As Big Pharma’s CEOs are making money hand over fist, ordinary Americans are paying far more for a wide range of drugs than the people of other nations.

I wish for all the world we could successfully boycott the “pharma’s market.” Create a real co-op with reasonable prices. Perhaps invoke the Defense Production Act and fund a competitive marketplace for essential prescription drugs. Disempower all those politicians who’ve gotten fat feeding at the political contributions trough of the pharmaceuticals and the drug companies who receive the very highest prices for products we desperately need—charging more here than drug companies charge anywhere else in the world.

Pharmaceutical companies are equal-opportunity donors. They will curry favor with anyone with political influence. And as opensecrets.org reveals, members of both parties receive lots of money from Pharma. For example, Republican Senator Tim Scott of South Carolina received $294,896 in 2022 while Democratic Senator Kyrsten Sinema of Arizona got $201,060.

We’ve all just witnessed a crystal-clear moment revealing all that’s wrong with the pharma’s market and our politics—watching Republican senators squeal at the very notion of capping insulin for every diabetic in the nation. Equity and compassion, not to mention sensible health policy, took a back seat for the Republicans. Capping insulin costs for the entire nation was just too much to ask of them. Instead, invoking the despicable rules of the Senate where the notion of majority rules doesn’t actually rule the day, they were determined to deny the Democrats a clear victory. A Senate which allows 60 out of a 100 to determine what our lives are like. Then the Republican Senators made sure to limit the new cost cap only to those who get their insulin under Medicare.

This is how Khaleda Rahman of Newsweek described the process: “The U.S. Senate passed a sweeping economic package aimed at lowering healthcare costs and combating climate change on Sunday. The Inflation Reduction Act of 2022 includes a cap on Medicare patients’ costs for insulin—an expensive diabetes medication—at $35 per month.

“But Democrats had wanted to extend the $35 cap to also include those with private insurance. The bill, which was passed through a process known as budget reconciliation, allowed them to sidestep GOP opposition and avoid the usual 60-vote threshold to get past a Senate filibuster. But the Senate parliamentarian, the adviser who helps interpret Senate rules, determined the insulin price cap for private insurers violated reconciliation rules.”

New Jersey Congressman Bill Pascrell Jr. took to Twitter to express his anger and name names:

And so ordinary, the-not-rich Americans who remain dependent on their private health insurance, will continue to overpay for, or even ration, their insulin.

Remember, these are the same politicians who are still able to assert with a straight face that we are the exceptional nation. At the very same time we force our citizens who suffer from diabetes to pay far more for their medicine than other nations.

You can also add insult and hypocrisy to the mix. Just a year and a half ago, Iowa Senator Chuck Grassley went to Twitter to declare his concern for insulin prices: “2day Sen Wyden & I released Finance Cmte report on INSULIN costs Prices hv gone THRU THE ROOF for patients/taxpayers bc of manufacturer, health plan & PBM biz practices They make $$ as percent of ballooning list price so no incentive to lower price on 100 yr old drug.”

But when he got the chance to do something substantial about those through-the-roof prices for insulin, well, defying the Democrats was more important than turning rhetoric into reality.

His opponent for Senate, former Admiral Mike Franken is criticizing Grassley’s approach to healthcare, while proposing an alternative: “Iowans deserve a healthcare system designed to provide quality, single payer healthcare—for everyone. Our current healthcare system is staffed by the world’s best health care providers, the best equipment, the best facilities, but too often, it puts profits over people. It’s inordinately hard to navigate and far too expensive. That’s why Admiral Franken supports universal healthcare for everyone unlike Senator Grassley who repeatedly blocks efforts to correct Medicare drug pricing.”

Then there’s Senator Lindsey Graham, who played an active role by making sure the parliamentarian’s ruling that the bill would require 60 votes was strictly enforced. Graham, in his press release about the Inflation Reduction Act, sidestepped the issue and didn’t even acknowledge voting against the insulin cap:

“This bill is a nightmare for South Carolina. It’s a nightmare for the American economy … The bottom line is that this bill raises taxes and creates new federal government programs at a time that we’re in a recession. The best way to get out of a recession is limit federal government spending and incentivize growth in the private sector.”

