The diagnosis on Gaetz resulting costs insulin misses the root cause


At the end of March, after the Chamber passed a bill that would cap the cost of insulin at $35 per month for insured consumers, Representative Matt GaetzR-Fla., tweeted why he voted against the bill.

“Insulin price increases have more to do with increased consumer demand than with bad behavior by Big Pharma, which I hasten to condemn,” Gaetz wrote.

He continued, in a Twitter feed into 10 parts, to offer weight loss as a potential solution to the cost of insulin rather than cap prices “90 to 95% of people with diabetes have type diabetes 2, which “can be prevented or delayed with good health.” lifestyle changes such as losing weight, eating healthy foods and be active. Arbitrary price controls do not replace the individual weight control. Since 2000, the number of diabetes cases in the United States nearly doubled. The increased insulin demand and the necessary price increase followed. In other words, the price of insulin increases. as the size increases. “

The tweet drew attention on social media and news electrical outlets, but we wondered if there was a link between the demand for insulin and the increase in the cost of the drug. An economic principle states that, for certain products, if demand increases, prices will follow.

Is this true for insulin, a drug that millions of Americans need to survive?

We contacted Gaetz’s office to request evidence to support his claim, but received no response.

So we asked the experts to explain what was happening with the price of insulin.

Types of diabetes and treatment

Insulin was first discovered in 1921 and patented two years later. The hormone is essential for people with Type 1 diabetes because their pancreas produces more natural insulin, needed to regulate blood sugar. Extremely high blood sugar can be fatal. These patients account for about a tenth of the total number of people with diabetes in the country.

Some patients need to inject insulin often, at least twice a day.

However, the majority of people with diabetes have Type 2, which has been linked to obesity. Being overweight can interfere with the body’s ability to use insulin effectively, leading to high blood sugar.

“As obesity increases, so does diabetes,” said Dr Paresh Dandonaprofessor at the University at Buffalo School of Medicine who studies diabetes.

But many of these patients are not prescribed insulin as a treatment. About 30% of people with type 2 diabetes use insulin when other drug options fail to treat the disease, Dandona said. For some type 2 patients, exercise and a healthier diet “may help reduce insulin dose, but it does not eliminate its use.”

How Insulin Drug Pricing Works

Experts in drug pricing stated that there was no doubt that the current price of insulin (the amount charged to consumers and their health plans) has increased over the last decade. A study 2020 found that the list price of insulin products increased by 262% from 2007 to 2018, while a study 2021 found that between 2014 and 2018, the list price of insulin products increased by 40%.

Is there a reason why the price exploded?

Not really, experts said, except that manufacturers and other stakeholders benefit from prices higher catalog. For example, pharmaceutical benefits managers – that manage prescription drug benefits on behalf of health plans – are paid based on the amount of discount they get insulin manufacturers. If they can negotiate a more favorable place for insulin from a manufacturer on a drug list (list of covered drugs and a diet), they receive a larger discount. Insurance companies also benefit from higher prices because they receive a higher amount on the patient’s part in the sharing of costs and can also benefit from discounts from pharmaceutical benefits managers. Moreover, consumers have little bargaining power because insulin is usually an essential purchase.

“Insulin makers set prices based on what the market will bear, not based on demand for their products,” he said. Dr Jing Luoassistant professor of medicine at the University of Pittsburgh whose research focuses on drug pricing and use.

However, the pharmaceutical industry does not agree with this assessment. PhRMA, the industry group representing pharmaceutical companies, told NHK that even if he recognizes that drug makers are responsible for the increased insulin catalog prices, the manufacturers do not reap the benefits of increased prices. Instead, manufacturers are forced to raise catalog prices to offer discounts and greater discounts to insurers and pharmacy benefit managers. But PhRMA claims that manufacturers do not realize higher prices because of higher earnings catalog.

“The discounts reduce about 84% that health plans pay for insulin and these savings should be shared with patients at the pharmacy,” said Brian Newell, spokesman for PhRMA. “Until we repair this broken system, patients will continue to face high costs for insulin.”

Although in general economic terms high demand can lead to higher prices as it is difficult to produce enough of a product, production is not an issue with insulin as it is easy to increase supplies. and there is no set amount of insulin that can be made, says Matthew Fiedler, member of the USC-Brookings Schaeffer Initiative for Health Policy. Insulin demand should therefore not affect prices.

“It is unlikely that production costs change significantly as more people buy insulin because production can be increased relatively easily, at least in the long term,” Fiedler wrote in an email. “In fact, production costs could eventually decline as more people buy insulin if manufacturers respond by developing more efficient production techniques.”

Ultimately, the list price of insulin is set by the manufacturers, and they and everyone else in the drug pricing system benefits from higher prices, except for the consumers who have to buy it. to survive, experts said.

“As we all know, increased demand does indeed drive up prices. This is especially true for commodities,” Luo said. “Unfortunately, the prices of brand name prescription drugs like insulin are very different from those of plain products.”

Would weight loss help reduce insulin costs?

In his Twitter feed, Gaetz said that diabetes cases nearly doubled since 2000. This is true.

According to data from the Centers for Disease Control and Prevention, approximately 12 million Americans were diagnosed with diabetes in 2000. By 2018, the number of new diagnoses had increased to approximately 27 million.

But a diagnosis of diabetes is not always related to weight or general health of a person, especially for people with type 1 diabetes who rely on insulin treatment for life .

“In fact, people with type 1 diabetes are usually very thin,” said Dr. Eron Manusovprofessor at the University of Texas-Rio Grande Valley School of Medicine.

Additionally, most people with diabetes have type 2, which is linked to weight gain but is not always treated with insulin.

Other factors may play a role in the risk of developing type 2 diabetes, such as genetics, lifestyle and age, Manusov said.

Relieving and treating diabetes isn’t as simple as eating healthier and exercising more, Dandona said.

If everyone ate the same healthy diet and exercised the same amount, some people would still get diabetes because a person’s genes and the environment they grew up in matter, he added.

“To expect that, in some magical way, insulin requirements will go away if patients lose weight is really speaking cuckoo clock country,” Dandona said.

Experts have concluded that while insulin list prices and diabetes cases increased at relatively the same time, they are not related.

“Although higher obesity rates have likely increased prevalence of diabetes, it is unlikely to have had much effect on insulin prices,” said Fiedler, health economist. “And, of course, none of this does not mean that reducing obesity or reduce diabetes is a bad thing. It just does not have much to do with the price of insulin in a way or another. “

How does Congress approach insulin pricing?

The House bill would cap the cost of insulin at $35 per month for people who have private insurance or those who receive Medicare. However, the bill does nothing to help the uninsured who need insulin.

Democrats unanimously backed the legislation, as did 12 Republicans. But there was significant opposition, with 193 Republicans voting against, including Gaetz.

The bill now goes to the Senate, where members are considering other strategies to control insulin prices. Details are in preparation.

Our decision

Gaetz said the reason for the rising cost of insulin was that more people were being diagnosed with diabetes, increasing demand for the product. And he linked this increase in diabetes cases to the increase in the number of overweight people in the United States.

Health economists and diabetes experts have told us that while he is correct that diabetes cases are on the rise, Gaetz’s general point is not accurate. His statement is based on a cause and effect argument which does not exist.

They said the rise in insulin prices was not related to high demand for insulin or production problems created by pressure.

Furthermore, although the increase in prices will occur as more cases of obesity are reported, medical experts said they are not necessarily linked. Many overweight people who develop type 2 diabetes are treated with insulin, and experts point out that many other factors help determine whether a person will develop diabetes.

We are evaluating this Misrepresentation.


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