Representatives from insulinmanufacturers blamed a system that requires them to pay higher andhigher rebates to pharmacy-benefit managers to gain access to thepatients whose prescriptions the PBMs manage.

Decisions by two of the world's biggest insulin producers to offer bigger discounts ondrugs used by millions of diabetics are raising questions fromCongress about whether the companies could have done so sooner.

On Wednesday, French drugmaker Sanofi said it would increasediscounts on insulin for some patients. The move follows recentefforts by Cigna Corp., which runs a major drug plan, and Eli Lilly& Co., another major insulin producer, to lower patients'out-of-pocket costs for the drugs.

Related: Class-action suit over insulin prices gets greenlight

The actions by the companies, which have come in the middle of aseries of hearings in the House and Senate on drug costs, haveraised questions from lawmakers about why it took a drumbeat ofpublic pressure before the companies altered their programs.

“It shouldn't take months of bad press, persistent public outcryand increasing congressional scrutiny to get a company to charge afair price,” Senator Chuck Grassley, the Iowa Republican who isleading hearings in the Senate, said of Sanofi's announcement.“That's not how a functioning marketplace works.”

Sanofi is expanding its “Valyou” discount program. Under theenhanced discounts, some patients would pay $99 a month for whatshould amount to a month's supply of Sanofi's Lantus, Toujeo andAdmelog insulins. It's an improvement from the existing program,which charged patients more for less insulin.

In March, Lilly said it would begin selling a lower-pricedversion of its top-selling insulin, Humalog, and Cigna this monthagreed to cap patient's out-of-pocket costs for the drugs.

House hearing

At a House Energy and Commerce subcommittee hearing Wednesday,Representative Joseph Kennedy III, a Massachusetts Democrat,referenced the Eli Lilly price reduction, expressingfrustration.

“It took 15 years and global outcry on this to do it,” Kennedysaid.

Representative Diana DeGette, a Colorado Democrat, said thediscount offerings weren't a permanent solution. “It's just atemporary Band-Aid,” DeGette said.

Representatives from insulin manufacturers blamed a system thatrequires them to pay higher and higher rebates to pharmacy-benefitmanagers to gain access to the patients whose prescriptions thePBMs manage.

“There's a significant demand for rebates,” said Doug Langa,executive vice president of North American operations at NovoNordisk A/S.

Lawmakers were frustrated by the finger-pointing that continuedthroughout the hearing, which featured the three biggest insulinmakers and the three PBMs that dominate the market.

“The PBMs blame the companies, the companies blame the PBMs andour constituents say, 'They're all no good. Just get rid of thesystem,”' said House Energy and Commerce Committee Chairman FrankPallone, a New Jersey Democrat.

For Sanofi's expanded program, only cash-paying patients orpeople who have private insurance are eligible. Medicare andMedicaid bar patients from using drugmaker-funded discountprograms, which can be a way for companies to steer patients towardexpensive drugs by covering their out-of-pocket costs.

Grassley questioned the lack of a discount for patients ingovernment health programs, saying, “If Sanofi can reduce the priceto patients for insulin while still making a profit, I can'timagine a legitimate reason taxpayers shouldn't be charged the sameprice.”

Sanofi said program was designed initially to help patients whentheir insurance lapsed. The company said that about 10 percent ofits insulin patients pay in cash. Drugs like Lantus, a popularlong-acting insulin, have a list price of $290 for five pens,according to GoodRx, which tracks drug prices.

Read more: 

• Is killing drug rebates really the answer to highdrug prices?
• Probes target insulin drugmakers and pharmamiddlemen
• Pharma execs in the hot seat on drugprices

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