But, in fact, his no vote needlessly continues the very real nightmare experienced by those South Carolina families struggling to afford insulin:

The Associated Press offers some basic facts about diabetes:

“The price of the 100-year-old drug has more than tripled in the last two decades, forcing the nation’s diabetics to pay thousands of dollars a year for the life-saving medication … Roughly 8.4 million Americans use insulin, according to the American Diabetes Association …

“People require insulin, it’s not an option and nobody should have to decide between life-sustaining medication or food and rent,” said Dr. Robert Gabbay, the chief scientific and medical officer for the American Diabetes Association. Insulin also helps control glucose levels for patients with other forms of diabetes. Some insulin users have rationed the drug because of its expense and risk numerous health complications as a result.” (Emphasis added.)

World Population Review, in its 2022 comparison of insulin prices, adds additional perspective: “Insulin is a hormone, made by the pancreas, which enables the body’s cells to absorb sugar (glucose) from the bloodstream and consume it for energy. However, in roughly 10 pecent of the world’s population … the body’s ability to produce and utilize insulin is disrupted, resulting in a chronic condition known as diabetes. There are two main forms of diabetes: Type 1, in which the pancreas fails to produce enough insulin; and type 2, in which the pancreas makes enough insulin but the cells can’t process it effectively. Diabetes is a serious condition. Without adequate insulin, the body becomes unable to manage its blood sugar level, which can lead to a host of medical complications—in fact, according to the International Diabetes Foundation, diabetes caused 6.7 million deaths in 2021.

“Fortunately, type 1 diabetes is usually treatable with the use of man-made insulin, which can be administered via a syringe or pen, an inhaler, or a surgically attached pump. Unfortunately, insulin prices have skyrocketed in the United States over the past two decades and continue to rise. For example, the American Journal of Managed Care pointed out that the cost of a one-month supply of the insulin Humalog cost $21 in 1996, but $275 in 2019—a 1,200 percent increase—but actual inflation during that same period was only 63.67 percent.

“Generally speaking, injectable insulin can range anywhere from $25-$300 per vial, and a patient may require as many as six vials per month. Moreover, diabetics must also purchase glucose monitors, test strips, lancets, and other supplies. Upgraded formats such as inhalers and insulin pens can be easier to use and travel with, but these tend to cost even more. Even with insurance, the cost of insulin and other necessary supplies can often cost more than a typical patient can reasonably afford.” (Emphasis added.)

As this graph from the Kaiser Family Foundation (KFF) reveals, the need for affordable insulin is critical:

On July 28, 2022, the Kaiser Family Foundation published a study “Insulin Out-of-Pocket Costs in Medicare Part D.” KFF noted that those with Medicare Part D drug coverage who don’t qualify for a low-income subsidy spent $572 per person for insulin in 2020 on average. While another small group of insulin users spent considerably more.

The Associated Press emphasizes that insulin prices vary: “Some people on private insurance pay hundreds of dollars monthly for the drug. For most Medicare beneficiaries, the average out-of-pocket cost per insulin prescription was $54 in 2020—an increase of nearly 40 percent since 2007, a study released last month by the Kaiser Family Foundation found. Others live in one of 22 states where the copay for a 30-day supply has been capped between $25 to $100. The cost has led some to use less insulin than their doctor prescribes or postpone paying for other medical care.”

Insulin is produced by only three manufacturers: Eli Lilly, Novo Nordisk, and Sanofi. And these three companies control the price of insulin.

In 2021, biospace.com published the annual salaries of the CEOs of 20 of the major pharmaceutical industry. Paul Hudson, the CEO of Sanofi, made $6,707,717. Lars Fruergaard Jørgensen at Novo Mordisk made only $2,256,324. You can read about Novo Mordisk explained their executive compensation policies here. “In 2020, Novo Nordisk made progress on Strategic Aspirations 2025. Sales increased by 4 percent in Danish kroner and by 7 percent at constant exchanges rates (CER) to DKK 126.9 billion. Sales within Diabetes and Obesity care increased by 5 percent to DKK 108.0 billion (8 percent at CER), driven by Diabetes care growing 8 percent at CER and Obesity care growing 3 percent at CER.”

