Fact Check: Is Joe Biden Responsible For the Rising Cost of Insulin?

Out of roughly 330 million people living in the U.S., about 34 million are living with diabetes. For individuals with type 1 diabetes, access to insulin is the difference between life and death. Recently, many Americans have been expressing their outrage on social media at the rising cost of insulin and wonder who is to blame.

The Claim

Constitutional attorney Robert Barnes on Thursday tweeted: "Insulin back up to $1,500 for a 90-day supply. Thank President Biden," in a post that has gained more than 27,000 likes and 11,000 retweets. In response to a Twitter video of a woman tearfully discussing how insulin costs have risen under Biden, one user replied on Thursday that, "My family is in the same situation. Our insulin cost went up 550% since Biden took office. He signed something that nullified Trump's EO that had significantly reduced the cost of insulin. He needs to fix this. This will devastate so many families," in a tweet that received 42 likes and 20 retweets.

The Facts

The average list price of insulin has nearly tripled between 2002 and 2013, according to the American Diabetes Association (ADA). On January 20, Ron Klain, assistant to the president and chief of staff, announced a Regulatory Freeze Pending Review in a White House memorandum. It froze any rules from the former administration for the next 60 days that were issued and published by the Federal Register that have not yet gone into effect "for the purpose of reviewing any questions of fact, law, and policy the rules may raise." This includes freezing Trump's Executive Order on Access to Affordable Life-Saving Medications (Executive Order 13937) that was supposed to go into effect January 22. In July, Trump signed four executive orders aimed at drug pricing to order the Secretary of the U.S. Department of Health and Human Services (HHS) "to take several steps to deliver for American patients lower costs on prescription drugs, including insulin and epinephrine, and ensure Americans are getting the lowest price possible for their drugs," according to a press release from HHS. Trump's Executive Order 13937, published by the Federal Register, supports improved access to affordable insulin and injectable epinephrine for low-income individuals "due to either lack of insurance or high cost sharing requirements." "The list price for a single vial of insulin today is often more than $250 and most patients use at least two vials per month," the executive order states while also adding that some injectable epinephrine kits can cost more than $600. The implementation of the executive order was published by the Federal Register on December 23. The order would have gone into effect on January 22. "This final rule establishes that health centers receiving funding under section 330(e) of the PHS Act are expected to offer insulin and injectable epinephrine at or below the price the health center paid through the 340B Program, plus a minimal administration fee," the document states. On January 26, the Federal Register published an announcement that the effective date of the final rule of Trump's executive order had been delayed until March 22. It is up to the Biden administration to decide whether to sign Trump's executive order into law. Regarding the rising cost of insulin, the ADA wrote in a 2018 report that, "The reasons for this increase are not entirely clear but are due in part to the complexity of drug pricing in general and of insulin pricing in particular." On January 14, Senator Chuck Grassley (R-Iowa) took to Twitter to announce why insulin prices have risen. "2day Sen Wyden & I released Finance Cmte report on INSULIN costs Prices hv gone THRU THE ROOF for patients/taxpayers bc of manufacturer, health plan & PBM biz practices They make $$ as % of ballooning list price so no incentive to lower price on 100 yr old drug." That day, the U.S. Senate Finance Committee released a 90-page bipartisan insulin investigation report by Grassley and Senator Ron Wyden (D-Ore.) that revealed business practices between drug companies and pharmacy benefit managers (PBM's) have been keeping the prices high. "First and foremost, pharmaceutical manufacturers have complete control over setting the list price (the Wholesale Acquisition Cost (WAC)) for their products. This investigation found that manufacturers aggressively raised the WAC of their insulin products absent significant advances in the efficacy of the drugs. These price increases appear to have been driven, in part, by tactics PBMs employed in the early 2010s," the report states on page 5. The same page also states that drug manufacturers increased the list price for insulin partially to allow them to offer larger rebates to PBM's and health insurers. Grassley and Wyden began their investigation nearly two years ago, according to the Senate Finance Committee. Their full report can be read here.

The Ruling

False. President Biden is not responsible for the rise in the cost of insulin since President Trump left office. The January report released by the U.S. Senate Finance Committee details Grassley and Wyden's extensive investigation into the rising cost of insulin and found that drug manufacturers, health plans and PBM business practices are responsible. Biden did freeze an executive order signed by Trump that was aimed at lowering the cost of insulin and injectable epinephrine that was not yet in effect.

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