WEBVTT

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>> PRESIDENT JOE BIDEN SIGNED

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THE INFLATION REDUCTION ACT INTO

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LAW THIS WEEK WHICH AMONG OTHER

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THINGS PUTS A $35 CAP ON INSULIN

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PRICES.

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BUT THAT ONLY APPLIES TO

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MEDICARE RECIPIENTS LEAVING THE

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REST OF AMERICANS WHO DEPEND ON

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THE MEDICATION TO CONTINUE

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PAYING HUGE PRICES.

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JOINING US TO DISCUSS THE

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SITUATION ARE JOANNA BUSCEMI

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ASSOCIATE PROFESSOR OF

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PSYCHOLOGY AT DePAUL

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UNIVERSITY.

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AND TIMOTHY CLASSEN, A R

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ASSOCIATE PROFESSOR OF ECONOMICS

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AT LOYOLA UNIVERSITY CHICAGO.

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WELCOME BOTH OF YOU TO "CHICAGO

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TONIGHT."

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JOANNA BUSCEMI FIRST OF ALL,

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REMIND US HOW IMPORTANT INSULIN

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IS TO THE MILLIONS OF FOLKS THAT

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HAVE TO REGULATE DIABETES?

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>> IT'S EXTREMELY IMPORTANT IT'S

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LIFE-SAVING.

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AND IT IS NOT A LUXURY IT IS A

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NECESSITY.

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IT IS A HORMONE AND WITHOUT IT

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PATIENTS WITH DIABETES GET VERY

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SICK OR DIE.

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SO IT IS ESSENTIAL.

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>> AND TIMOTHY CLASSEN FILL US

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IN HOW EXPENSIVE OUT OF POCKET

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COSTS HAVE GOTTEN FOR THOSE THAT

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HAVE INSURANCE FOR INSULIN?

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>> THERE'S QUITE A BIT OF

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VARIETY ACROSS INSURANCE PLANS

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IN TERMS OF THE OUT OF POCKET

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COSTS FOR THOSE NEEDING INSULIN.

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BUT ON MEDICARE THE EVIDENCE

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INDICATES AN AVERAGE COST OF $55

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A MONTH FOR A LOT OF THOSE ON

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MEDICARE NEEDING IT.

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LOOKING AT $20 ON AVERAGE FOR

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THE AVERAGE INDIVIDUAL ON

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MEDICARE NEEDING INSULIN IN

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THEIR MONTHLY OUT OF POCKET

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COSTS.

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THIS IS A SIGNIFICANT OUT OF

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POCKET REDUCTION.

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THOSE WITHOUT INSURANCE CAN FACE

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COSTS AS HIGH AS $300 A MONTH.

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I THINK THE VARIETY OF INSURANCE

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PLANS THOSE ON HIGH DEDUCTIBLE

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PRIVATE INSURANCE PLANS COULD

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FACE HIGH COSTS TOO FOR THE OUT

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OF POCKET COSTS FOR INSULIN.

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>> THE LAW GOOD NEWS FOR THOSE

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THAT RECEIVE MEDICARE.

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$35 CAP.

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JOANNA BUSCEMI HOW MANY MILLIONS

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OF AMERICANS PAY OUT OF POCKET

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HAVE PRIVATE INSURANCE THAT PAY

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THE HIGH RATES ARE STILL OUT

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THERE?

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>> THAT IS A GREAT QUESTION.

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THERE IS BETWEEN FOUR AND FIVE

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MILLION OTHER AMERICANS WITH

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DIABETES WHO ARE NOT MEDICARE

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BENEFICIARIES.

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WHO HAVE TO PAY OUT OF POCKET OR

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THEY HAVE HIGH PREMIUMS.

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SO WHILE THIS IS A HUGE STEP IN

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THE RIGHT DIRECTION THERE'S

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STILL IMPROVEMENTS TO BE MADE

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PARTICULARLY TO CAP THE COST OF

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INSULIN FOR THOSE COVERED BY

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PRIVATE INSURANCE COMPANIES.

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>> AND TIMOTHY CLASSEN AS I

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UNDERSTAND, THE COST OF

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PRODUCING A VIAL OF INSULIN

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RANGERS FROM $2 TO $6.

