Nonprofit Plans to Make Affordable Generic Insulin

March 4, 2022 — Everyone knows that insulin prices in the United States are ridiculously high and unaffordable for many people with diabetes, but so far no one has done anything about it.

Civica Inc., a nonprofit led by health systems and philanthropists, announced Thursday that it plans to manufacture and sell generic insulin at a steep discount to current market prices. The generic insulin has a recommended price of no more than $30 per vial and no more than $55 for a box of five pen cartridges, according to Civica.

In contrast, Eli Lilly’s Humalog cost $269 per vial in 2017, according to Mike Magee’s book Code Blue: Inside America’s Medical Industrial Complex. In 2019, Lilly introduced lispro, the generic equivalent of Humalog, priced at $137 per vial or $265 for five pen cartridges. Those prices dropped this year to $82.41 for individual vials and $159.12 for a pack of five pens.

Other insulin makers with similarly high prices include Sanofi and Novo Nordisk.

Subject to FDA approval, Civica expects the first of its three insulin products (glargine, the equivalent of Lantus) to be available for purchase as early as 2024. The insulin drugs will be made in Civica’s 140,000-square-foot facility under construction in Petersburg, Virginia. Other types of insulin will be available later, including lispro and aspart (the Novolog equivalent).

Civica was founded in 2018 by health systems and foundations as a kind of health care institution. The concept was to bypass the major drug manufacturers and produce or outsource the generic drugs needed by the more than 1,500 member hospitals. The money to operate Civica Rx, the subsidiary created for this purpose, came from health systems and charitable organizations.

The first governing members were seven health systems — Catholic Health Initiatives (now CommonSpirit), HCA Healthcare, Intermountain Healthcare, Mayo Clinic, Providence, SSM Health and Trinity Health — and three charities: the Laura and John Arnold Foundation, the Peterson Center on Healthcare, and the Gary and Mary West Foundation. Kaiser Permanente and Memorial Hermann later joined Civica’s board.

To jump-start the operation, Civica outsourced Rx to companies that already had government licenses to make generic drugs. To date, Civica Rx has delivered more than 50 generic drugs to 55 health systems representing more than 30% of US hospital capacity. It also supplies the Department of Veterans Affairs and the Department of Defense and has provided 11 essential drugs needed to treat COVID-19 patients.

Recently, Civica founded CivicaScript to reduce the cost of generic drugs in pharmacies. CivicaScript’s founding members include the Blue Cross Blue Shield Association (BCBSA), 18 independent BCBS health plans, and Anthem. Other groups involved in the insulin project include foundations and some health systems, such as Intermountain, Kaiser Permanente, Providence and Trinity.

Martin VanTrieste, president and chief executive officer of Civica Rx, said in a press release, “More than 8 million Americans rely on insulin for a living, but many cannot afford to take the amount they need because of the historically high and prohibitive cost of insulin We know that to really solve the insulin cost and the access problems that so many Americans face, we need a process — from manufacturing to setting a transparent price — that ultimately lowers the cost of the drug for people with diabetes.”

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