What lower insulin costs mean for other drug price fights

Transcript

NIALA: Good morning! Welcome to Axios Today!

It’s Thursday, March 2nd.

I’m Niala Boodhoo.

Here’s what we’re covering: the FAA investigates more near-collisions at U.S. airports. And, TikTok sets limits for its youngest users. But first, one drugmaker cuts insulin costs… what that could mean for future drug price fights. That’s our One Big Thing.

One drugmaker cuts insulin costs

NIALA: Pharmaceutical giant Eli Lilly announced yesterday it’s slashing the price of insulin and capping out-of-pocket costs for patients at $35 a month at most retail pharmacies. The company says the generic insulin Lispro will now cost less than it did in 1999. The move comes after Eli Lilly faced criticism from both the Biden administration and consumers for years of price hikes. Axios’ Senior Healthcare Editor Adriel Bettelheim has more. Hi Adriel.

ADRIEL BETTELHEIM: Hi. Nice to be with you.

NIALA: Adriel, the exorbitant price of insulin has been a hardship on many patients for years. What finally pushed Eli Lilly to decrease their prices?

ADRIEL: Well, there's been a drum beat of calls, most recently, President Biden and the State of the Union address, but, uh, efforts in Congress too, to cap out-of-pocket insulin costs. And, last year the Democrats succeeded in the inflation reduction act by capping it at $35 a month, out of pocket for Medicare recipients. But now, the push is to extend it further to the commercial market. So I think they kind of took stock of which way the, the winds are blowing and these many, you know, studies showing that more than a million American adults are rationing insulin because of its high costs. And I think they decided this was the time to make a concession.

NIALA: Are other insulin producers expected to follow suit?

ADRIEL: We haven't heard yet. Sanofi and Novo Nordisk are the two other big ones in this country with Eli Lilly. They are set to control about 90% of the markets. So, Biden and others on Capitol Hill are now urging the other major manufacturers to follow suit. So we'll see.

NIALA: More than 8 million Americans depend on insulin. Why else has this been such a big issue for them?

ADRIEL: I think the costs out of pocket. The fact that this drug has been around for decades, and yet the prices, uh, have been ticking up. In a bigger sense, insulin has sort of become a proxy for bigger frustration with rising drug costs. People take all sorts of medicines. There's some widely prescribed blood thinners and statins and such. Um, but I, I think insulin is, it's just sort of this visceral thing. It's very much a life or death situation. And I, I think, you know, occasionally in these health policy debates, you get sort of a, a cut through moment like this where, you know, it's a real pocketbook issue.

NIALA: Could we see other companies following suit outside of those who were producing insulin?

ADRIEL: Well, I mean there's some who say, this is a moment, you know, that could kick off some momentum and it could get policy makers to, look at other widely used prescription drugs, and it could spur a discussion about the cost, the government, insurance companies and patients are, are paying for those drugs. The question is, do you sort of publicly shame companies into voluntarily cutting prices or do you have to do the tough work and actually write legislation. Republicans certainly don't want Biden to take credit for reducing cost any further, and the opportunities for agreement may not really be there, especially as we get closer to the presidential election.

NIALA: House Republicans announced yesterday they're opening an investigation into how pharma middlemen are affecting drug prices. Could this result in further regulation around high drug prices?

ADRIEL: Well, I think the drug companies would like the focus to be on other players in the drug supply chain. And they say these pharmacy benefit managers who negotiate the formularies are, are some of the main culprits behind the price increases that are upsetting people. So, some Republicans are adopting that line and taking a harder look at the PBMs. I think it probably confuses the debate a little bit and might make it a little bit harder to, to come up with a one shot solution. But it also does give people a bigger appreciation of how complicated it is where you have insurers and middle people and the drug manufacturers and it's, it's quite an elaborate process.

NIALA: Adriel Bettelheim is a senior healthcare editor for Axios. Thanks Adriel.

ADRIEL: Thanks so much.

NIALA: In a moment, a reality check on recent airplane near-disasters.

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The FAA investigates more near-collisions at U.S. airports

NIALA: Welcome back to Axios Today. I'm Niala Boodhoo.

There have been two more near collisions at U.S. airports in the last couple of weeks, Boston's Logan International and the Hollywood Burbank Airport. The FAA is investigating both. And if this sounds familiar, it's because there's been a number of similar stories lately.

Axios’ Editor Alex Fitzpatrick, who's actually also a pilot, has more on what's going on and whether there's a serious cause for concern for airline passengers or the industry. Hey, Alex.