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AND THE MONTHLY COST FOR

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PATIENTS ARE IN THE HUNDREDS.

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SOMETIMES WHY ARE PRICES SO

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EXPENSIVE?

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>> WELL, THAT IS A DIFFERENT

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SEGMENT THAT IS HOW PRESCRIPTION

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DRUG PRICES ARE SET.

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BUT THE NECESSITY AS SHE POINTED

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OUT OF INSULIN FOR DIABETICS

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DRIVES DEMAND FOR THE PRODUCT.

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IT IS ESSENTIAL FOR THOSE WHO

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NEED IT.

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SO IT WILL BE USED INSULIN AS AN

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EXAMPLE OF DEMANDED WHERE

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PATIENTS ARE NOT PRICE

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SENSITIVE.

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SO THAT LACK OF PRICE

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SENSITIVITY ALLOWS THEM TO RAISE

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PRICES TO THE LEVELS WE'VE SEEN.

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AND IT'S HISTORIC PRICES IS THAT

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WHEN WE HAVE INSURANCE WHO ARE

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NOT AWARE OF THE FULL PRICE OF

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THINGS.

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SO THE INSURANCE COMPANY IS

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PAYING SOMETHING FOR THESE DRUGS

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AND OUR OUT OF POCKET COSTS ARE

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A PORTION OF THAT.

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THE LACK OF TRANSPARENCY IN DRUG

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PRICING, THE ESSENTIAL NATURE OF

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INSULIN AND THE LIMITS IN THE

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MARKET FOR IT.

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THERE'S THREE MAIN PRODUCERS OF

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INSULIN THAT THEY HAVE DONE A

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GOOD JOB OF PREVENTING ENTRY

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INTO THE MARKET.

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IT ADDS UP THE ABILITY TO CHARGE

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THE PRICES WE SEE FOR INSULIN.

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>> AND JOANNA BUSCEMI YOU'VE

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DONE RESEARCH HOW DIABETES

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IMPACTS COMMUNITIES OF COLOR,

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LOW INCOME COMMUNITIES.

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HOW ARE LOW INCOME FOLKS ABLE TO

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AFFORD THESE NECESSARY COSTS

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EVERY MONTH FOR INSULIN?

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>> THEY ARE NOT.

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THEY ARE JUST NOT.

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AND OFTENTIMES THEY ARE TRYING

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TO FIND INSULIN ON SOCIAL MEDIA

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SITES.

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THEY ARE MAKING DECISIONS OF

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WHETHER OR NOT THEY CAN AFFORD

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THEIR INSULIN THAT MONTH OR BUY

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GROCERIES FOR THEIR FAMILIES.

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IT IS A HUGE PROBLEM THAT

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EXACERBATES INEQUITIES MORE

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BROADLY.

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>> AND TIMOTHY CLASSEN, I MEAN

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YOU MENTIONED A LOT OF THESE

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PRICES ARE DUE TO MARKET FORCES.

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IS THERE ANYTHING ELSE BEYOND

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LEGISLATION THAT CAN BRING THESE

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DOWN FOR MORE PEOPLE WHO AREN'T

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ON MEDICARE?

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>> POTENTIALLY THE ENTRY OF

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BIOSIMILARS INTO THE MARKET

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GENERIC ENTRY WOULD REDUCE THE

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PRICES OF DRUGS.

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THERE HAVE BEEN MASSIVE

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INNOVATIONS THAT PROVIDED

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TREMENDOUS BENEFIT TO PATIENTS.

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THE OPPORTUNITY FOR SOME SORT OF

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GENERIC ENTRY TO ALLOW MORE

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COMPETITION.

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THE BRANDED MANUFACTURERS HAVE

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BEEN OFFERING SOME PSEUDO

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GENERIC PRODUCTS AT SLIGHTLY

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LOWER PRICES BUT MORE ROBUST

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ENTRY INTO THE MARKET WOULD BE

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ONE WAY TO REDUCE PRICES.

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I THINK ONE THING TO POINT OUT

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IS THE CONCERN I HAVE IS JUST

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REDUCING THE OUT OF POCKET COSTS

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TO PATIENTS, IF THE INSURER IS

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UNABLE TO NEGOTIATE LOWER PRICES

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THAT WILL RESULT IN HIGHER

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PREMIUMS FOR THE INSURANCE

05:16.000 --> 05:18.933 align:start position:10% line:74% size:22.5%
PRODUCTS.

