- Sanofi said Wednesday it is amending an insulin assistance program to further lower out-of-pocket costs for some U.S. diabetes patients, coming amid increasing political pressure to ease insulin prices for patients.
- The program launched a year ago is meant for patients meeting certain criteria, including those with high deductible commercial insurance plans or ineligible for other assistance programs. Right now, patients in the program pay per month $99 for every 10 mL vial of insulin and $149 for every box of pens they need. Starting in June, they will instead pay per month $99 for up to 10 boxes of pens, vials, or a combination of the two.
- Unable to foot the out-of-pocket costs, some diabetes patients — and particularly those on high deductible insurance plans — are turning to rationing their medicines or pursuing cheaper alternatives. The trend hasn't sat well with consumers or Congress, which is now investigating the three biggest insulin makers in the U.S.
Less than two months ago, Sen. Ron Wyden of Oregon called Sanofi a "company wringing more and more cash out of people with an incurable disease."
The comment from the top Democrat on the Senate Finance Committee came as seven pharmas were hauled in to explain rising drug prices before the panel. That hearing also saw a rare concession from pharma representatives, who admitted list prices are partly to blame for the overall cost burden on patients.
As pressure from lawmakers has mounted over the past year, Sanofi and some fellow big pharmas began disclosing more information about their pricing practices. In 2018, for instance, the French drugmaker hiked prices for 35 of its 76 prescription medicines, according to a report released in February.
The report highlighted too the difference between a drug's list price and its net price, which takes into account rebates and discounts offered to payers. Drug companies often note how net prices of their products have been going down, suggesting that larger affordability problems stem from payers not passing along discounts to patients.
Affordability has been a key concern in diabetes care, prompting both companies and payers to take action.
Eli Lilly, a leading diabetes drugmaker in the U.S., said last month it will introduce an authorized generic of its blockbuster insulin Humalog. The generic costs $137.55 per vial and $262.50 for a five-pack of KwikPens, reflecting a 50% discount from the reference product.
More recently, insurance giant Cigna announced plans to cap co-pay costs for a 30-day supply of insulin at $25. The cap is lower than the out-of-pocket $42 that members of its Express Scripts PBM paid on average last year.
Sanofi, meanwhile, claims its insulin assistance program has saved patients around $10 million since debuting last April.
While some commercially insured patients with a high deductible can benefit from the program, its target population is uninsured patients who don't qualify for traditional patient assistance programs like co-pay and free-medicine initiatives. A Sanofi spokesperson wrote in an email to BioPharma Dive that, because they're uninsured, these patients won't have a deductible and therefore no sign-off is required from insurance companies.
Sanofi has also used co-pay cards — with upwards of 9,600 patients using the insulin assistance program card in 2018. The company spokesperson noted that more than 90% of people using Sanofi co-pay cards pay $10 or less per month for their Sanofi insulin.
In 2018, the French pharma's diabetes business reported 5.5 billion euros ($6.5 billion) in net sales — which, under constant exchange rates, was 10% lower than 2017's sum, primarily because of the pricing and coverage headwinds that insulins are facing in the U.S.