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Hastings Law Journal

Abstract

Insulin, an injectable drug discovered about 100 years ago that now costs less than $5 to manufacture, is currently sold between $300 and $500 in the United States. The continuously growing price forces many insulin-dependent diabetics to forego their lifesaving medication, which can result in death. Although insulin manufacturers are a significant cause of insulin unaffordability in this country, pharmacy benefit managers (PBMs), such as CVS Caremark, OptumRx, and Express Scripts, are essential in the insulin market and pressure insulin manufacturers to provide higher rebates, leading to higher prices for consumers.

Some states have addressed this issue by passing legislation capping the price that insured, and in some instances uninsured, individuals pay for insulin. However, these laws generally do not provide assistance for the underinsured, or those with self-funded plans governed by federal law. State laws capping the price of insulin are a viable short-term solution, but they do not tackle the root cause of price manipulation in the pharmaceutical industry. There must be a comprehensive plan to address PBMs and their influence on the pharmaceutical market. Federal legislation capping the price of insulin for all insulin-dependent diabetics will increase transparency, create universal price limits on insulin, and prevent unnecessary deaths.

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