Collins and Shaheen—Co-Chairs of the Senate Diabetes Caucus—were joined by patients and health care providers from Maine and New Hampshire to urge action on the Senators’ bipartisan bill to hold health care middlemen & insulin manufacturers accountable fo
Portsmouth, NH—U.S. Senators Susan Collins (R-ME) and Jeanne Shaheen (D-NH), co-chairs of the Senate Diabetes Caucus, held a press conference this afternoon at Wentworth-Douglass Hospital’s Portsmouth Outpatient Center with patients and health care providers to highlight the Senators’ new bipartisan bill that would roll back over a decade of insulin price hikes. Their legislation – the Insulin Price Reduction Act – would hold pharmacy benefit managers (PBMs), pharmaceutical companies, and insurers accountable for these surging prices by incentivizing reductions in list prices. The Senators introduced the bill on Monday with Senators Tom Carper (D-DE) and Kevin Cramer (R-ND).
Shaheen and Collins were joined by patients from New Hampshire and Maine living with diabetes, as well as local health care providers. Pete Buckley of Portland, Maine, said not a single minute of the day goes by that he doesn’t think about his insulin. Jay Dunigan of York, Maine, described his experience being without insurance for a short period of time, when he went from paying $40 per month for insulin to more than $250 per month for one of the insulins he required. Robert Slavin of Franklin, New Hampshire, told his personal story and explained the financial strains caused by surging insulin prices. Slavin shared that he has had to choose between paying rent and buying insulin – his lifesaving medication to manage his diabetes.
“Senator Shaheen and I work very closely together as co-chairs of the Senate Diabetes Caucus to advance policies that will improve the lives of those with diabetes. One of our top priorities is making insulin more affordable, and this bipartisan legislation will help do exactly that,” said Senator Collins. “I very much appreciate the willingness of Pete and Jay from Maine and Robert from New Hampshire for sharing their personal stories about what they have faced when trying to obtain affordable insulin when the price has doubled in the past seven years. This bill would make a real difference in their lives and in the lives of millions of other people with diabetes.”
“Today, the price of a month-supply of insulin can be as high as a new car payment,” said Shaheen. “There’s absolutely no reason for drug companies and middlemen to demand that 30 million Americans with diabetes reach deeper and deeper into their pockets to pay for the medication they need to stay alive. That’s why Senator Collins and I have introduced the Insulin Price Reduction Act to roll back over a decade of insulin price hikes. The goal of this bill is to protect Americans with diabetes from elaborate price gouging and hold health care middlemen and insulin manufacturers responsible for keeping prices down. We can’t continue to allow insulin prices to determine whether Granite Staters and Mainers with diabetes can put food on the table or pay their bills.”
Rising insulin prices have been a growing concern for people with diabetes and their families in recent years. Between 2012 and 2016, the average 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. Between 2006 and 2019, several popular brands of insulin even quadrupled in price. Recent research suggests that insulin “list” prices, paid by many patients at the pharmacy counter, are growing at significantly faster rates than the growth of “net” prices paid to insulin manufacturers for their product.
This is where rebates come in. Rebates are paid by insulin manufacturers to middlemen, known as pharmacy benefit managers (PBMs), and insurers. This rebate system between manufacturers, PBMs, and insurers has contributed greatly to the increase in the list price paid by patients because the rebates are based on a percentage of the list price. As PBMs and insurers require a greater percentage rebate off of list prices, it creates incentives for manufacturers to in turn increase the list price. These higher list prices are often borne by patients.
While some patients do not have to pay these full list prices at the pharmacy counter and instead simply pay co-pays or limited coinsurance for insulin, uninsured patients and individuals in high-deductible health plans are forced to pay the full list price when purchasing insulin. For these individuals, the prices are hitting a tragic breaking point, as patients have died from complications that result from rationing insulin due to its high cost.
The Insulin Price Reduction Act would prohibit PBMs and insurers from receiving rebates for insulin products for which the manufacturer has complied with the bill’s list price reduction requirements. Specifically, insulin manufacturers that reduce the 2020 list price of their insulin product to a level no higher than the 2006 list price will be eligible for these rebate restrictions. To retain the rebate restriction treatment for the following year, any increases in the list price for the insulin product must be limited to no more than the increase in medical inflation for the year. These rebate restrictions would apply to all private insurance plans and Medicare Part D plans. The bill also requires that PBMs and insurers waive the deductible for any insulin product that meets these list price reduction requirements each year. The deductible limitations would apply to all private insurance plans.
The bill’s insulin list price reductions and waiver of deductibles for those insulins have the potential to save many people with diabetes hundreds or even thousands of dollars per year in insulin costs.
As co-chairs of the Senate Diabetes Caucus, Senators Collins and Shaheen have worked together to increase awareness of the threats posed by diabetes, invest in research, and improve access to treatment options. They have consistently pressed to hold insulin manufacturers, insurers, and PBMs accountable for the skyrocketing cost of life-saving insulin. In March, the Senators reintroduced their bill to expand access to diabetes self-management training, and last month they led the bipartisan push in the Senate to ensure continued support for the Special Diabetes Program.
Bill text of the legislation can be found here.