Erratum. Insulin Access and Affordability Working Group: Conclusions and Recommendations. Diabetes Care 2018;41;1299–1311

Cefalu, William T.; Dawes, Daniel; Gavlak, Gina; Goldman, Dana P.; Herman, William H.; Nuys, Karen Van; Powers, Alvin C.; Taylor, Simeon I.; Yatvin, Alan L.

doi:10.2337/dc18-er08

Cited by 7 publications

(2 citation statements)

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“…This gap suggests that the pharmaceutical companies that manufacture insulin are not the main beneficiaries of list price increases, and that other actors in the insulin supply chain may have an important role to play in increasing the price of insulin. The data show that the compound annual growth rate (CAGR) for the list prices of Novo Nordisk's NovoLog and NovoLog Flexpen have been in the range of 9.8-9.9%, while the CAGR for the net prices received by the manufacturer increased at a CAGR of 0.2-2.1% (Cefalu et al, 2018a(Cefalu et al, , 2018b. The Wall Street Journal similarly reported in 2016 that while the net price of Sanofi's Lantus had increased more or less in parallel with the list price from 2007-2013, the net price growth rate decreased between 2014 and 2016 (Loftus and Roland, 2016).…”

Section: Do Insulin Manufacturers Benefit From List Price Increases?mentioning

confidence: 99%

Profits, Innovation and Financialization in the Insulin Industry

Collington

2020

INET Working Paper Series

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The list prices of analogue insulin medicines in the United States have soared during the past decade. In the wake of high-profile cases of prescription medicine “price-gouging”, such as Mylan’s EpiPen and Turing-acquired Daraprim, actors across the insulin supply chain are today facing growing scrutiny from US lawmakers and the wider public. For the most part, however, the role of shareholders in the insulin supply chain has been overlooked. This paper considers the relationship between profits realized from higher insulin list prices, pharmaceutical innovation, and the financial structures of the three dominant insulin manufacturing companies, which set list prices. It shows that despite claims to the contrary, insulin manufacturers extracted vast profits from the sale of insulin products in the period 2009-2018, as insulin list prices rose. Distributions to the company shareholders in the form of cash dividends and share repurchases totaled $122 billion over this period. The paper also considers the role of other actors in the insulin supply chain, such as pharmacy benefits managers (PBMs), in the determination of list prices. The data and analysis presented in the paper indicates that financialization could be considered in tension with not only the development of new drugs that will be available to patients in the future, but also the affordability of products that already exist today.

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Section: Do Insulin Manufacturers Benefit From List Price Increases?mentioning

confidence: 99%

Profits, Innovation and Financialization in the Insulin Industry

Collington

2020

INET Working Paper Series

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“…1-3 Diabetes affects 11.3% (37.3 million) of the U.S. population, 4 with nearly 25% using insulin. 5 Despite being a high-risk medication, 6 errors in insulin prescribing are common, especially during transitions of care such as hospital discharge. 7-9 The American Diabetes Association (ADA) recommends adding or increasing insulin posthospital discharge if diabetes is uncontrolled, and especially with hemoglobin A1c (HbA1c) level >9%.…”

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confidence: 99%

Developing a Diabetes Discharge Order Set for Patients With Diabetes on Insulin

Miles,

McKnight,

Schmitz

et al. 2024

J Diabetes Sci Technol

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Background: Insulin, a high-risk medication, is prone to prescribing errors. Patients with diabetes experience higher hospitalization rates and extended hospital stays. Prescription errors, such as missing orders, inappropriate insulin type, missing instructions, and lack of appropriate intensification of insulin regimens are common issues. This project explored the use of system-based interventions and educational tools to minimize errors and improve the quality of insulin discharge regimens. Methods: A needs assessment and baseline chart review were conducted before adapting a diabetes order set obtained from the University of California, San Diego. Subsequent beta testing and broader implementation were followed by repeat chart reviews to assess the impact. Results: Providers strongly desired an insulin discharge order set, with 98% of those surveyed expressing this preference. Those who were high utilizers of the order set showed increased rates of ordering all supplies (55%), compared with pre-intervention rates (27%). However, no change was observed in the practice of intensifying insulin regimens in patients with uncontrolled diabetes upon discharge. Discussion: Insulin prescribing is prone to error. A diabetes discharge order set may improve the percentage of patients who receive necessary insulin supplies at discharge and provide educational resources to encourage appropriate insulin regimens at hospital discharge.

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Out-of-Pocket Costs of Insulin and Diabetes-Related Supplies Among Patients With Type 1 Diabetes

Julian

Liu

et al. 2021

Clinical Therapeutics

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Erratum. Insulin Access and Affordability Working Group: Conclusions and Recommendations. Diabetes Care 2018;41;1299–1311

Cited by 7 publications

References 0 publications

Profits, Innovation and Financialization in the Insulin Industry

Profits, Innovation and Financialization in the Insulin Industry

Developing a Diabetes Discharge Order Set for Patients With Diabetes on Insulin

Out-of-Pocket Costs of Insulin and Diabetes-Related Supplies Among Patients With Type 1 Diabetes

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