The three drug companies that control the insulin market have seen their net sales climb over the past 12 years even as they have had to agree to bigger discounts, according to an Axios analysis of insulin types sold by Eli Lilly, Novo Nordisk and Sanofi.
The big picture: Drug manufacturers have largely blamed the broken insulin market — where many people with diabetes are rationing their medication — on other actors within the supply chain.
- But insulin makers have still been able to collect more money overall and retain their power over the market, Axios' Bob Herman reports.
By the numbers: Net global insulin sales, after accounting for rebates, rose by at least 80% from 2008 through 2019 for each of the big three companies.
Between the lines: Revenue is a function of price and quantity, and both have risen.
- Insulin's list prices have gone up drastically over the past two decades. List prices matter a lot for the uninsured and people with less generous health plans.
- Net prices have not increased as much, and for some insulin types they have dropped, because pharmacy benefit managers have extracted higher discounts, called rebates, in exchange for giving certain insulins preferred coverage status.
- The growing prevalence of diabetes has led to higher insulin use, but outside data shows total prescriptions and daily insulin use have grown modestly over the past several years.
The intrigue: Insulin sales are rising even though many of the drugs' patents have expired.
The bottom line: Discounts and price negotiations have inconvenienced, not fundamentally hurt, insulin makers. And patients, along with the public, are footing the bills.