ADA suggests ways to improve insulin affordability

The American Diabetes Association calls for increasing transparency across the entire supply chain, streamlining the approval process for biosimilars, lowering or removing patient cost-sharing, and increasing access to health care coverage for people with diabetes.

The American Diabetes Association (ADA) released recommendations for improving insulin affordability in a May policy paper.

The ADA's four recommendations outlined in “ADA Public Policy Statement: Insulin Access and Affordability” include increasing transparency across the entire insulin supply chain, streamlining the approval process for biosimilar insulins, lowering or removing patient cost-sharing for insulin, and increasing access to health care coverage for all people with diabetes.

The ADA concluded that there is a lack of transparency throughout the insulin supply chain after in-depth discussions with manufacturers, wholesalers, pharmacy benefit managers, health plans, and pharmacies. The association also noted that it is unclear precisely how the dollars flow through the supply chain and how much each intermediary profits. “Without additional information about insulin pricing and patient costs, it is difficult to prescribe long-term, sustainable solutions that will address the underlying systemic problems,” the report stated.

While biosimilar alternatives to insulins might lower prices, the ADA report stated, they lack FDA approval. The FDA recently announced that it will expedite review of applications for biosimilars, including one type of insulin that is off-patent but has no alternative versions available. “The ADA recommends the FDA continue its efforts to encourage additional competition within the insulin landscape, including fostering biosimilar competition,” the report said.

The ADA also recommends that the government and private insurers cover insulins without cost-sharing. “At minimum, we recommend insulins not be subject to a deductible nor co-insurance, since this exposes people with diabetes to high list prices, often creating financial barriers to accessing the medicine. If cost-sharing is imposed for insulins, it should be a flat dollar amount, which can be more manageable and consistent for consumers,” the report said.

Finally, the ADA made multiple recommendations on ways to increase access to health care coverage, ranging from expanding Medicaid to offering patient communication tools.