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"Executives from top insulin makers Eli Lilly and Company, Novo Nordisk, and Sanofi testified alongside the three largest pharmacy benefit managers (PBMs)—CVS Health, Optum Rx, and Express Scripts—in a Senate Health, Education, Labor, and Pensions (HELP) Committee hearing Wednesday over the drug’s increasing prices.

The hearing provided few solutions on how to make insulin more affordable, as the pharma executives and PBMs blamed each other for the high drug prices, echoing arguments made in 2019 that brought the same companies in front of Congress.

“If somebody in the real world is watching this hearing, they have heard every single person from the drug companies and from the PBMs say, ‘We are working tirelessly to lower the cost of prescription drugs, just knocking our brains out.’ And yet, at the end of the day, 1.3 million Americans are rationing their insulin,” HELP Committee Chairman Sen. Bernie Sanders said in the hearing Wednesday.

The insulin makers argued that higher rebate demands from PBMs have pushed list prices up. Drug manufacturers give PBMs rebates in exchange for preferential placement on a health plan’s list of approved medications. For every $1 increase in rebates, the list price of a prescription drug goes up $1.17 on average, according to a 2020 study from the University of Southern California."

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