Everyone is aware that insulin costs in the United States are absurdly excessive and out of reach for many individuals with diabetes. Still until recently, no one has taken any action to address the problem. That is, until now.
Founded by health systems and foundations, Civica Inc. stated on Thursday that it intends to produce and distribute generic insulin at a significant reduction to the current market price. According to Civica, the generic insulin will have a suggested price of no more than $30 per vial and no more than $55 for a package of five pen cartridges, with the lowest price being $30 per vial.
According to Mike Magee’s book Code Blue: Inside America’s Medical Industrial Complex, the cost of Eli Lilly’s Humalog per vial in 2017 was $269, a significant increase from the previous year. Lilly and Company debuted lispro, a generic version of Humalog, in 2019. According to the company, the drug is priced at $137 per vial or $265 for five pen cartridges. Individual vials are now $82.41 and a pack of five pens is $159.12, respectively, a decrease from the previous year.
Sanofi and Novo Nordisk are two other insulin manufacturers who charge comparably high rates.
Civica estimates that the first of its three insulin medicines (glargine, which is the equivalent of Lantus) will be ready for purchase as early as 2024, pending clearance by the Food and Drug Administration. The insulin medications will be manufactured at Civica’s 140,000-square-foot manufacturing facility, which is now under construction in Petersburg, Virginia. Other kinds of insulin, such as lispro and aspart, will become accessible in the future (the Novolog equivalent).
Health systems and foundations came together in 2018 to form Civica, which operates as a kind of health utility. Its goal was to circumvent big drug companies by manufacturing or subcontracting for generic drugs required by more than 1,500 member hospitals. The funds to run Civica Rx, the subsidiary established specifically for this purpose, come from healthcare systems and charitable organizations.
Seven health systems — Catholic Health Initiatives (now CommonSpirit), HCA Healthcare, Intermountain Healthcare, Mayo Clinic, Providence, SSM Health, and Trinity Health — as well as three charitable organizations — the Laura and John Arnold Foundation, the Peterson Center on Healthcare, and the Gary and Mary West Foundation — were among the founding members of the board of directors in 2001. Kaiser Permanente and Memorial Hermann eventually became members of the Civica board of directors.
Civica Rx entered into subcontracting agreements with firms that already had government-issued licenses to manufacture generic medications in order to jump-start its operations. So far, Civica Rx has given more than 50 generic medications to 55 health systems, which together account for more than 30% of total hospital capacity in the United States. It also provides the Department of Veterans Affairs and the Department of Defense, and it has delivered 11 critical pharmaceuticals for the treatment of COVID-19 patients and other organizations.
Civica has launched CivicaScript, which aims to provide generic medications in retail pharmacies lower costs. Blue Cross Blue Shield Association (BCBSA), 18 independent BCBS health plans, and Anthem are among the organizations that contributed to the creation of CivicaScript. In addition to foundations and certain health systems, such as Intermountain Healthcare and Kaiser Permanente as well as Providence and Trinity Health, are collaborating in the insulin study.
“More than 8 million Americans need insulin to survive, yet many cannot afford to take the quantity of insulin they require because of the historically high and prohibitive cost of insulin,” said Martin VanTrieste, president and chief executive officer of Civica Rx, in a press release. To really address the insulin pricing and access issues that so many Americans are facing, we need a procedure that reduces the cost of the medicine for persons living with diabetes at every stage of the process — from manufacturing to establishing a clear price.”