A bipartisan group of Ohio lawmakers has introduced a bill that would cap the cost of the life-saving insulin drug at $35.
Drug prices are rising, but the demand for drugs has not changed.
“I went to school full time and sometimes I really had to debate about tuition, food, other living expenses and insulin,” said Munira Abdullahi, who has type 1 diabetes.
According to the American Diabetes Association, the total cost of insulin and other blood glucose-controlling medications increased by 26% between 2017 and 2022. The organization found that the total annual cost of diabetes in 2022 was $412.9 billion. According to the research organization RAND Corporation, although the price of insulin has dropped, the average cost of insulin remains around $99.
Diabetics like Munira Abdullahi have a pancreas that does not produce the insulin needed to survive. All people with type 1 need insulin, but only some people with type 2 need it.
Type 1 is a chronic, lifelong autoimmune disease in which the body’s immune system attacks the insulin-producing cells in the pancreas. According to the Cleveland Clinic, the main cause of type 2 is insulin resistance, which occurs when the body does not respond to insulin and therefore tries to raise the amount of insulin to combat rising blood glucose levels. Type 2 is also a long-term condition, but can be managed with lifestyle changes such as exercise and monitoring blood sugar levels.
She found comfort in her friend Thomas Hall, who also has type 1. They both realized they wanted to assist people suffering from the same disease.
“In Immiedaltey I thought, ‘I’ve got a bill to cut insulin. Do you want to join forces?” she asked as Hall stood next to her during the interview. “And I’m lucky he agreed to it.”
Both are actually lawmakers: Democratic state Rep. Abdullahi of Columbus and Rep. Hall Hall of Madison Township. They presented House Bill 384that would limit cost-sharing requirements for a 30-day supply of insulin to $35 and for diabetes management devices such as glucose monitors or insulin pumps to $100.
“This does not benefit my party or their party,” Hall said. “This benefits all Ohioans.”
The bill mirrors federal law that caps insulin at $35 for adults 65 and older on Medicare. Lawmakers say their legislation will cover all juniors. However, HB 384 only covers insured patients. Lawmakers say they are working on another bill for those who don’t have insurance.
Under the Inflation Reduction Act, people on Medicare are eligible for the following benefits:
- The federal government will negotiate drug costs
- The price of insulin does not exceed $35
- Free vaccines
- Reducing current expenses
- Discounts if prices raise too quickly
We contacted the world’s largest insulin manufacturers and pharmaceutical associations but did not receive a response by deadline, so Case Western Reserve University medical law professor Sharona Hoffman explained why these groups might not support the legislation.
“It could cut into profits,” Hoffman said matter-of-factly.
Companies may argue that bringing a modern drug to market is exorbitant, she added.
“They are concerned about whether they will be able to remain profitable if we tend to increase price restrictions,” the professor said, noting that insulin has been available for so long that this would not apply.
This is ridiculous, Abdullahi said.
“The average cost for them is about $5,” she said. “The fact that it costs the average American $99, and for some more, is unacceptable.”
Meeting the deadline, Pharmaceutical Research and Manufacturers of America issued a statement blaming insurers for the high prices.
“Insulin is a perfect example of how insurers and PBMs that too often do not share rebates and discounts with patients raise out-of-pocket costs. Manufacturer rebates and discounts reduce the average price that insurers and PBMs pay for insulin by 80% or more, but these intermediaries can charge patients the full list price. Moreover, PBMs refuse to finance cheaper versions of insulin introduced by biopharmaceutical companies. Policymakers must reform these misaligned incentives to improve affordability and stop middlemen from gaming the system at the expense of patients,” said PhRMA spokesman Reid Porter.
Insurance groups I spoke to today said they disagree with this bill because it could in turn reduce the amount they would have to cover.
Eli Lilly, Novo Nordisk and Sanofi these are the three largest producers of insulin. Each announced a price cap, with Eli Lilly being the first to make the change.
Novo Nordisk responded to our request for comment by saying it has reduced U.S. list prices for several insulin products by up to 75% for people with type 1 and type 2 diabetes.
They couldn’t comment on the bill, but they did give us a general statement.
“We know that not all patient situations are the same, which is why we offer a wide variety of affordable insulins NovoCare. Importantly, we are constantly reviewing and revising our offering and working with various stakeholders to create solutions that meet different patient needs,” said spokeswoman Charlotte Zarp-Andersson.
HB 384 will continue to be heard in the coming months.
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This article was originally published on News5Cleveland.com and are published in the Ohio Capital Journal under a content sharing agreement. Unlike other OCJ articles, it is not available for free republication on other news outlets because it is owned by WEWS in Cleveland.
