One fact that may surprise many is that the net price of insulin has been decreasing for years. But much to the dismay of those who depend on the drug to survive, those negotiated savings are rarely shared directly with patients — who see the list price of the drug climbing. As a result, patients with chronic conditions (like diabetes) are paying higher out-of-pocket costs. And unfortunately, PBMs’ business practices only exacerbate the situation.
PBMs — the middlemen of America’s healthcare system—are notorious for raising drug prices, and insulin is no exception. A 2018 study from the American Diabetes Association found that PBMs’ efforts to “negotiate” drug costs actually contribute to higher list prices. This system incentivizes higher list prices and larger rebates — only those discounts are not passed along to patients at the pharmacy counter, leading to higher health care costs.