CANNON TOWNSHIP, Mich. (WOOD) — Every year, over 69,000 people in Michigan get the diagnosis: They have diabetes.
Samuel Dater puts a face and a voice to the challenges of being diabetic. Two years ago, a trip to the emergency room after a bike accident led to a surprise diagnosis.
“Got a concussion, was in the hospital and turns out something wasn’t right. And it was type 1 diabetes. 24 years old,” Dater said. “It’s not diet, it’s not lifestyle. My pancreas does not produce any insulin.”
Dater became one of the more than 37 million Americans with diabetes.
First came the shock over the diagnosis. Then came the sticker shock over the two doses of insulin he needs to take.
“I believe it’s like $300-ish for each one,” Dater said. “Sometimes up to five times a day just to get that insulin to let me live my life how I want to. “
Dater, who manages a liquor store in Cannonsburg, is now shelling out $400 a month for insurance to alleviate that cost but still pays a $75 deductible for his insulin.
“Then I have needles, test strips, my continuous glucose monitor. It all adds up,” Dater said. “I know some people that they have to go without certain things to make sure they can get their insulin. I’m lucky enough to be able to afford better insurance.”
There may be some relief in sight for Dater and others. In an interview with the Michigan Advance, Gov. Gretchen Whitmer said she will announce her support for House Bill 4346, which would cap the cost of insulin at $50 per month.
AG LAUNCHES INVESTIGATION INTO ELI LILLY
Also Wednesday, Michigan Attorney General Dana Nessel announced she is launching an investigation into Eli Lilly, one of the nation’s largest makers of insulin, over pricing.
“The average out-of-pocket cost of a single vial of insulin is nearing $100,” Nessel said in a statement. “No Michigander should have to face that kind of cost for life-saving medicine. While drug companies profit off of people’s health, they also benefit from a current market in which they control the pricing. Enough is enough.”
Nessel said her Consumer Protection Team will tackle the matter — but she says to do it right, the office will have to challenge two earlier rulings by the Michigan Supreme Court that limited how the Michigan Consumer Protection Act applies to some companies. Those two rulings, from 1990 and 2007, exempted any sales that are specifically authorized by law and thereby “generally regulated” from the MCPA. Nessel says that created a loophole that allows companies not to be prosecuted for misconduct under MCPA.
Nessel has filed a petition asking an Ingham County court to allow her investigation and also asked the court say that MCPA applies to Eli Lilly. Nessel said she expects the Indianapolis-based drugmaker to reference the 1999 and 2007 cases in its response, so she’s preparing to appeal.
If you think you are paying too much for insulin or if you are a doctor or pharmacist who has concerns, the AG’s Office wants to hear from you. You can file a complaint on its website. People were reminded to include information about a specific brand and product and what their insurance covers.
In a statement to News 8 Wednesday, Eli Lilly said Nessel’s claims are “false … and inaccurate.” It said it can make insulin available to patients for $35 per month and that its out-of-pocket costs for insulin have actually dropped 27% in the last four years.
“We have strictly adhered to all national and state laws in providing this low-cost insulin to Michigan residents,” the statement said.
Eli Lilly added that it would support the monthly copay cap.
For Samuel Dater and the more than 912,000 people in Michigan who deal with diabetes every day, Whitmer’s announcement and Nessel’s action are a step in the right direction.
“(The cap) would save me so much money for something that I have to have to live. I can’t go without it,” Dater said.
“Lilly is deeply disappointed by the false accusations and inaccurate claims about Lilly’s insulins that the Michigan Attorney General is making. These claims are particularly surprising given the multiple affordability solutions that Lilly offers – where anyone is eligible to purchase their monthly prescription of Lilly insulin for $35 or less, regardless of the number of pens or vials, whether they are uninsured or use commercial insurance, Medicaid, or a participating Medicare Part D plan.
“The fact is that Lilly is offering real solutions that are making a real impact for people living with diabetes. In fact, despite rising insurance deductibles, the average monthly out-of-pocket cost for Lilly insulin has dropped 27 percent, to $28.05, over the past four years. Third-party prescription data confirms that, on average, people pay about $9 per vial of Lilly insulin and our non-branded insulin, which as of January 1, 2022, has a list price 70% lower than its branded counterpart, is an important part of our efforts to ensure affordable access to our insulins – especially for the uninsured, Medicare Part D recipients, and those in high deductible health plans. We have strictly adhered to all national and state laws in providing this low-cost insulin to Michigan residents.
“Lilly welcomes systemic solutions and new public policies, such as copay caps on insulins like the one Governor Gretchen Whitmer has proposed, which could bring much-needed relief to people who face higher out-of-pocket costs for their medications. Until actual reforms fill these gaps, Lilly remains firmly committed to providing affordability solutions to people who need them.
“We encourage anyone in Michigan, or any other U.S. state or territory, paying more than $35 per monthly prescription to call the Lilly Diabetes Solution Center at (833) 808-1234 or go to insulinaffordability.com to see what options are available.”Lilly Diabetes Communications
—News 8 digital executive producer Rachel Van Gilder contributed to this report.