Lower Cost Insulin May Be A Lifeline For Thousands Of Southern California Diabetics Struggling With High Costs Of Treatment

Drug giant Eli Lilly will cut the price of some of its insulin products later this year. That could make the life-saving drug affordable and accessible to more diabetic Angelenos.

The high cost of insulin has been the focus of increasing criticism from lawmakers, patients, patient advocates and others who question how the drug so many depend on went up 600% price in the last two decades. That high cost is why the state of California has said it plans to explore making its own cheaper insulin.

Dr. Don Garcia is medical director at Clinica Romero, a federally qualified health center in Los Angeles County whose patient population is primarily Latino.

“Access to care is not just having access to a medical provider,” Garcia said, explaining patients must also be able to access “medical therapeutic interventions,” such as insulin. To do that, the pharmaceutical drug must be on the list of generic and brand-name prescription drugs covered by a specific health insurance plan, known as a formulary.

Garcia hopes the Eli Lilly insulin products will be added to the list of pharmaceutical drugs covered by programs such as L.A. County’s My Health, making them available to those patients.

Why that access is so important

“At our clinic sites we have about 4,000 diabetic patients, and about 30% of them are uncontrolled. That means their diabetes is not at an acceptable level,” Garcia said.

He said the gap between those diagnosed and those on effective treatment regimens underscores the “urgency to get access as soon as possible on the formulary.”

If a drug isn’t covered by insurance, he explained, it may be out of reach for a patient who needs “these therapeutic interventions available in order to gain better control of their diabetes.”

The majority of California residents have health insurance that includes coverage for prescription drugs such as insulin. But unfortunately, that doesn't ensure they can afford the specific drugs their doctors want to prescribe for them. Most of Garcia’s diabetic patients do not use Eli Lilly insulin products because they are too expensive.

“This is a tremendous impact in the right direction supporting our marginalized communities who do not have the type of benefit access to the formulary either because of the expense of these products or the copayment,” Garcia said.

Even though the price drop will take months, Garcia is hopeful it will expand access.

That’s because having more options for affordable prescriptions helps doctors control the blood sugar level in diabetic patients — who otherwise might suffer serious complications such as loss of limbs or blindness. When those complications take place, Garcia said it costs the health care system more money, costs that ultimately are passed on to consumers.

Additional factors at play

Insulin isn’t the only pharmaceutical drug cost people with diabetes incur. Diabetic care often involves other medications used to protect organ systems and reduce hypertension and other comorbidities.

There are different types of insulin, including long- and short-acting insulin. Not everyone can use the same type or brand.

Garcia is concerned about how long the lower price could last.

“How long are the manufacturers gonna cooperate and be able to maintain access?” he said. “How long will our patients be able to have access to the diabetic insulin?”