Last is David A. Ricks of Eli Lilly with an annual salary of $1,483,333. Oddly enough, fiercepharma.com has wildly different estimates of CEO salaries. Their 2020 chart has the Len Schleifer, the CEO of Regeneron, leading the pack with a whopping $135.35 million, and David Ricks of Eli Lilly with a respectable $23.70 million. Sadly, the compensation packages for the CEOs of Novo Nordsk and Sanofi are missing from their list.

It turns out that the reported yearly salary is just the very beginning of the financial gains for pharmaceutical executives. There are additional bonuses, which in the case of Regeneron’s, Schleifer’s amounted to $4,030,584 and “Realized Options” of $446,385,144 and the category of “other,” a mere $673,130. All in all, a total of $452,855,658. Fiercepharma.com noted that “Schleifer got a staggering $130 million in stock awards, a more than 2,500 percent increase over what he earned in shares the previous year.”

Meanwhile, as Big Pharma’s CEOs are making money hand over fist, ordinary Americans are paying far more for a wide range of drugs than the people of other nations. KFF’s Health Tracker System shows how per capita spending for prescription drugs, both for those Americans with private insurance and out-of-pocket expenses, compares with consumers in other nations:

The Kaiser Family Foundation’s survey conducted in March, 2022 is revelatory. While 60 percent of those who responded believe that prescription drugs developed over the last two decades has made their lives better, their increased cost has forced large numbers of people to ration their prescription pills, cutting them up so they last longer. Or deciding not to take them. Kaiser found that to be true for about a third of the people who have been prescribed these drugs:

The RAND Corporation, a non-profit research organization, recently published its International Prescription Drug Price Comparisons. They found:

“Prices in the United States are higher than those in all comparison countries

Here’s a chart from Rand showing the percentage difference of United States prices for brand-name originator prescription drugs as compared to prices in a range of other nations. For example, in 2018 Americans were paying 344 percent more for these drugs than consumers in all other countries:

Emily Miller at drugwatch.com describes a solution many in the United States have turned to: “Prescription drugs cost more in the U.S. than in most anywhere else in the world. As a result, Americans are illegally importing drugs from other countries.”

Miller tells the story of an American, whose name she chooses not to reveal, desperate to save money on her insulin: “Each month, Jane breaks the law. She does this to stay alive. Jane is a Type I diabetic, which means she requires insulin to keep living. The problem is a 10 ml. bottle of insulin in the U.S. has a list price of about $450. Jane estimates it would cost her $3,000 a month to stay alive without insurance.

“‘So here is this medicine—it is life-saving, keeps me alive—and here we have a few companies who are preying upon people who don’t have a choice but to take this medication or we die,’ she said. ‘So, how do we get it? How do we afford it? Where do we get it? Where are we being forced to go? The U.S. is the only country that gouges [patients]. It’s insane.’

“Jane buys her insulin illegally from Canada, where a comparable bottle of insulin costs about $21. ‘It makes more sense to purchase it from Canada, where life-saving medication is affordable,’ she said. ‘These prices won’t make you make the choice between going to the grocery store to put food on the table for you and your kids or buying insulin.’”

Remember that Kaiser Family Foundation poll? Well, they found that 19 million adults in the U.S. imported medication from Canada or other countries.

I’ve focused on insulin, but drugwatch.com offers a handy price comparison tool to see how much you’d pay for other prescriptions abroad. I checked for the popular cholesterol drug, Crestor:

If you ask me, it’s clear that it costs us dearly to suffer in a system where pharmaceutical companies are allowed to set their own prices. We suffer financially, and with unnecessary stress, increased illness, and premature death. In other European nations, the government can set prices, and consumers have seen prices fall. We, on the other hand, have experienced almost a doubling of prices in recent years.

Our pharma’s market works only for Big Pharma, not the people.

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