Bernie Sanders: The Insulin Crisis – OpEd


Sen. Bernie Sanders’s prepared remarks at the opening of the Senate Health, Education, Labor, and Pensions Committee’s  hearing titled “The Need to Make Insulin Affordable for All Americans.”

First, let me begin by thanking the CEOs of Eli Lilly, Sanofi and Novo Nordisk – the three major manufacturers of insulin – as well as the heads of CVS/Caremark, Express Scripts, and Optum Rx – the three major Pharmacy Benefit Managers – for being with us today. You all had to juggle busy schedules and I appreciate your willingness to be here today.

I also want to take this opportunity to thank Eli Lilly, Sanofi and Novo Nordisk for, in recent months, substantially lowering their lists prices for some of their insulin products. That’s an important step forward.

And as we gather today to discuss the insulin crisis, I want to acknowledge those whom we have lost because they could not afford the insulin that they needed to keep them alive.

Alec Smith, was 24 years old and dreamed of opening a sports bar. He is dead.

Antavia Lee-Worsham was 22-years old and worked two jobs. She is dead.

Allen Rivas was 20 years old and had already lost his home because of insulin costs. He’s dead.

And these are just a few of the many Americans who have needlessly lost their lives because of the unaffordability of insulin.

Further, we must also acknowledge the thousands who wound up in emergency rooms and hospitals suffering from diabetic ketoacidosis – a very serious medical condition as a result of rationing their insulin.

This committee is convening today for two major reasons – and one of those is a little bit personal for me. Three years ago I took a busload of American diabetics from Detroit, Michigan to Windsor Ontario to purchase the life-saving insulin that they needed for one-tenth the price they were paying in the United States. One-tenth of the price for the exact same product. At that time I promised them that I would do whatever I could to end that insanity, and I intend to keep that promise. That’s one reason for this hearing.

Secondly, this committee is determined to end the outrage in which Americans pay, by far, the highest prices in the world for virtually every brand name prescription drug on the market – whether it is a drug for cancer, heart disease, asthma, or whatever. We want to know why there are Americans who are dying, or are becoming much sicker than they should, because they can’t afford the medicine they need. Why, in the richest country on Earth, do 1.3 million Americans ration insulin because of the cost? Why are 1 out of 4 Americans not able to afford the prescription drugs their doctors prescribe?

And let’s be clear. The high cost of prescription drugs not only impacts the health of individual Americans, but the budget of the United States. If we paid the same prices for prescription drugs as major countries around the rest of the world were paying, we could save over a trillion dollars over 10 years. Further, we would drive down the cost of healthcare in America which is now double the cost of almost any other major nation.

And let’s also be clear. While Americans pay outrageously high prices for prescription drugs, the pharmaceutical industry and the PBMs make enormous profits.

In 2021, 10 major pharmaceutical companies in America made over $100 billion in profits – a 137% increase from the previous year. The 50 top executives in these companies received over $1.9 billion in total compensation in 2021 and are in line to receive billions more in golden parachutes once they leave their companies.

Last year, the 3 major PBMs in America made $27.5 billion in profits – a 483% increase over the past decade. These PBMs manage 80 percent of all prescription drugs in America.

In other words, Americans die, get sicker than they should and go bankrupt because they cannot afford the outrageous cost of prescription drugs, while the drug companies and the PBMs make huge profits. That has got to change and this committee is going to do everything possible to bring about that change.

Let’s get back to insulin. Importantly, and not discussed very often, a vial of insulin costs less than $10 to manufacture.

Meanwhile, Eli Lilly increased the price of Humalog 34 times since 1996 from $21 to $275—a 1,200 percent increase. The same exact product. No changes at all. The only reason for the huge increase in price during that period was that there was no legislation to stop them. In America, the drug companies could charge any price they want.

But it’s not just Eli Lilly.

Novo Nordisk increased the price of Novolog 28 times from $40 in 2001 to $289—a 625 percent increase.

And then there is Sanofi – a company that increased the price of Lantus 28 times from $35 in 2001 to $292—a 730 percent increase.

In every instance it is the same exact product that rose astronomically.

And let’s be clear. This is a problem that is unique to the United States. In France, 20 years ago, the cost of Lantus was $40. Today, it has gone down to just $24.

Meanwhile, as insulin manufacturers continued to increase prices, PBMs signed secret deals to increase their profits by putting insulin products on their formularies not with the lowest list price but the ones that gave PBMs the most generous rebates.

The good news is that as a result of public outrage, a strong grassroots movement and government action, major pharmaceutical companies have announced that they will be substantially reducing the price of some insulin products.

Eli Lilly announced it would reduce the price of Humalog by 70 percent later this year—from $275 to $83. Eli Lilly also decreased the price of its generic Humalog to $25 per vial.

Novo Nordisk announced it would reduce the price of Novolog by 75 percent beginning next year—from $289 to $72.

Sanofi announced it would reduce the price of Lantus by 78 percent beginning next year—from $292 to $64.

Our job today, as I see it, is twofold.

First, we must make sure that these price reductions go into effect so that every American with diabetes gets the insulin they need at an affordable price. This committee intends to hold a hearing early next year to make certain that happens.

But lowering the cost of insulin is only one part of what we must accomplish.

This committee must do everything possible to make sure that the American people no longer pay, by far, the highest prices in the world for prescription drugs.

And we’ve got to ask some hard questions.

If Eli Lilly can lower the price of Humalog by 70 percent, why is it still charging the American people about $200,000 for Cyramza (CYR-AMZA) to treat stomach cancer – a drug that can be purchased in Germany for just $54,000?

If Novo Nordisk can lower the price of Novolog by 75%, why is it still charging Americans with diabetes $12,000 for Ozempic when the exact same drug can be purchased for just $2,000 in Canada?

If Sanofi can reduce the price of Lantus by 78%, why is it still charging cancer patients in America over $200,000 for Caprelsa – a drug that can be purchased in Japan for just $37,000.

We have got to ask how does it happen that nearly half of all new drugs cost over $150,000?

How does it happen that cancer drugs which, in some cases, cost just a few dollars to manufacture are selling on the market for over $100,000?

Now I know that our guests from the drug companies will tell us how much it costs to develop a new drug and how often the research for new cures is not successful. I get that. But what they are going to have to explain to us is why, over the past decade, 14 major pharmaceutical companies, including Eli Lilly, spent $747 billion on stock buybacks and dividends.

The truth is that these 14 major drug companies have spent $87 billion more on stock buybacks and dividends over the past decade than what they spent on research and development.

They will also have to explain how as an entire industry pharma spent $8.5 billion on lobbying and over $745 million on campaign contributions over the past 25 years to get Congress to do its bidding.

Unbelievably, last year, drug companies hired over 1,700 lobbyists including the former congressional leaders of both major political parties – that’s over 3 pharmaceutical industry lobbyists for every Member of Congress.

Maybe I’m wrong, but I think that could well explain why we pay the highest prices for prescription drugs in the world and why today drug companies can set the price of new drugs at any level they wish.

Bernie Sanders is a US Senator, and the ranking member of the Senate budget committee. He represents the state of Vermont, and is the longest-serving independent in the history of Congress

Sen. Bernard Sanders

Sen. Bernard "Bernie" Sanders is an American politician serving as the senior United States senator from Vermont, a seat he has held since 2007.

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