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THIS IS HELPFUL TO THE PATIENTS

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INITIALLY.

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BUT IF PREMIUMS GO UP TO

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COMPENSATE FOR THE LOWER OUT OF

05:23.000 --> 05:28.066 align:start position:10% line:74% size:75%
POCKET COSTS I'M NOT SURE WHAT

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BENEFIT THERE MIGHT HOPE IS

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HAPPENING.

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>> THE LAW OF UNINTENDED

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CONSEQUENCES.

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JOANNA BUSCEMI WHAT ABOUT YOU?

05:32.166 --> 05:37.666 align:start position:10% line:74% size:80%
WHAT OPTIONS ARE THERE TO REDUCE

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THE COSTS FOR FOLKS, ESPECIALLY

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LOW INCOME FOLKS WHICH ARE

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PERHAPS TURNING TO MORE RISKY

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OPTIONS TO GET THEIR TREATMENT?

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>> I THINK THE DIABETES

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COMMUNITY WANTS INSURANCE LYNN

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TO BE FREE-FOR-ALL AMERICANS AND

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SOME PEOPLE MIGHT THINK THAT IS

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A PIPE DREAM OR FAR IN OUR

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FUTURE.

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BUT LOTS OF COUNTRIES PROVIDE

05:55.833 --> 06:01.366 align:start position:10% line:74% size:52.5%
INSULIN FREE OF COST.

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AND I THINK THAT WOULD BE THE

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BEST OPTION.

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THERE'S SOME LEGISLATION THAT

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HAS BEEN INTRODUCED RECENTLY FOR

06:04.933 --> 06:12.600 align:start position:10% line:74% size:62.5%
EXAMPLE, IMPROVING NEEDED

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SAFEGUARDS OF USERS OF INSULIN

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LYNN ACT THAT FOCUSES ON CAPPING

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THE COST OF INSULIN ACROSS

06:15.600 --> 06:19.833 align:start position:10% line:74% size:77.5%
PATIENTS WITH DIABETES NOT JUST

06:17.300 --> 06:21.666 align:start position:10% line:74% size:45%
MEDICARE PATIENTS.

06:18.166 --> 06:23.033 align:start position:10% line:74% size:67.5%
SO THAT IS ONE POSSIBILITY.

06:19.833 --> 06:24.600 align:start position:10% line:74% size:75%
AND THE OTHER THING WE NEED TO

06:21.666 --> 06:26.733 align:start position:10% line:74% size:72.5%
FOCUS ON A LITTLE BIT MORE IS

06:23.033 --> 06:27.633 align:start position:10% line:74% size:67.5%
CAPPING THE COST OF INSULIN

06:24.600 --> 06:31.133 align:start position:10% line:74% size:77.5%
ITSELF AND NOT JUST FOCUSING ON

06:26.733 --> 06:32.766 align:start position:10% line:74% size:25%
THE COPAY.

06:27.633 --> 06:33.700 align:start position:10% line:74% size:67.5%
BECAUSE SOMETIMES THAT ALSO

06:31.133 --> 06:36.000 align:start position:10% line:74% size:77.5%
BRINGS ABOUT NEW CHALLENGES FOR

06:32.766 --> 06:41.033 align:start position:10% line:74% size:57.5%
PATIENTS WITH DIABETES.

06:33.700 --> 06:42.633 align:start position:10% line:74% size:77.5%
>> AND TIMOTHY CLASSEN, AS THIS

06:36.000 --> 06:44.566 align:start position:10% line:74% size:72.5%
BILL WAS BEING NEGOTIATED AND

06:41.033 --> 06:46.333 align:start position:10% line:74% size:70%
LEGISLATED, THE PROVISION TO

06:42.633 --> 06:48.833 align:start position:10% line:74% size:77.5%
KEEP CAPS ON INSURANCE LYNN FOR

06:44.566 --> 06:50.000 align:start position:10% line:74% size:77.5%
PRIVATE INSURERS WAS TAKEN OUT.

