Shaheen, Collins, DeGette & Reed Unveil Bipartisan Policy Priorities to Lower Insulin Costs, Invite Lawmakers and Stakeholders to Share Input on Final LegislationApril 11, 2022
**Bicameral Co-Chairs of the Senate and House Diabetes Caucuses revealed their top policy priorities to limit out-of-pocket costs for patients with diabetes & encourage insulin manufacturers to reduce list prices**
(Washington, DC) – U.S. Senators Jeanne Shaheen (D-NH) and Susan Collins (R-ME) – Co-Chairs of the Senate Diabetes Caucus – unveiled new bipartisan policy priorities today with House Diabetes Caucus Co-Chairs Diana DeGette (CO-01) and Tom Reed (NY-23) to lower skyrocketing insulin costs. Senator Shaheen and Senator Collins also invited their Senate colleagues to provide input as the members finalize their legislation. Shaheen and Collins previously spearheaded the Insulin Price Reduction Act, which would hold those throughout the insulin supply chain – like big pharmaceutical companies, pharmacy benefit managers and insurers – accountable for surging insulin costs by incentivizing reductions in list prices. The priorities unveiled by the Senate and House Diabetes Caucus Co-Chairs today builds on Shaheen and Collins’ previous effort, increasing measures to encourage insulin manufacturers to reduce list prices, while extending beneficiary protections that will foster competition and broader access to desperately needed insulin products.
More than 37 million Americans live with diabetes, including an estimated one in every three seniors. Untreated, diabetes can lead to vision problems, nerve damage, kidney failure, heart disease, stroke, and ultimately death. It is one of the leading causes of death in the United States, claiming over 100,000 lives in 2021. Diabetes is also the most expensive chronic condition in the nation, costing a total of $327 billion per year. Medical costs for Americans with diabetes are more than double those incurred by individuals without diabetes, and one out of every three Medicare dollars go to treating people with diabetes.
Insulin is one of the most expensive categories of drugs purchased by private and government health care payers. The rising cost of insulin presents a barrier to care for a growing number of Americans with diabetes. Out-of-pocket costs increase with list prices, and for people without insurance, the costs are untenable. Between 2012 and 2016, the average list price of insulin nearly doubled. 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 is a life-or-death concern for many of the millions of Americans living with diabetes. Lowering skyrocketing costs to ensure this critical medicine is never out of reach is an urgent need and a crucial bipartisan priority in Congress. We’ve been working for years to find common ground to get this done and we now have an opportunity to get bipartisan legislation over the finish line and ensure that patients with diabetes and their families are no longer burdened with insurmountable costs for this critical, life-saving medication,” said Shaheen and Collins. “Our proposal holds all parties accountable by encouraging them to reduce list prices, and critically, it limits out-of-pocket costs for patients with diabetes. We have made great progress, and soliciting feedback is the next step in our process. With strong bipartisan leadership, we look forward to continuing to work together to deliver on this issue for Americans with diabetes and their families – we must seize the moment and uphold our commitment to finally combat the decades-long surging prices of insulin.”
Shaheen, Collins, DeGette and Reed are specifically prioritizing the following policies in their proposal:
- Encourage insulin manufacturers to reduce list prices by:
- Ensuring insurance plans and pharmacy benefit managers cannot collect rebates, which drive up drug costs at the point of sale, on insulins that roll prices back to 2006 or equivalent levels;
- Making such insulins eligible for cost-sharing protections, including a waiver on any applicable deductible and limiting copays or coinsurance to no more than $35 per month; and
- Supporting patient access to such insulins by ensuring coverage and that prior authorization or other medical management requirements cannot be imposed to limit beneficiary use.
- 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 per month, for at least one insulin of each type and dosage form.
A Dear Colleague from Shaheen and Collins inviting Senators to provide input on final legislation is available here. Senators Shaheen and Collins also solicit input from all interested stakeholders as they refine the policy. Stakeholders should submit feedback to firstname.lastname@example.org by April 20, 2022.
As Co-Chairs of the Senate Diabetes Caucus, Shaheen and Collins have worked to increase awareness of the threats posed by diabetes, invest in research and improve access to treatment options. They have consistently held insulin manufacturers, insurers and pharmacy benefit managers accountable for the skyrocketing cost of life-saving insulin. Last year, Shaheen and Collins led a bipartisan group of Senators to reintroduce the Expanding Access to Diabetes Self-Management Training Act, which would expand Medicare coverage for diabetes self-management training (DSMT) sessions, where diabetes educators help train Medicare patients on how to manage their glucose, maintain a healthy weight, eat healthy foods, manage their insulin levels and improve general care for their diabetes.
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