News

Prime Therapeutics Finds Big Uptick In Costs For Diabetes Care

The price of insulin and other items increased sharply.

Eagan-based Prime Therapeutics is reporting that insulin costs for patients with diabetes increased 80 percent over four-and-a-half years. A separate study found that insulin use among diabetic patients has spiked 50 percent over the same period, from January 2011 through June 2015.
 
Prime Therapeutics also found that the cost of all drugs for diabetes increased 168 percent during the same time period for the patients that were studied. The study analyzed 4 million of its members
 
Prime Therapeutics is a pharmacy benefits manager for customers including health plans, employers and government programs including Medicare and Medicaid. Prime Therapeutics serves nearly 26 million members across the U.S. The organization undertook the study to gauge the current costs of insulin therapy as part of its broader goal of containing health care costs.
 
“Gaining a deeper understanding of provider prescribing and member behavior in the diabetes category is important as Prime works to control drug and overall health care costs,” said Kevin Bowen, principal health outcomes researcher for Prime Therapeutics. The pharmacy benefit manager is pushing for greater use of generic drugs.
 
The patent for Lantus, which has been the most commonly used, long-acting insulin, expired in February 2015, which brings lower-cost generic options to the market. But the debut of one of those new drugs, Basaglar, has been pushed to December 2016, per the settlement in a patent infringement lawsuit.
 
The privately held Prime Therapeutics is a for-profit company owned by 13 nonprofit Blue Cross and Blue Shield plans and subsidiaries and affiliates of those plans. The company had revenue of $4.36 billion for 2015.
 
Diabetes is the seventh leading cause of death in the United States, according to the Centers for Disease Control. Nearly one in ten Americans is estimated to have diabetes. A 2012 study from the American Diabetes Association on the economic costs of the disease estimated that a patient with diabetes pays 2.3 times more for medical expenses than someone who does not have diabetes. 
Newsletter Sign Up