The Senate Diabetes Caucus released a bill aimed at lowering the price of insulin to 2021 net Medicare rates and capping monthly copays to $35 or 25% of list price under Medicare Part D plans, according to Roll Call.
The Endocrine Society, American Diabetes Association, and other groups were quick to endorse the bill, which was introduced by co-chairpersons Jeanne Shaheen (D-NH) and Susan Collins (R-ME). The Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act would take steps to reduce out-of-pocket costs of insulin, the escalating price of insulin, and formulary management for people with diabetes, according to a statement from the Endocrine Society. The senators’ previous insulin bill aimed to reduce prices to 2006 list prices.
The INSULIN Act aligns with recommendations in the Endocrine Society’s Insulin Access and Affordability Position Statement, which recommends ways to lower the price of insulin through rebate reform and limiting copays to no more than $35 per month for insulin.
The bill proposes several ways for the government to improve insulin access and affordability, according to the Endocrine Society, including:
- Ensuring insurance plans and pharmacy benefit managers cannot collect rebates on insulins that limit list price to the 2021 net prices for Medicare Part D or equivalent levels
- Making insulin eligible for cost-sharing protections, including waiving any applicable deductible and limiting copays or coinsurance to no more than $35 per month, or 25% of list price
- Supporting patient access to insulin by ensuring coverage and that prior authorization, step therapy, or other medical management requirements cannot be imposed to limit beneficiary use
- Ensuring that group, individual market, Medicare Part D, and Medicare Advantage health plans waive any deductible and limit cost-sharing to no more than $35 per month or 25% of list price, for at least 1 insulin of each type and dosage form
“This bill is about our patients and making insulin affordable for them. The Endocrine Society urges the Senate to pass this bill quickly,” said Joshua Joseph, MD, Endocrine Society Clinical Affairs Core Committee Chair. “People with diabetes who rely on insulin cannot wait any longer. We are very grateful to Senators Shaheen and Collins for their leadership and persistence in identifying a bipartisan solution,”
Senate Majority Leader Charles E. Schumer, D-NY, immediately endorsed the measure. “It is my intention to bring the INSULIN Act to the floor of the Senate very soon, and it ought to pass this chamber expeditiously,” said Schumer, as reported in Roll Call.
It is not yet clear whether Republicans support the measure, according to Roll Call. Sen Collins recently briefed Minority Leader Mitch McConnell, R-Ky, on the deal but he has not publicly endorsed the bill. In a House bill, only 12 Republicans voted to cap insulin copays.
“This is a very complicated issue when you get into the pricing of insulin,” Sen Collins said. “So my goal is to talk to people about the rebate system, about why it keeps prices high, and talk to them about our bill,” she said.
Prices Keep Rising
The price of insulin nearly tripled between 2002 and 2013 and the trend upward has continued over the past decade, noted the Endocrine Society. According to the Health Care Cost Institute, the price of an average 40-day supply of insulin rose from $344 in 2012 to $666 in 2016.
“Access to insulin can be the difference between life and death for many Americans living with diabetes. For far too long, patients have stretched their budgets, rationed insulin, and made difficult personal decisions to keep this drug within reach for themselves or those they love. Bringing Democrats and Republicans together to address the surging cost of insulin has long been a priority for us as co-chairs of the Senate Diabetes Caucus, and today, we’re announcing a bipartisan proposal to deliver on that shared goal,” said Shaheen and Collins in a press release.
“Lack of access to affordable insulin will only become direr the longer Congress waits to act to reduce patient costs,” said the Endocrine Society. Efforts to address insulin prices have been stalled in the Senate for months. The House of Representatives passed the Affordable Insulin Now Act in March. The House bill to cap copays was estimated to cost $20.4 billion over a decade, with $9 billion of that attributed to increased money for a Medicare improvement fund, noted Roll Call.
Clason L. Senators release bill targeting insulin prices. Roll Call. June 22, 2022. Accessed June 23, 2022. https://rollcall.com/2022/06/22/senators-release-bill-targeting-insulin-prices/
Endocrine Society urges Congress to pass bill to make insulin more affordable for people with diabetes. News release. Endocrine Society. June 23, 2022. Accessed June 23, 2022. https://www.endocrine.org/news-and-advocacy/news-room/2022/endocrine-society-urges-congress-to-pass-bill
Diabetes Caucus co-chairs Shaheen and Collins release bipartisan legislation to lower insulin costs. News release. Jeanne Shaheen. June 22, 2022. Accessed June 23, 2022. https://www.shaheen.senate.gov/news/press/new-diabetes-caucus-co-chairs-shaheen-and-collins-release-bipartisan-legislation-to-lower-insulin-costs_