Hu­malog's list price may have gone up, but Lil­ly says it got paid less per sale in 2018 ver­sus 2014

As scruti­ny in­to in­sulin pric­ing in the Unit­ed States in­ten­si­fies, Lil­ly is lay­ing out the ground­work for its de­fense ahead of a third Con­gres­sion­al hear­ing on soar­ing drug prices next month in which the mid­dle­men — phar­ma­cy ben­e­fit man­agers — will do their ut­most to ex­on­er­ate them­selves in the role they play in pre­scrip­tion drug pric­ing.

Drug pric­ing is a con­tentious is­sue that has pro­voked wide­spread furor and elicit­ed bi­par­ti­san sup­port. While pa­tients and law­mak­ers de­cry out­ra­geous prices, drug­mak­ers and PBMs are point­ing fin­gers at each oth­er: The drug­mak­ers say list prices are ris­ing to com­bat the big­ger re­bates/dis­counts the all-pow­er­ful mid­dle­men ne­go­ti­ate, while PBMs ar­gue that ul­ti­mate­ly the pow­er to set list prices lies with the drug­mak­ers. The losers are the fi­nal end-users — the pa­tients whose out-of-pock­et costs are close­ly in­ter­twined with list prices.

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