Save Lives by Capping the Out-of-Control Cost of Insulin
One hundred million Americans are at elevated risk of being required to use insulin, including 7 million who rely on daily doses to stay alive. Their life is in danger not just from their disease, but from the exploitative drug companies that make this life-saving drug unaffordable. Nearly a quarter of all insulin-dependent diabetics now skimp on doses due to cost. Yet the tripling of cost in the last decade is attributable almost entirely to the three large pharmaceutical companies that control 90% of the U.S. market. A carton of insulin that sells for $300 in the U.S. can be purchased in Canada for $20! Capping the monthly cost of insulin ensures that millions of Americans can afford a medicine that they cannot live without....
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Families impacted by diabetes
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Patient and consumer advocates
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Healthcare providers
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Pharmaceutical companies and pharmacy benefit managers profiting off of the high price of insulin
This act shall be known as the Insulin Cost Reduction Act
To reduce the cost of insulin for diabetics who are insured through commercial insurers by limiting their monthly cost sharing payments to reasonable amount.
(a) Every health plan offered by a carrier shall set the cost-sharing payment that a covered person is required to pay for a covered prescription insulin drug at an amount that does not exceed $30 per 30-day supply of the prescription insulin drug, regardless of the amount or type of insulin needed to fill the covered person’s prescription.
(b) Nothing in this section shall prevent a carrier from setting a covered person’s cost-sharing payment for a covered prescription insulin drug at an amount that is less than the maximum amount permitted pursuant to subsection (a).
(c) No provider contract between a carrier or its pharmacy benefits manager and a pharmacy or its contracting agent shall contain a provision
-(i) authorizing the carrier’s pharmacy benefits manager or the pharmacy to charge,
-(ii) requiring the pharmacy to collect, or
-(iii) requiring a covered person to make a cost-sharing payment for a covered prescription insulin drug in an amount that exceeds the amount of the cost-sharing payment for the covered prescription insulin drug established by the carrier pursuant to subsection (b).
