What’s With Amazon Prime’s Discounts on Insulin?
Amazon launched its online pharmacy this week, a long-awaited move that many believe will disrupt the traditional retail pharmacy space. With outlets like the Associated Press touting the brand’s new foray into selling “insulin and inhalers,” some are left with the impression that Amazon Pharmacy will somehow make insulin more affordable. The major draws offered by the company are discounts on drugs for Amazon Prime members who don’t have health insurance.
However, the savings for uninsured diabetics are likely to be disappointing. The discounts offered to Prime members on some insulins appear to be proffered through InsideRx, a drug coupon company that works with many existing pharmacies. Diabetes Twitter was also quick to notice that discounts were seemingly applied to higher than normal list prices on some insulins, like Novolog and Tresiba, giving the impression of giant savings, but still costing pretty much the same price you’d get at a brick and mortar.
For example, Amazon Pharmacy lists a 10 ml vial of Tresiba at $572, whereas brick and mortar retailers featured on GoodRx list the same for around $405. Prime members get a 39% discount, rendering the price $349 — pretty much the same price you can find at brick and mortars with coupons available through companies like GoodRx and other coupon services.
Amazon facing backlash over inflated list prices would not be totally new. In 2017, the FTC was said to be reviewing the practice after receiving complaints from the group Consumer Watchdog. The company also faced a class action lawsuit in California that the court ultimately dismissed and sent to arbitration, citing Amazon’s conditions of use.
Still, getting your prescriptions delivered straight to your door during this pandemic might be an attractive option to some people with diabetes — and indeed the only option for some people with disabilities. But many retail pharmacies already offer that service. Plus, it remains to be seen how Amazon’s customer service stacks up when compared to the first-name basis some people with diabetes end up on with their local pharmacists, especially given the maze of prior authorizations and insurance company antics that we’re regularly subjected to.
Are you switching to Amazon Pharmacy? I’d love to hear about your experience. >>> theshotnewsletter@gmail.com
Biden Appoints Ex-Lilly Lobbyist Steve Richetti to Transition Team
President-elect Biden has selected Steve Richetti to join his transition team as a counselor to the President. Richetti is a former lobbyist for clients including Eli Lilly, Sanofi, the American Medical Association, and Blue Cross Blue Shield. Richetti’s lobbying firm continues to operate in the hands of his brother Jeff, leading some to consider whether Richetti should recuse himself from advising on health care issues.
Richetti has had a long career bouncing back and forth between serving in government administrations and lobbying on behalf of corporations — with a few stints as campaign advisor and bundler for Hillary Clinton and Joe Biden’s various campaigns. He’s also served on the board of the anti-single-payer Center for American Progress. (See: David Dayen’s extensive profile of Richetti.)
The appointment raises serious questions about Biden’s willingness to deliver on promises to lower the cost of prescription drugs. As one former Lilly lobbyist, Alex Azar, exits, so enters another.
The Hill’s Diabetes and the Future of Health Care Reform: A Review
On Wednesday, the Hill hosted “Diabetes and the Future of Health Care Reform,” a livestream sponsored by the Diabetes Leadership Council and the Diabetes Patient Advocacy Coalition. Guests included both co-chairs of the Congressional Diabetes Caucus, along with JDRF Chief Mission Officer Cynthia Rice, Kelly Close, a health care consultant and founder of diaTribe (streaming live from atop her moving treadmill), and a few other leading voices in the diabetes-verse.
The livestream was a typical example of a problem that many in the #Insulin4All community worry about — that the big name organizations entrusted to represent the interests of people with diabetes may be just as likely to represent the interests of their corporate sponsors.
On its surface, it was an opportunity for the Diabetes Leadership Council (DLC) to promote their recent Consensus Statement on U.S. Health Care Reform for People with Diabetes. In general, the statement’s list of recommendations focus on expanding insurance coverage through the ACA, covering insulin, pumps, and other supplies pre-deductible, and passing insurer rebates through to customers. These are all reforms aimed at limiting patients’ exposure to high list prices — and some of that makes sense. But they do not reform the process by which pharmaceutical companies determine their prices in the U.S.. Unsurprisingly, the DLC is sponsored by all three major insulin makers and a handful of other pharmaceutical companies.
In my opinion, the dissonance between reality and the kind of conversation on this livestream was intense. Imagine a world where the interests of industry and patients are completely aligned. Democrats who care about people with diabetes get along great with Republicans who feel the same way, and they’ll be able to work across that famous aisle to deliver for their diabetic constituents. Sounds lovely, right?
But off screen, there are merciless power struggles at play. Just as members of the Republican Party in real time attempt to undermine the legitimacy of the recently elected Democratic Party president, pharmaceutical companies are waging their own battle to protect their shareholders’ winnings — suing states over hard won patient-led reforms and pulling out of community health center programs for the poor. And patients, for their part, are fighting to keep each other alive.
For instance, later that night, Diabetes Twitter was scrambling, lit up with #Insulin4All activists trying to cobble together enough money to buy a stranger in Ohio some insulin so that they would have some more when they would soon finish rationing their very last vial. But while the community sprints into action, the pharma-funded organizations and Congressional Diabetes Caucus aren’t on that journey with them. Any steps they’ve taken so far seem to have gotten us no closer to ending insulin deprivation than if they were just walking on a treadmill.
Small doses
The Colorado Attorney General’s office conducted a survey as per the state’s 2019 insulin copay cap law, finding that more than 40% of respondents ration their insulin at least once a year.
Eli Lilly and Swiss device company Ypsomed have announced an exclusive agreement on a new insulin pump, using Lilly-brand pre-filled insulin cartridges. They’re hoping to get FDA clearance in 2022.
NYInsulin4All is working to get Gov. Andrew Cuomo to request and sign a bill recently passed by both state legislative bodies (in near unanimity). The bill allows emergency refills and sets the stage for an insulin assistance program similar to an existing program for HIV drugs.
Insider NJ: Vitale, Pou, Sweeney Bill to Limit Copayments for Insulin Advances
New Jersey lawmakers look to pass a copay cap on insulin.
Windsor Star: Local diabetic with vision loss pushing for improvements to insulin pumps
A Canadian diabetic is working to improve visual accessibility in insulin pumps.
Cato Institute: Insulin & Disobedience
The Cato Institute, a Koch-funded libertarian think tank, calls for an end to insulin prescription requirements.
Othering and Belonging Institute: Community-based Insulin | Othering & Belonging Institute
Nicole Foti’s paper examines the potential impact of projects like the Open Insulin Project.
That’s all for this week’s Shot. You were so brave. Have a lollipop.
Remember, my inbox is always open for feedback, ideas, and tips at theshotnewsletter@gmail.com.
-Emily Pisacreta