Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, 3609 Forbes Ave., 2nd Floor, Pittsburgh, PA, 15213, USA.
Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.
Curr Diab Rep. 2020 Jan 29;20(1):2. doi: 10.1007/s11892-020-1286-3.
High insulin prices and cost-related insulin underuse are increasingly common and vexing problems for healthcare providers. This review highlights several factors that contribute to high prices and limited generic competition in the US insulin market.
An opaque and complex pricing and reimbursement system for insulin, allegations of collusive practices by insulin manufacturers, and a lack of generic competition drive and sustain high insulin prices. When combined with increasing insurance deductibles and cost sharing, these factors contribute to cost-related insulin underuse and are associated with adverse clinical outcomes. Healthcare providers facing patients with type 2 diabetes who struggle to afford insulin should consider initiating or switching from analogue to human insulin as one way to help address the challenges of access and affordability. However, it is also important to support initiatives to advocate for affordable pricing for insulin for patients who can benefit from the flexibility offered by many of the newer insulin preparations.
高胰岛素价格和与费用相关的胰岛素使用不足，是医疗保健提供者越来越常见和棘手的问题。这篇综述强调了美国胰岛素市场中导致高价格和有限仿制药竞争的几个因素。
胰岛素定价和报销系统不透明且复杂，胰岛素制造商存在共谋行为的指控，以及缺乏仿制药竞争，这些因素推动并维持了高胰岛素价格。当与不断增加的保险免赔额和费用分担相结合时，这些因素导致了与费用相关的胰岛素使用不足，并与不良的临床结果相关。面临因负担不起胰岛素而挣扎的 2 型糖尿病患者的医疗保健提供者，可考虑从胰岛素类似物转换或起始使用人胰岛素，以帮助解决可获得性和可负担性方面的挑战。然而，支持为能从许多新型胰岛素制剂提供的灵活性中受益的患者争取胰岛素合理定价的倡议也很重要。