06:46.333 --> 06:52.033 align:start position:10% line:74% size:70%
IS THAT SAFE TO SAY THAT BIG

06:48.833 --> 06:55.166 align:start position:10% line:74% size:80%
PHARMA INSURANCE COMPANIES DON'T

06:50.000 --> 06:56.966 align:start position:10% line:74% size:57.5%
WANT THE CAPS IN THERE?

06:52.033 --> 06:58.666 align:start position:10% line:74% size:70%
>> A LOT OF STATES INITIATED

06:55.166 --> 07:00.166 align:start position:10% line:74% size:57.5%
CAPS ON INSULIN PRICES.

06:56.966 --> 07:02.266 align:start position:10% line:74% size:75%
ILLINOIS INTRODUCED ONE TO CAP

06:58.666 --> 07:03.766 align:start position:10% line:74% size:55%
MONTHLY SPEND AT $100.

07:00.166 --> 07:06.500 align:start position:10% line:74% size:65%
AND IT TURNED OUT A LOT OF

07:02.266 --> 07:06.833 align:start position:10% line:74% size:80%
PEOPLE'S INSURANCE PROVIDED THEM

07:03.766 --> 07:08.833 align:start position:10% line:74% size:72.5%
LOWER THAN $100 OUT OF POCKET

07:06.500 --> 07:10.133 align:start position:10% line:74% size:15%
COSTS.

07:06.833 --> 07:12.066 align:start position:10% line:74% size:70%
SOME OF IT WOULD BE HOW MUCH

07:08.833 --> 07:13.233 align:start position:10% line:74% size:72.5%
BITE WOULD A CHANGE LIKE THAT

07:10.133 --> 07:14.600 align:start position:10% line:74% size:75%
HAVE IN TERMS OF THE PRIVATELY

07:12.066 --> 07:17.466 align:start position:10% line:74% size:37.5%
INSURED MARKET.

07:13.233 --> 07:19.033 align:start position:10% line:74% size:60%
GENERIC DRUGS ON PRIVATE

07:14.600 --> 07:21.766 align:start position:10% line:74% size:75%
INSURANCE ARE A DOLLAR OR FOUR

07:17.466 --> 07:23.200 align:start position:10% line:74% size:42.5%
DOLLARS A SCRIPT.

07:19.033 --> 07:26.766 align:start position:10% line:74% size:60%
FOR THE GENEROUS PRIVATE

07:21.766 --> 07:29.866 align:start position:10% line:74% size:77.5%
INSURANCE, SUCH A CAP MIGHT NOT

07:23.200 --> 07:31.666 align:start position:10% line:74% size:70%
HAVE MUCH EFFECT BUT FOR THE

07:26.766 --> 07:34.666 align:start position:10% line:74% size:80%
UNINSURED OR THE HIGH DEDUCTIBLE

07:29.866 --> 07:36.766 align:start position:10% line:74% size:70%
HEALTH PLANS A LOT OF PEOPLE

07:31.666 --> 07:38.166 align:start position:10% line:74% size:80%
FACE HIGH OUT OF POCKET COSTS IN

07:34.666 --> 07:40.266 align:start position:10% line:74% size:80%
THE PREDEDUCTIBLE PHASE OF THEIR

07:36.766 --> 07:42.200 align:start position:10% line:74% size:25%
INSURANCE.

07:38.166 --> 07:44.066 align:start position:10% line:74% size:80%
SO THAT CERTAINLY WOULD HAVE HAD

07:40.266 --> 07:44.566 align:start position:10% line:74% size:80%
SOME EFFECT FOR THOSE WHO NEEDED

07:42.200 --> 07:46.100 align:start position:10% line:74% size:80%
INSULIN IN THE PRIVATELY INSURED

07:44.066 --> 07:46.433 align:start position:10% line:74% size:17.5%
MARKET.

07:44.566 --> 07:48.100 align:start position:10% line:74% size:65%
HOW BIG THAT IS IS HARD TO

07:46.100 --> 07:48.966 align:start position:10% line:74% size:20%
MEASURE.

07:46.433 --> 07:50.833 align:start position:10% line:74% size:60%
>> A LOT TO IRON OUT FOR

07:48.100 --> 07:51.666 align:start position:10% line:74% size:45%
DIABETES PATIENTS.