April 02,2019

Grassley, Wyden Question Role of Middlemen in Skyrocketing Insulin Prices

WASHINGTON – U.S. Senate Finance Committee Chairman Chuck Grassley of Iowa and Ranking Member Ron Wyden of Oregon today sent letters to Cigna Corporation (Express Scripts), CVS Health Corporation and Optum, the three leading pharmacy benefit managers (PBMs), regarding their role in the skyrocketing cost of insulin in the United States.
Last month, the senators sent letters to Eli Lilly, Novo Nordisk and Sanofi, the three largest insulin manufacturers in the United States, kicking off their bipartisan investigation into insulin prices.
In their letters today to the PBMs, the senators wrote, “while manufacturers set the list price for insulin, pharmacy benefit managers (PBMs) play a critical role in the pricing of insulin on which people living with diabetes depend…As the primary negotiators for government payers, commercial insurers and individual employers, PBMs are in a unique position to leverage their size to lower drug prices.”
“As consumers face rising bills at the pharmacy counter, it is unclear whether PBMs are appropriately leveraging their power for the benefit of taxpayers and patients, especially patients who take multiple or high-cost medications,” the senators continued.
The letters are seeking information and documents related to PBMs’ business relationships with insulin manufacturers, public insurance programs and private insurance plans, as well as pharmacies. The letters also seek information about how PBMs determine the size of rebates and which drugs are available on formularies. Finally, the senators seek information about the types of patient health information that PBMs collect, evaluate and maintain, and how that information is utilized and protected.
The Centers for Disease Control and Prevention (CDC) estimate that more than 30 million Americans have diabetes. On January 29, the Finance Committee held a hearing on drug pricing and witness Kathy Sego testified that her son, worried about the financial burden that the monthly $1,700 cost of insulin was having on his parents, began rationing treatment at the sacrifice of his health.
The Senate Finance Committee is tasked with oversight of Medicare and Medicaid, which are administered by the Centers for Medicare and Medicaid Services (CMS).
The letter to Cigna Corporation (Express Scripts) can be found HERE.
The letter to CVS Health Corporation can be found HERE.

The letter to Optum can be found HERE.