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Trump: I am getting insulin for so cheap that it’s like water

Trump's executive order from July aiming to lower the price of insulin is yet to be implemented. The current average cost of insulin is $300 in the US

On May 26, 2020, Trump unveiled a plan to cap the cost of insulin for Medicare recipients at $35 per month beginning in 2021. “Across the Nation, participating enhanced Part D plans will provide many seniors with Medicare access to a broad set of insulins at a maximum $35 copay for a month’s supply of each type of insulin,” the White House press release stated. The extent to which senior citizens will benefit from this move is yet to be gauged as the plan is yet to be implemented, and the benefit is only available to the seniors enrolled in the specified insurance plans.

Since 1991, growth in insulin prices has been accelerating. The list price of insulin per milliliter in the United States increased, on average, 2.9 percent annually from 1991-2001, 9.5 percent per year from 2002 and 2012, 20.7 percent annually between 2012 and 2016, and 1.5 percent per year from 2016-2018. According to a report by the American Diabetes Association (ADA) and the University of Southern California Center for Health Policy and Economics, between 2007 and 2016, major brand insulin list prices increased by 252%, while net prices saw less growth at 57%. The average retail prices of insulin in the US were around $300 in 2019, according to BBC. Furthermore, insulin prices remain relatively high for patients although Trump claims that he’s lowering drug prices at about $300 a vial in 2020. As Stat News explained, most patients require multiple vials a month, with some having to pay thousands of dollars each month. Therefore, the claim that insulin costs as little as water is false.

On July 24, 2020, Trump issued the Executive Order on Access to Affordable Life-saving Medications. The fourth proposal requires the provision of insulin and/or an EpiPen free through an existing program mandating pharmaceutical companies to provide steep discounts to thousands of hospitals and community health centers that serve large numbers of low-income patients, reported The Washington Post. However, that plan still hasn’t been enacted.

FactCheck.org citing experts stated that the scope of their effects remained to be seen since the orders first required further action by the administration.

The benefits of the order can only be reaped by a small section of the population, according to a PolitiFact analysis. “Trump’s order targeted a select group of health care providers, Federally Qualified Health Centers. These centers serve people of limited means, focusing on rural and low-income communities. There are over 1,300 of these health centers. That’s a lot, but in terms of the particular federal drug discount program that they use to buy insulin — something called the 340B program — they represent less than a fifth of the 340B participating clinics and hospitals nationwide. And out of all operations that contract with the program, which includes individual pharmacies, these clinics represent less than 2%. So the executive order affects only a slice of providers, and it hinges on the 340B drug program.”

The Washington Post observed in a report that the orders were unlikely to take effect anytime soon, if they do so at all, because the power to implement drug pricing policy through executive order is limited and that the drug industry was likely to challenge it in court. “White House aides spent much of Thursday fielding calls from drug company executives expressing frustration the administration is pushing the orders even as it presses the industry — including awarding companies billions of dollars — to develop and manufacture vaccines and treatments for COVID-19, the disease caused by the coronavirus, according to a senior administration official and a Republican lobbyist who spoke on the condition of anonymity to relate internal deliberations. “

Steve Ubl, president, and chief executive of PhRMA, the largest drug industry trade group, told The Washington Post, “The research-based biopharmaceutical industry has been working around the clock to develop therapeutics and vaccines to treat and prevent COVID-19. The administration’s proposal today is a reckless distraction that impedes our ability to respond to the current pandemic — and those we could face in the future.”

That the law may face legal bottlenecks was corroborated by Bloomberg Law. A report based on interviews with health lawyers said the community health centers targeted in the order already sell discounted drugs to patients, and the Trump administration might not have the legal power to force deeper discounts at enough pharmacies to make a difference.

On Sept 25, Trump announced that his administration would allow the importation of prescription drugs from Canada. Even though insulin was not included among the drugs covered by the rule, the Trump administration has issued a request for proposals seeking plans from private companies on how insulin could be safely brought in from other countries and made available to consumers at a lower cost than products here, as per the Kaiser Family Foundation.

Given that none of Trump’s orders for reducing insulin costs have actually been implemented, his claims that insulin has become so cheap that it is like water is a long stretch.

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