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Medicare patients would pay up to 92% less for insulin outside U.S., report from Maryland Rep. Cummings finds

Millions of people suffering from diabetes in the United States have faced steep increases in the cost of their insulin, forcing some to ration their medicine and risk severe complications, according to U.S. Rep. Elijah Cummings, who released a report Wednesday showing how much less they would pay in other countries.

The report from the Baltimore Democrat and chair of the House Committee on Oversight and Reform is the latest effort to highlight rising drug prices, which has become a bipartisan cause in Washington in recent years.

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“Diabetes is not something to play around with,” Cummings told a crowd at the Catonsville Senior Center. “For people with diabetes, access to their medication is a matter of life and death. In spite of this, drug companies have repeatedly increased the price of their diabetes drugs, including insulin, over the past 20 years.”

The committee’s report found that the prices of diabetes drugs are far higher in the United States than in other countries specifically because Medicare, the government health program for seniors and disabled people, is not allowed to negotiate directly with drug makers.

In the congressman’s Baltimore-area district, the report found there were more than 42,000 Medicare recipients diagnosed with diabetes, and they and the health plan spent $21 million on the most popular brand-name medications for the condition in 2016. They would pay 92 percent less in Australia, 88 percent less in the United Kingdom and 87 percent less in Canada.

The House committee planned to produce reports for every congressional district.

Cummings and other Democrats see price negotiation as a means of lowering costs, an idea supported by a majority of Americans, according to Kaiser Family Foundation polling.

But it’s not clear whether they will find agreement with Republicans who favor other strategies such as increased competition from generic drugs as a path to affordability. Committee chairmen in the House and the Senate, both Democrats and Republicans, have held hearings, however, on the cost of diabetes drugs and other pharmaceuticals during which patients spoke about rationing of their medications to save money.

In a statement, the Pharmaceutical Research and Manufacturers of America wrote that the industry already is working with Medicare’s drug program, Part D, to lower costs.

“The fact is there is already robust negotiation in Part D with plans negotiating discounts and rebates directly with manufacturers, resulting in an average rebate in Part D of 35 percent. In fact, [the Congressional Budget Office] has repeatedly said that the Secretary of Health and Human Services would not be able to secure lower prices than are already achieved through current negotiation without jeopardizing patient access to medicines by reducing choice and restricting coverage.”

There will be action, Cummings insisted after the Catonsville press conference. He said he’s been working behind the scenes with Health Secretary Alex Azar and congressional Republicans, though they have not yet reached a consensus.

Vincent DeMarco, president of the Maryland Citizens’ Health Initiative, said Maryland lawmakers decided to take their own steps this year. A bill passed the Maryland General Assembly that would create a Prescription Drug Affordability Board. It authorizes the board to determine ways to control high drug costs, including capping drug prices in state and local government health plans, but to limit spending the board would need further approval from a legislative panel.

Others at the event — public officials, a seventh-grader and a doctor — all spoke about the human toll of high drug prices.

Dr. Sherita Golden, endocrinologist and Johns Hopkins professor of medicine, said she has learned that patients aren’t taking their medications — not because patients have told her, but because tests reveal to her that their blood sugar is no longer controlled. She said she’s forced to prescribe cheaper but less effective medications that don’t control complications as well, jeopardizing patient health and increasing costs over time.

Patients use a variety of drugs to regulate their blood sugar and stave off complications including heart disease, stroke, kidney failure and blindness, according to U.S. Center for Disease Control and Prevention. The American Diabetes Association reported that diabetes contributed to 277,000 deaths in 2017. About 30 million people have diabetes, including more than one in four seniors.

The synthetic insulin in use for the past 30 years is primarily made by three companies: Sanofi, Eli Lilly and Novo Nordisk. The report found that in the past two decades manufacturers have raised prices on insulin products more than tenfold, often in lockstep.

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