Brookhaven Daily Leader
INSULIN Act would limit out-of-pocket costs to $35 monthly
By Daily Leader Staff
Legislation now in the U.S. Senate would lower the cost of insulin for patients with diabetes, as well as reinforce patient protections.
Senate Bill 4189, The Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act would cap the monthly out-of-pocket cost of insulin at $35 for Americans on private and employer-sponsored insurance, and create a pilot program to provide insulin at the same cost to American’s with no insurance.
“The INSULIN Act represents a strong, bipartisan effort to try to stop the unnecessary year-over-year increase in the price of insulin. Mississippians from across the state share their stories of their stress caused by insulin prices,” said Mississippi Senator Cindy Hyde-Smith, of Brookhaven. “These elevated insulin prices not only affect family budgets, but they also cost taxpayers more as those living with diabetes ration dosages and end up hospitalized with other complications. The INSULIN Act is a step in the right direction.”
S.4189 would directly address the root causes of high insulin list prices, while simultaneously extending vital patient protections, fostering competition and broadening access to needed insulin products.
The INSULIN Act would:
- Limit out-of-pocket costs for patients with diabetes by ensuring that group and individual market health plans waive any deductible and limit cost-sharing to no more than $35 per month for at least one insulin of each type and dosage form.
- Mandate that pharmacy benefit managers (PBMs) pass through 100 percent of insulin rebates and other discounts received from manufacturers to plan sponsors, reducing perverse incentives in the insulin market that encourage high list prices to help patients in the form of reduced premiums.
- Promote generic and biosimilar competition to lower costs for patients.
- Create a pilot grant program for 10 states to implement programs to identify uninsured diabetes patients and provide them with insulin at $35 a month.
- Establish an insulin resource center and hotline for uninsured diabetes patients to connect them with resources about diabetes and programs to help them secure insulin.
Senate Diabetes Caucus Co-Chairs U.S. Senators Shaheen (R-N.H.) and Susan Collins (R-Maine) introduced S.4189, which has been referred to the Senate Health, Education, Labor, and Pensions Committee. With Hyde-Smith, a total of 26 Senators are sponsoring the measure.
According to the Mississippi State Department of Health, Mississippi is ranked in the top five states nationally for diabetes rates, with an estimated one in seven Mississippians living with the disease. Mississippi has one of the highest diabetes mortality rates in the country, recording upwards of 34.7 to 42.1 deaths per 100,000 residents. The national rate is 27.8 deaths per 100,000 residents.
S.4189 is supported by the American Diabetes Association, Breakthrough T1D, the Endocrine Society, the National Kidney Foundation and other stakeholders.