Two U.S. senators launched an investigation into rising insulin prices on Friday, sending letters to the three leading manufacturers seeking answers as to why the nearly 100-year-old drug’s cost has rapidly risen, causing patients and taxpayers to spend millions of dollars a year.

Republican Sen. Chuck Grassley of Iowa, chairman of the Senate Finance Committee, and Sen. Ron Wyden of Oregon, the committee’s top Democrat, sent letters to the heads of Eli Lilly and Co., Novo Nordisk A/S and Sanofi SA, the longtime leading manufacturers of insulin. 

The senators pointed to similar, large insulin price increases at all three companies. Eli Lilly’s Humalog, for instance, rose from $35 to $234 per dose between 2001 and 2015, a 585 percent increase, they wrote. Insulin has been available since the early 20th century. 

The senators asked for information on the process used to determine list prices and the process used to determine net prices after negotiations with pharmacy benefits managers (PBMs) and health insurance plans. Their letters also asked for information about the cost of research and development, production, revenues and gross margins from insulin sales. 

“These hardships can lead to serious medical complications that are entirely preventable and completely unacceptable for the world’s wealthiest country,” the senators wrote in similarly worded letters. 

‘Increasingly severe hardships’

“We are concerned that the substantial increases in the price of insulin over the past several years will continue their upward drive and pose increasingly severe hardships not only on patients that require access to the drug in order to stay alive but also on the taxpayer,” they wrote. 

While Democratic lawmakers have launched several drug price investigations, this is one of the first bipartisan inquiries. 

The Senate Finance Committee has the power to subpoena drugmakers. 

The letters came just days before the same committee is scheduled to hold a hearing with seven pharmaceutical company executives, the latest congressional hearing on rising drug prices. 

U.S. lawmakers have intensified scrutiny on prescription medicine costs as the issue consistently polls as a top voter concern. In January, top Democrats on the House Energy and Commerce Committee also wrote to the three insulin manufacturers asking for information on why their prices have rapidly risen. 

About 1.2 million Americans have type 1 diabetes, requiring daily insulin. Type 2 diabetes, which affects nearly 30 million Americans, according to the American Diabetes Association, is treated with a variety of other medicines. But those patients may also eventually become dependent on insulin. 

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