Gabriella Corley is a 9 year old with Type I diabetes who's allergic to the insulin covered by her low-income parents' healthcare; to live, she must take Sanofi's proprietary Apidra brand insulin, which has increased in price by 1,123% since 1996, and which is only covered to 25% by her insurer's Pharmacy Benefit Manager, CVS.
Corely's insurer, pharmacy manager, and Sanofi all blame one another for the situation, but the reality is that Corley's parents simply can't afford to buy the drugs that would keep her alive, and none of the programs that are supposed to cover this situation — like discounts for uninsured people — apply to them.
So they've turned to the black market, trading the insulin that Corely's insurer will buy with other diabetic people they meet on the internet, who are covered on plans that buy the kind of insulin Corely needs to not slip into a coma and die before her tenth birthday.
Because the Corleys' insurance does cover some of the costs, they're not eligible for a reduced copay under company policy, said Diane Brown, Director of Communication for the West Virginia Department of Administration, on behalf of PEIA.But this little bit of insurance coverage, which doesn't put the drug within reach, is also hurting them in another way. Since they're not uninsured, the Corleys don't qualify for free insulin under Sanofi's patient assistance program. She's written everyone from her state's Senator, Joe Manchin, to the state insurance regulator, with no pricing relief in sight.
NBC News contacted the drugmaker, insurer, and the pharmacy benefits manager or PBM, who is contracted to negotiate drug prices for the insurer.
Each party defends its policies, didn't offer the Corleys any new solutions, and tried to shift focus to each other.
The insurer pointed to the PBM, the PBM pointed to the drugmaker, and the drugmaker pointed back to the insurer.
Desperate Families Driven to Black Market Insulin
[Ben Popken/NBC]
(via Naked Capitalism)
(Image: Raymond Thompson Jr/NBC News)
