In a move that could revolutionize the insulin market, Eli Lilly has announced that it will cap insulin prices at $35 a month. This move has sparked similar actions from other major insulin manufacturers amidst growing concerns about skyrocketing insulin costs.

Eli Lilly and Co. is a healthcare company that develops and markets medicines for various health conditions, such as cardiovascular, diabetes, cancer and immune disorders.

Eli Lilly announced this decision on March 1, aligning with the Inflation Reduction Act, which mandates a $35 monthly out-of-pocket cap on insulin costs for seniors enrolled in Medicare. Individuals who have private insurance will be automatically subject to the cap, while those without insurance can qualify by enrolling in Eli Lilly’s copay assistance program.

Insulin prices in the United States are significantly more expensive compared to other countries, which has led to concerns about access and affordability for people with diabetes. This price disparity has also sparked debates about the role of pharmaceutical companies in setting prices and the need for regulatory reform.

As reported by NPR, Eli Lilly CEO David Ricks spoke about the company’s values regarding the cost of insulin.

“I think that’s sort of our contract with society: while they’re expensive, insurance should cover them and shield people from that cost. When they become cheap, everybody wins for reasons that are difficult to explain. That does not happen with insulin, so we’re taking these actions independent of those external effects,” Ricks said.

Assistant Director of the Academic Resource Center Laura Cummings helps establish accommodations for students when days of extremely high (or low) glucose occur. Cummings is disappointed about the motives behind Eli Lilly’s recent decision.

“Eli Lilly is instituting this cap as a proactive measure due to plans forming within the Biden administration. I find it truly disheartening that these are actions that Big Pharma would not take on their own,” Cummings said.

Associate Director of Academic Resources Antonia Keithahn similarly criticized the reasoning behind why corporations are reducing the costs of medications. 

“I’m definitely not an expert, but I think it’s probably naive to think that corporations will limit their profits without being compelled to do so. Some kind of government intervention may continue to be necessary to move the needle towards providing health care as a primary goal rather than profit maximization,” Keithahn said.

Cummings explained some of the issues regarding insulin prices in the U.S. These problems involve having to choose between essentials like housing and food in order to afford insulin.

“There have been many stories about people being forced to decide between buying their insulin or paying for things like rent or groceries,” Cummings said. “Some of those who opted to skip medication have died because they did not truly have access to the medications that they need.” 

Cummings highlighted the numerous changes that she thinks must be made to address the issue of medication accessibility and affordability, including factors such as cost and supply chain challenges. Additionally, she pointed out another problem that concerns insurance pre-authorizations. This refers to the procedure in which insurance providers mandate healthcare providers to obtain their consent before requesting particular tests, procedures or medications. 

“These often turn into battles of patients and doctors trying to justify to insurance companies why these decisions are the actual needs and best interests of the patient while the insurance companies effectively hold medical treatments hostage and allow these decisions to be made by individuals who have no medical training whatsoever,” Cummings said. “Sometimes, if you can actually get the approval, it comes with stipulations.”

Cummings elaborated on situations where patients are compelled to bypass their insurance and pay for the necessary treatment out of their own pocket due to the lack of alternatives.

“Sometimes patients are forced into situations where the only way they can get what they actually need is to bypass insurance entirely and pay it out of pocket. Of course, not everyone has that privilege and attempting to do so can result in making some of those difficult decisions about where to spend limited funds,” Cummings said.

Keithahn also criticized insurance pre-authorizations and their effect on people today. 

“It is shameful that our insurance systems deny coverage that medical providers have determined are in the best interest of the health and well-being of their patients,” Keithahn said.