State lawmakers can better aid communities bearing the brunt of high insulin prices by expanding policies to cover the uninsured and addressing practices of drug industry middlemen, analysts and patient groups say.
A Democratic state lawmaker in Wisconsin recently proposed a bill that would cap the price of insulin at $35 for residents with state-regulated commercial health plans. Legislatures in others states, including Massachusetts and Pennsylvania, are also considering proposals that would add them to the list of 25 states that currently limit copayments for patients covered by commercial plans.
In California, Gov. Gavin Newsom (D) recently vetoed a bill that would have set a $35 insulin copay cap, citing the state’s efforts to manufacture its own low-cost insulin. But that plan, which Newsom argued would better address high prices, is facing unanticipated delays and likely won’t meet its initial 2024 timeline.
At a time when the cost of insulin remains a major policy issue for the Biden administration and federal lawmakers, drug pricing analysts say states need a more multipronged approach that accounts for rebates and fees drugmakers pay to pharmacy benefit managers, which manage prescription drug coverage on behalf of employers and others. Additionally, they argue 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.
Copay caps “do stop the bleeding” by reducing some patients’ out-of-pocket costs, but they don’t address, “why is it that we don’t have cheaper insulin? And why haven’t prices been driven lower?” said Dana Goldman, co-director of the University of Southern California’s Schaeffer Center for Health Policy & Economics.
Print Page
Email to a Friend