DOCTORS ' LOUNGE
DOCTORS ' LOUNGE
SPEAK YOUR MIND If you would like to respond to an article in this issue , please submit an article or letter to the editor . Contributions may be sent to editor @ glms . org . The GLMS Editorial Board reserves the right to choose what will be published . Please note that the views expressed in Doctors ’ Lounge or any other article in this publication are not those of the Greater Louisville Medical Society or Louisville Medicine .
IT ’ S ABOUT TIME !… IT ’ S ABOUT PRICE !
The astronomical price of insulin has killed Americans - including those with health insurance - who cannot buy it … and food , and gas , and pay LG & E and the Water Company and get schoolbooks and baseballs and phone bills and clothes . So they give up insulin and if lucky , acquire only ever-higher medical bills while surviving their DKAs . The unlucky and sickest simply die - young adults on their own , especially .
Finally , there is hope for a partial solution at hand via Congress , while a better one all-around from Civica Rx is on the horizon : but Civica Rx can help only its partner health systems .
Civica Rx was founded in 2018 , initially to save the supply of injectable generic drugs that hospitals desperately need , like vancomycin , the anti-Staph aureus antibiotic . 1 The manufacturing of these drugs had shifted to overseas operations with very few mainland U . S . companies still in business . Shortages still abound , meaning people otherwise expected to live through an illness , may not . Brand name alternatives can bankrupt hospitals and also throw secondand third-line drugs ( that should always be held in reserve for only super-resistant germs ) prematurely and unwisely into the breach . Civica Rx therefore began to manufacture its own supplies of these medicines and has succeeded in maintaining a sort of stockpile .
Civica Rx has around 55 partner health systems ( none here unless the generic name Baptist Health includes ours ) who can more cheaply obtain all sorts of medicines . Semglee , 2 the first generic insulin substitute for long-acting insulin glargine ( Lantus , etc .) is still priced at only 5 % below the name brands , because pharmaceutical companies continue to rake it in while hiding behind the banner of “ Need Money for Research .” Civica Rx took one look at Semglee ’ s offer and quoted General McAuliffe from the Battle of
AUTHOR Mary Barry , MD the Bulge : “ Nuts !”
Last month , Civica Rx put out its plan to manufacture and sell biosimilars for the three main types of insulin : aspart , lispro and glargine , all at the same wholesale price , on identical terms . For instance , five pens of glargine will be $ 55 or less . 2 Lantus is currently listed at $ 425 for comparing to $ 404 for Semglee brand and $ 148 for unbranded Semglee - which is NON-formulary for the three largest pharmacy benefit managers ( if they don ’ t sink you , they ’ ll at least strand you ).
It will take until at least 2024 to gear up the manufacturing , packaging and distribution , etc .
In the meantime , we have the U . S . House Bill from Rep . Lucy McBath ( D-Marietta , Ga .) et al ., The Affordable Insulin Act , which passed unanimously from her side and got 12 GOP votes as well . 3 It will need at least 10 Republican votes to pass the Senate ( plus Senators Manchin and Sinema ) and avoid filibuster . It caps the cost of an insulin prescription at $ 35 - if you have insurance . The Kaiser Family Foundation thinks it will help one in five Americans who take insulin .
There ’ s another bill which has failed to advance in the Senate which is an extensive makeover of drug pricing , and includes helping the uninsured with the cost of insulin . However , it ’ s inside the climate action bill . One of its critics in the house , Rep . Cathy McMorris Rodgers , said only , “ This is not the right bill ” without advancing details , reminding me of the “ No Way No How ” approach that has characterized the current Senate leadership .
Could Civica Rx help our community more ? Have our hospital systems ever studied them in depth ? I am not privy to such discussions , but I do wonder .
On another government front , the White House announced in
late March that we are running out of COVID-19 money and that ( continued on page 30 )
MAY 2022 29