

  • As a user of lantis insulin, which is only available in a pen, I experience paying a very high copay for this needed drug each month. It is not only increases in the cost of the medication, it is also restricting the availability of the medication to a specific patented delivery system, which the manufacturer can then charge high prices for. Enough is enough!

  • “A minor impact on patients’ out of pocket?” Maybe if patients are lucky enough to have a Cadillac insurance plan that shields them. More and more people are paying full price. This is the disconnect that pharma and insurance seem to be too busy pointing fingers at each other to understand.

  • My fathers insulin costs have gone up a lot. It is not a minor impact, it is a major impact. My Dad is retired and on a fixed income. The cost to him out-of-pocket has gone from $65 a bottle to $297 a bottle. There is a time period in which my Dad must pay the entire cost of his medicines, ( the donut hole period), the period in which his coverage is no longer paying for his medications. Do not tell me that the rise in cost is not passed directly on to the consumer; that the rising prices have minor impact on the consumer. The pharmaceutical companies are ripping people off and putting peoples lives at risk for profit !!!!!

    • I’ve been a type 1 diabetic for 32 yrs and produce no insulin myself. Insulin prices are slowly killing me! I’m getting to the point were I can’t afford it so I guess I’ll die when that happens. I’m 54 and take good care of myself but with prices rises 3 or more times a year it’s almost impossible. We need generic insulin so people like me can live

Sign up for our Morning Rounds newsletter

Your daily dose of news in health and medicine.

X