U.S. Senator Katie Britt announced that she is cosponsoring two pieces of bipartisan legislation to help all Alabamians access insulin. This includes the Affordable Insulin Now Act of 2023, which would cap the price of insulin for all patients, including those who are uninsured, at $35 for a 30-day supply.
“For many, insulin is essential for their long-term health and survival. Alabamians should not have to make the unthinkable choice about whether to purchase life-saving insulin or another basic necessity like food simply due to the drug’s prohibitive cost,” said Sen. Britt. “Additionally, these pieces of legislation would help support our healthcare system by increasing access to insulin for diabetic Alabamians, keeping them healthy so they do not require more costly treatments and extensive medical care down the road. I’ll continue to fight to ensure that every Alabamian, no matter their zip code, can live the American Dream.”
The bill was introduced by U.S. Senators John Kennedy (R-Louisiana) and Raphael Warnock (D-Georgia).
“I’ve long been focused on strengthening access to affordable health care and lowering costs for Georgians, and that’s why I am proud to lead the effort in the Senate to cap patients’ out-of-pocket costs for insulin,” Sen. Warnock said. “Georgians should never have to choose between paying for life’s basic essentials or life-preserving medicines.”
The Affordable Insulin Now Act would cap out-of-pocket costs of insulin products at $35 per month for people with private health plans and Medicare Part D plans, including Medicare Advantage drug plans. For commercial plans, this applies to one of each dosage form (ie. vial, pump, inhaler) of each different type of insulin (rapid-acting, short-acting, intermediate-acting, long-acting, ultra-long-acting, and premixed). For Medicare plans, this applies to all covered insulin products, and copays are capped at $35 for all preferred and nonpreferred products included on plan formularies. Require private group or individual plans to cover one of each insulin dosage form (i.e. vial, pen) and insulin type (i.e. rapid-acting, short-acting, intermediate-acting, and long-acting) for no more than $35 per month.
The legislation requires the Secretary of Health and Human Services to establish a program to reimburse qualifying entities for covering any costs that exceed $35 for providing a 30-day supply of insulin to uninsured patients.
“We need to stop nibbling around the edges,” Sen. Kennedy said. “We need to be smart enough to figure this out. And the cost? I think it can be done for $250 million a year, and I’m not talking about taking out a reverse mortgage on Alaska and borrowing more money. I’m talking about finding it in our budget. The federal budget is 6,000 billion dollars every year—and we can’t find $250 million to cap the price of insulin? Let’s do it right.”
Sen. Britt says that she is bringing awareness to the devastating impact of diabetes across Alabama and fighting to ensure that all Alabamians are able to access the life-saving benefits of affordable insulin. Senator Britt this week discussed the topics during a hearing of the Senate Committee on Appropriations with medical experts and youth diabetes advocates.
Dr. Griffin Rogers is the Director of the National Institute of Diabetes and Digestive and Kidney Diseases at the National Institutes of Health.
During the questioning of Rogers, Senator Britt noted the high rate of diabetes among Alabamians. Approximately 568,000 people in Alabama, or almost 12% of the state’s population, have been diagnosed with diabetes.
In Alabama, direct medical expenses total an estimated $4.2 billion a year for those who are diagnosed with diabetes.
Sen. Britt has also signed on as a co-sponsor of the Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act of 2023, which would comprehensively address the skyrocketing costs of insulin, removing barriers to care and making it more accessible for millions more Americans. This bipartisan legislation was introduced by U.S. Senators Susan Collins (R-Maine) and Jeanne Shaheen (D-N.H.).
The INSULIN Act of 2023 would limit out-of-pocket costs for patients with diabetes by ensuring that group and individual market health plans must waive any deductible and limit cost-sharing to no more than $35 or 25% of the list price per month for at least one insulin of each type and dosage form. Additionally, the legislation forbids pharmacy benefit managers (PBMs) would be prohibited from placing utilization management tools – prior authorization, step therapy, etc. – on products with capped out-of-pocket costs. Mandate PBMs pass through 100% of insulin rebates and other discounts received from manufacturers to plan sponsors, reducing perverse incentives in the insulin market that encourage high list prices and helping patients in the form of reduced premiums. It also promotes generic and biosimilar competition to lower costs to patients by creating a new expedited FDA approval pathway for biologic drugs lacking adequate biosimilar competition, similar to FDA’s current Competitive Generic Therapies pathway. This will improve the timeliness of resolving regulatory barriers slowing down market entry of lower-cost products; ensuring adequate oversight of the Food and Drug Administration’s (FDA) citizen petition process, easing approval of generic and biosimilar drugs; allowing Medicare Part D plans to place biosimilar drugs on formulary immediately after entering the market, identical to other generic drugs; and, requiring a report to Congress on issues and market dynamics delaying or restricting biosimilar insulin competition.
The Cardinal Institute opposes price caps on insulin. They argue that there is a growing idea that the government should create ceilings for drug pricing, manufacturing, and marketing, but that fundamental economics teaches that such restrictions fail to create an ethical, accessible healthcare system.
The Cardinal Institute argues that when governments create price limits on goods and services, they always initiate scarcity. When supply is low, and demand is high, prices rise, or, in this case, where businesses are constrained, profits must be funneled away from research and innovation. They claim that numerous economic studies indicate price caps reduce the number of new drugs being brought into the market. Thus, temporary relief creates disastrous long-term effects.
Katie Britt was elected to her first term in the U.S. Senate in 2022.
To connect with the author of this story or to comment, email brandonmreporter@gmail.com.
