Congressman aims to break pharma’s insulin ‘pricing monopoly’ by legalizing Canadian imports

U.S. legislators have been introducing bills left and right proposing a variety of methods for bringing down drug prices. Now, Vermont's congressman is zeroing in on a specific class of diabetes medicines that he says have become far too expensive: insulin.

Rep. Peter Welch introduced a bill on Wednesday that would make it legal for patients, wholesalers and pharmacists to import insulin from Canada, and eventually from other countries with acceptable safety standards. Welch, a Democrat, announced the bill during an event at a health center in Burlington, Vermont.

"This commonsense legislation bypasses big Pharma's pricing monopoly by making available to patients safe, lower-cost insulin," Welch said in a statement. The congressman added that insulin prices "have gone through the roof and are hammering" patients.

Welch didn’t pick on any pharma companies by name in his statement, but U.S. insulin suppliers are already well aware of heightened scrutiny on their pricing in Washington. In late January, the House Energy and Commerce Committee and Oversight and Investigations Subcommittee sent letters to Sanofi, Novo Nordisk and Eli Lilly raising questions about rising insulin prices. Welch is a member of the Energy and Commerce Committee.

The two committees cited statistics from the Health Care Cost Institute and American Diabetes Association showing that insulin prices nearly doubled between 2012 and 2016, after having almost tripled in the decade before that. They asked the companies to answer nine questions, demanding that they explain, for example, the root causes of rising insulin prices and whether they had struck any deals over the last 10 years to limit the availability of generic equivalents.

Sanofi, Lilly and Novo were given until last week to respond. Spokespeople for the companies told FiercePharma they were reviewing the requests. All three companies emphasized that they have patient-access programs designed to bring out-of-pocket costs down for patients.

"A comprehensive policy solution for people with chronic diseases requires commitment from everyone in the healthcare system," a spokesman for Lilly told FiercePharma.

Sanofi CEO Olivier Brandicourt is scheduled to testify next week at a broader drug pricing hearing where the cost of insulin is guaranteed to come up. Six other Big Pharma executives are set to testify as well, including AbbVie CEO Rick Gonzalez, whose company has drawn its own fire for price hikes on its top-selling Humira.

But Welch clearly wants to make an end run around Lilly and its fellow insulin makers. If his bill were to become law, patients with valid prescriptions would be able to import low-cost insulin and have it covered by their insurance plans.

Welch’s proposal comes amid a string of similar bills that target drug pricing more broadly, including legislation introduced in early January by Senator and now presidential candidate Bernie Sanders, a Vermont Independent; Rep. Ro Khanna, a California Democrat; and Rep. Elijah Cummings, a Maryland Democrat. They proposed three drug-pricing bills, one of which would allow imports from Canada and other countries. Other ideas bandied about include tying annuity-style payments for pricey treatments like cell therapy to performance and overhauling the drug rebating system for federal health plans.

Welch’s home state of Vermont has been ahead of the curve on the drug-importation issue. Last year, it became the first state to pass a law allowing wholesalers to import drugs from Canada. The catch was that the state needed a blessing from Alex Azar, secretary of the U.S. Department of Health and Human Services, who at the time didn’t seem amenable to the idea. In fact, he called drug importation a "gimmick" that would pose safety risks to patients.

It’s not clear where President Donald Trump falls on this issue, either. Florida’s governor, Ron DeSantis, said during a press conference on Wednesday that he wants to legalize the importation of drugs from Canada in his state—and that Trump had told him personally his administration would approve such a measure, according to several press reports. But Trump himself has not confirmed his support of the idea.

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