Is insulin now REALLY affordable? Not for everyone. Recently passed legislation called the "Affordable Insulin Now Act" is not living up to its name. It's time for Americans to exercise their rights as citizens by contacting their SENATORS and demanding REAL reform.
The "Affordable Insulin Now" Act, recently passed by the US House of Representatives does NOT, as many headlines read, cap the cost of insulin. It is simply not living up to its name, as summarized in this recent article.
The Act effectively only caps the copayment owed by patients with diabetes who have coverage through Medicare and for those with private insurance. Problem solved?
NOT EVEN CLOSE.
While the legislation may be a "Band-Aid" at the pharmacy counter for those who have insurance and Medicare patients (many of whom report having to ration their month's supply of insulin as prices have skyrocketed), the cost of insulin will remain unacceptably high. To the tune of an 800% increase over the past few decades, which all of America will continue to pay. As we all know, skipping doses of insulin for someone with diabetes is VERY dangerous, and over time can lead to accelerated kidney damage, heart disease, impaired vision, amputated limbs (due to poor circulation) and other terrible health consequences.
WHY IS INSULIN SO COSTLY?
Is it because insulin is difficult to produce? Is it because of shortages in the supplies needed to manufacture it? Is it because many expensive studies have to be funded to find out whether or not insulin works?
No. No. and No.
Insulin was discovered in 1921 by a Canadian physician Dr. Frederick Banting who sold the patent to the University of Toronto for $1, stating “Insulin belongs to the world, not to me.” He and his fellow Nobel Prize recipients did not want this drug to be misused for profit or personal gain. Why, then, has the price of a vial of Humalog (insulin lispro) gone from $20 to over $300 in the span of the past 2 decades? Simply: GREED.
It's no wonder that patients have resorted to skipping doses, buying vials from strangers on CraigsList, or (before the pandemic) traveling to other countries to be able to afford their medication.
The Act passed by the House of Representatives does NOTHING for the uninsured patient and, in the end, also hurts those with insurance through their employers. Any money saved in copayments will be erased when employers raise employee contributions, lay workers off, or offer plans with huge out of pocket deductibles. What patients don't pay at the pharmacy counter they will pay dearly for on the back-end. Patients will continue to need to choose between buying groceries or their insulin.
DO NOT PASS "GO" DO NOT COLLECT $200
The cap on insulin copays simply shifts the costs and allows profiteers to keep profiting. Who are these MONOPOLY-playing profiteers? Pharmaceutical Benefit Managers. The biggest of the PBM middlemen, all Fortune 500 top earners, have been legally granted the right to collect kickbacks, that are euphemistically call "rebates." Except that this "so-called" rebate does not go back to the patient; it ends up in the pockets of the greedy PBM middlemen.
Any insulin pricing bill that does not address the PBM and middleman issue will not reduce the root cause of WHY the price of insulin (and other drugs) has soared.
Worse yet, the uninsured will be forced to come up with the full inflated price at the pharmacy counter, as the Affordable Insulin Now Bill does NOTHING to make insulin more affordable for these economically disadvantaged patients. This includes the many uninsured and uninsurable immigrant patients who are in our country who suffer from diabetes, the most common chronic illness in the world.
THERE IS HOPE
It's now the Senate's turn. The Senate still has time to craft a bill that will address the role of the PBMs in the cost of insulin and every other drug in America.
Do your part by contacting the Senators in your state and tell them you support an approach that holds the PBMs accountable. There is a bill being crafted by Democrat Jean Shaheen (New Hampshire) and Republican Susan Collins (Maine) who co-chair the Senate Diabetes Caucus. This bill has the support of Senate Majority Leader Chuck Schumer and is NOT one that is popular amongst the powerful and influential lobbyists who represent the profiteers.
Lawmakers and shareholders are invited to share input on the final legislation by APRIL 20, 2022. Your Senators need to hear from their constituents (YOU!!). Make sure your Senator has received and responded to Shaheen and Collins' "Dear Colleague" letter that was sent to them on April 11, 2022.
Everyone knows SOMEONE affected by diabetes, and as such are stakeholders. For too long we have allowed lobbyists and special interests to profit from a game that has perverse incentives and rules, and it is high time that we level the playing field.
We deserve legislative action that TRULY reduces the cost of insulin and other needed medications for ALL who need them. We need to build back better with REAL drug pricing reform that will only come with oversight and transparency for PBMs and other middlemen who have been allowed to profiteer for TOO long.
To contact YOUR own Senators, use this link (www.senate.gov/senators/senators-contact.htm) and cc your comments to firstname.lastname@example.org.
If you have never contacted your Senator's office before, don't be intimidated. Most Senators ask you to leave a comment via voicemail and/or you can email your comments. Do both! If your Senator's staff happens to actually answer your phone call, don't panic! Ask to speak to the Congressional Staffer in charge of healthcare matters for your Senator, and tell that Staffer or Aide that you are a stakeholder calling to share input about the upcoming insulin pricing bill.
If you have a relevant personal story to tell, share it! Keep your message concise and to the point. Show your friends, family and colleagues how easy it was.
Below is some sample wording for comments that you can say verbally or send via email:
As a (physician) (patient with diabetes) (relative of a patient with diabetes), I STRONGLY support legislation that prohibits insurance plans and pharmacy benefit managers (PBM's) from collecting rebates from insulin manufacturers. These rebates drive up the cost of ALL drugs at the pharmacy counter and directly harm patients (particularly the uninsured and uninsurable). Thank you for your strong work on this front and for putting patients before profits.