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Insulin costs increased 600% over the last 20 years. States aim to curb the price

STEVE INSKEEP, HOST:

The price of gas has gone back down in recent weeks. The price of insulin remains very high. Leading manufacturers have increased prices by more than 600% over the last 20 years. Many diabetes patients ration this lifesaving drug. So who's helping? NPR's Allison Aubrey is here to look at state and federal efforts.

Good morning.

ALLISON AUBREY, BYLINE: Good morning, Steve.

INSKEEP: OK. First, the federal level. Congress recently passed the Inflation Reduction Act, as it was called. And it did include some prescription drug provisions. Does that help?

AUBREY: Yes. It will help Medicare patients. There will be a new cap on out-of-pocket costs for them. But among the other roughly 80% of Americans, there are many families struggling to afford insulin.

I spoke to Clayton McCook in Edmond, Okla. His 14-year-old daughter Lily has Type 1 diabetes. And due to their very high deductible health plan, they pay thousands of dollars out of pocket each year. He says he's very angry that pharmaceutical companies can price a vial of insulin at about $300 when it only costs about $6 to make.

CLAYTON MCCOOK: I could go to Canada right now and get my daughter's insulin, the same exact drug, for 35 to $40 a vial because the Canadian government says this is it. This is the most you can charge. They're still making a profit at that price. They're still making a handsome profit. This is a very visceral thing for me. Without insulin, my daughter will die.

AUBREY: He says her financial future is threatened by these high prices, and his family is not alone. About 30 million people in the U.S. are diagnosed with diabetes. About a quarter require insulin. And McCook, who's now an advocate with the group Patients for Affordable Drugs Now, says if there's not more action in Washington, D.C., to fix what he says is a broken system, he points to momentum at the state level.

INSKEEP: Well, let's talk about that. What are states doing?

AUBREY: Well, about 20 states have passed laws or programs to limit the amount patients pay for insulin. But I'd say the boldest initiative is in California, where they are looking to completely overhaul the system. Instead of buying insulin from the big pharmaceutical companies, such as Eli Lilly and Novo Nordisk, they want to make their own insulin. Governor Gavin Newsom has said that nothing epitomizes market failures as much as the cost of insulin.

I spoke to Dr. Mark Ghaly. He's secretary of the California Health and Human Services Agency.

MARK GHALY: The cost of actually creating the insulin that makes a difference in people's lives is not nearly as much as what people are paying for it. California is looking at, what approach can we take to make sure what people pay for it is as close to the actual cost of creating it as a possible? So we are looking for partners.

AUBREY: Earlier this summer, state lawmakers approved a hundred million dollars for the project - 50 million for a manufacturing facility and 50 million to bring so-called biosimilar insulin products to market. These are akin to generic versions of existing drugs.

INSKEEP: I would presume that pharmaceutical companies have charged so much for insulin because there is some difficulty in making it, and they have a product that is of limited supply. Can the state simply wade in and make a generic?

AUBREY: Well, not quite yet, but Californians are not the only ones thinking about this. Civica Rx is a nonprofit generic drug company that started back in 2018. They're already in the process of developing three biosimilar insulin products that they say will cost no more than $30 a vial. So Civica Rx could be a partner for California. I spoke to Civica's Allan Coukell.

ALLAN COUKELL: Our timeline is to bring the first of those three insulins to market in 2024. We're working with the FDA now as we move through the development process.

AUBREY: He says the agency would need to authorize these insulin products, and he's optimistic that this can happen.

COUKELL: One of the great things about Civica is that we're a mission-driven nonprofit. Our goal here is to reduce costs for patients.

AUBREY: And if all goes as planned, Steve, this could usher in much cheaper insulin for millions of Americans.

INSKEEP: Yeah, 30 bucks instead of 300 - that's a difference for a lot of people.

Allison, thanks.

AUBREY: Thank you, Steve.

INSKEEP: NPR's Allison Aubrey.

(SOUNDBITE OF THE PUTBACKS' "SNAKE EYES") Transcript provided by NPR, Copyright NPR.

Steve Inskeep is a host of NPR's Morning Edition, as well as NPR's morning news podcast Up First.
Allison Aubrey is a correspondent for NPR News, where her stories can be heard on Morning Edition and All Things Considered. She's also a contributor to the PBS NewsHour and is one of the hosts of NPR's Life Kit.