Background
Congressional oversight has recently fixated on exorbitant inflation in insulin costs – such extreme and consistent price increases over many years that even reasonably insured patients may experience access issues. This is a critical concern for US public health, as estimates by the American Diabetes Association (ADA) suggest that approximately 8.4 million Americans with diabetes rely on insulin.
Contributing factors to the insulin pricing phenomenon are sufficiently convoluted that even industry insiders may be unclear on how and why insulin prices are what they are. Confidential discounts and classified rebates among pharmaceutical manufacturers, health insurers, and pharmacy benefits managers (PBMs) obfuscate the picture. In 2023, growing public outcry for transparency and fair pricing drove government action in the form of several key policy reforms.