Analysts and patient groups are urging state lawmakers to take action to address the high cost of insulin. They recommend expanding policies to cover the uninsured and addressing the practices of drug industry middlemen.
A Democratic state lawmaker in Wisconsin has proposed a bill to cap the price of insulin at $35 for residents with state-regulated commercial health plans. Legislatures in other states like Massachusetts and Pennsylvania are also considering similar proposals.
In California, Governor Gavin Newsom recently vetoed a bill to set a $35 insulin copay cap, citing the state’s efforts to manufacture its own low-cost insulin. However, the plan is facing delays and likely won’t be ready by the initial 2024 timeline.
Experts argue that states need a multipronged approach that considers rebates and fees paid to pharmacy benefit managers by drugmakers. They also believe copay caps should be extended to people with other types of insurance or those without insurance, who on average spend more than double on insulin annually compared to patients with private insurance.
Americans diagnosed with diabetes make up a significant portion of health-care spending in the US, with insulin spending tripling in the past decade.
Several states have already enacted laws limiting what patients with state-regulated commercial health insurance pay for insulin. Wisconsin state lawmaker Brad Pfaff is looking to follow the lead of other states by proposing a bill to cap insulin copays at $35 for residents with commercial health insurance.
Experts emphasize the need to address insulin affordability and the financial burden of out-of-pocket costs for consumers. They also stress the importance of addressing high margins in the supply chain and the role of pharmacy benefit managers in increasing drug costs.
Overall, developing multifaceted solutions to insulin affordability issues is crucial as policymakers look to address high prescription drug costs in general. By getting it right for insulin, it could pave the way for addressing affordability issues with all chronic medications.