ALEX FITZPATRICK: Hey, thanks for having me on.

NIALA: So how common are these near misses typically?

ALEX: They're uncommon, but not entirely unheard of. I think a little bit of what's happening right now is that because there have been a, a handful in the past few weeks and months, uh, the media, including us, you know, we're on high alert for this kind of thing, and so they're getting more headlines than they usually do.

NIALA: You're actually a pilot of small planes, I should clarify, but what are the processes involved in takeoff and landing, and where are we seeing issues in these most recent incidents?

ALEX: Sure. So a lot of these incidents can be boiled down to miscommunications or misunderstandings between pilots and air traffic controllers. Any pilot, whether it's me in a small Cessna or somebody in a 747, gets a clearance from air traffic control. The air traffic controller will tell them, you know, hey, you're cleared for takeoff on runway 33, or line up and wait on runway 33, which means exactly what it sounds like.

You're not allowed to take the runway until you get a clearance like that. In at least one of these cases, the Boston Logan Case, uh, one pilot very clearly did not get permission to take off. They got the lineup in weight command or, or instruction. Uh, and they, they started of taking off anyway, which forced an incoming JetBlue flight to, to go around.

NIALA: The FAA is investigating these, what's the FAA's role in all of this? Especially after they recently said there was a safety call to action to prevent these things from happening.

ALEX: So the FAA is chiefly responsible for safety in the national airspace system. they, along with the NDSB are gonna look at every incident like this, even though it didn't cause, and there are no actual accidents. They wanna look at everything. That almost could have become an accident to learn from it.

And figure out, okay, what rules can we put into place? What processes can we put in place? What additional training can we do to make sure that none of these happen again in a way that might actually develop into a real accident?

NIALA: This has been a pretty chaotic time in the airline industry generally. There's been just a lot of bad headlines about delays and cancellations. Is any of that related to this?

ALEX: It's really hard to say that, uh, at the moment. It's, that would really be conjecture until we understand, you know, the NTSB’s, uh, investigations are done and that kind of thing. That being said, you know, it is busy. Uh, people are flying a lot more. You've had, you know, controllers and pilots come on board who, you know, maybe first started during Covid when things were a little bit slower and now they're sort of learning how to do their jobs in a much busier, more complicated environment. Uh, and so that could be contributing, but it's really difficult to say that with any degree of certainty at this point.

NIALA: Obviously these stories are pretty scary, but I wonder if you can offer a reality check for us, because statistics show that air travel is significantly safer than, for example, driving in a car. Should these incidents change how we think about airline safety?

ALEX: I don't think it should stop anybody from traveling on an airplane at this point. The number of these that happen per year is still fairly small. And, look, we've had all of these incidents in the past, few months and or weeks.

But in every single case, you know, some pilot in the situation realized, hey, something's not right here. I'm gonna do a go around. I'm gonna sort of do what I need to do to keep everything safe. So basically, tthe way that aviation safety works is sort of the Swiss cheese model. And so when there's an actual accident, it's often because there are these layers of safety that are placed, you know, between each other and something got through each one of those holes in the Swiss cheese, right?

In this case, a Swiss cheese model works. Some, somebody along the way figured out, okay, something's not right here, I'm gonna do what I need to do to sort of stay safe. Uh, so if there's anything positive to take away, it’s that.

NIALA: Alex Fitzpatrick is an Axios editor based in Albany. Thanks Alex.

ALEX: Sure. Thanks for having me on.

TikTok sets limits for its youngest users

NIALA: One final headline for you before we go…

TikTok says it’s setting a daily 60-minute time limit for all its users under the age of 18. They will have to enter a passcode in order to watch more than an hour of content. TikTok says this will require users to “make an active decision to extend that time.”

For users under 13, a parent or guardian will need to enter a passcode to enable 30 minutes of additional watch time. The new screen-time limit is set to be rolled out in the coming weeks.

Meanwhile… on Capitol Hill a House committee voted to advance legislation that would make it easier to ban TikTok in the U.S. This comes as bipartisan concerns grow over the app's Chinese ties. We’ll keep an eye on this story.

NIALA: That’s it for us today! I’m actually not on TikTok. But, you can reach out to me on Twitter or Instagram. Or you can text me at (202) 918-4893.

I’m Niala Boodhoo - thanks for listening - stay safe and we’ll see you back here tomorrow morning.