COLUMBUS, Ohio — A bipartisan group of Ohio lawmakers has introduced a bill to cap the costs of the life-saving medication insulin to $35.
Medication prices are rising, but the need for the drugs hasn't changed.
"I went to school full time and really had to debate sometimes — tuition or food or different life expenses and insulin," Munira Abdullahi, who has Type 1 diabetes, said.
The total cost of insulin and other medications that manage blood glucose levels increased by 26% from 2017 to 2022, according to the American Diabetes Association. The organization found that the total annual cost of diabetes in 2022 was $412.9 billion. Although it has gone down, the average cost of insulin remains about $99, according to research organization RAND Corporation.
RELATED: Insulin prices are soaring, Ohioans are dying, and many are calling for capped costs
Diabetics like Munira Abdullahi have a pancreas that doesn’t create the insulin they need to survive. All Type 1's need insulin, but only some people with Type 2 need it.
Type 1 is a chronic, lifelong autoimmune disease, one where the body's immune system attacks cells in the pancreas that make insulin. The main cause of Type 2 is insulin resistance, which is when the body doesn't respond to insulin, and thus tries to make more to combat the increasing blood glucose levels, according to the Cleveland Clinic. Type 2 is also long-term, but it can be managed with lifestyle changes, like exercising and blood sugar monitoring.
She found solace in her colleague Thomas Hall — who also has Type 1. Both realized they want to help out people who suffer from the same condition.
"Immiedaltey I went into, 'I've got a bill to cap insulin. Do you want to team up?'" she said while Hall stood beside her in the interview. "And I'm so fortunate he was down for it."
The pair are actually lawmakers: Democratic state Rep. Abdullahi from Columbus and Republican state Rep. Hall from Madison Township. They introduced House Bill 384, which would cap cost-sharing requirements for a 30-day supply of insulin at $35 and for diabetes care devices, such as glucose monitors or insulin pumps, at $100.
"It doesn't benefit my party, it doesn't benefit her party," Hall said. "It benefits all Ohioans."
The bill mirrors federal law that capped insulin at $35 for adults 65 and older who are on Medicare. The lawmakers say their legislation will cover everyone younger. However, H.B. 384 only covers insured patients. The legislators say they are working on another bill for those who don’t have insurance.
Through the Inflation Reduction Act, those on Medicare are eligible for the following:
- Federal government will negotiate the costs of drugs
- The price of insulin is no more than $35
- Free vaccines
- A cap on out-of-pocket spending
- Rebates if prices rise too fast
RELATED: Inflation Reduction Act to lower costs of prescription drugs for those on Medicare
We reached out to the world’s major insulin manufacturers and pharmaceutical associations but didn’t hear back by our deadline, so Case Western Reserve University medical law professor Sharona Hoffman explained why those groups may not support the legislation.
"It can cut into profits," Hoffman said matter-of-factly.
Companies may argue that it's expensive to bring a new drug to the market, she added.
"They worry about whether or not they'll be able to remain profitable if we have a trend of increasing price limitations," the professor said, noting that insulin has been around for so long that this wouldn't apply.
This is ridiculous, Abdullahi said.
"The average cost to them is about $5," she said. "It being an average cost of $99 to the average American, and more for some, is unacceptable."
Following our deadline, the Pharmaceutical Research and Manufacturers of America gave a statement, blaming insurers for the high prices.
“Insulin is a prime example of how out-of-pocket costs are driven up by insurers and PBMs who, too often, fail to share rebates and discounts with patients. Manufacturer rebates and discounts lower the average price insurers and PBMs pay for insulin by 80% or more, but these middlemen can charge patients the full list price. On top of that, PBMs refuse to cover lower-cost insulin versions introduced by biopharmaceutical companies. Policymakers need to reform these misaligned incentives to improve affordability and stop middlemen from gaming the system at the expense of patients,” said PhRMA spokesperson Reid Porter.
The insurance groups I spoke to today said they were fine with the bill because it could — in turn — lessen the amount they would need to cover.
Eli Lilly, Novo Nordisk and Sanofi are three of the largest insulin makers. Each has announced a price cap, with Eli Lilly being the first to make a change.
Novo Nordisk responded to our request for comment, saying that they lowered the U.S. list prices of several insulin products by up to 75% for people living with Type 1 and Type 2 diabetes.
They could not comment on the bill but did give us a general statement.
"We recognize that not all patient situations are the same and we have a number of different insulin affordability offerings available through NovoCare. Importantly, we continually review and revise our offerings as well as work with diverse stakeholders to create solutions for differing patient needs," spokesperson Charlotte Zarp-Andersson said.
H.B. 384 will continue to be heard in the coming months.
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