Mar 30, 2022 - Politics & Policy

Senate making moves to lower insulin cost

Illustration of a syringe pulling from a vial with a hundred dollar bill as a label.

Illustration: Aïda Amer/Axios

The Senate is zeroing in on legislation to lower the cost of the insulin — a lifeline for millions with diabetes.

Why it matters: The drug costs eight times more in the U.S. than 32 other high-income nations, according to a 2020 study commissioned by the Health and Human Services Department. A $35 monthly price cap would help many diabetics.

  • As the Axios Vitals team points out, capping out-of-pocket insulin costs — a narrow sliver of President Biden's stalled Build Back Better package — might be the only way for Democrats to show they're capable of passing something on prescription drug prices before this fall's midterms.

Driving the news: Senate Majority Leader Chuck Schumer plans to bring legislation to the floor just after Easter that would cap the out-of-pocket cost for insulin products at $35 per month, and take other steps to extend relief to diabetics.

  • Sens. Susan Collins (R-Maine) and Jeanne Shaheen (D-N.H.) are finalizing their own bipartisan bill now that Shaheen has returned to work after a bout with COVID-19.
  • Their legislation will be based on a 2019 bill the two introduced targeting the middlemen between health insurance companies and pharmacies, Collins told Axios.
  • "We have a big advantage in that ... we've got a bill that we can use as a basis and further refine," Collins said.
  • The New Englanders' legislation would also build on Sen. Raphael Warnock's (D-Ga.) own bill capping the cost of insulin at $35 per month.

Even some Republicans are interested in engaging on the issue, which affects voters across the political spectrum.

  • "I'd be for some kind of regulation where we can help. Too many people paying thousands of dollars a month. I'm not big on regulating process, but that one's costing a lot of people a lot of money," Sen. Tommy Tuberville (R-Ala.) told Axios.
  • Senate Minority Whip John Thune told Axios there's "an interest in doing everything we can to bring drug prices down."
  • He said that includes "some efforts to get insulin prices down to that $35 number ... without having to slap a cap, or have the government set price controls."

The big picture: For years, lawmakers from both parties have tried to tackle the soaring cost of insulin.

  • Former President Trump passed a rule in 2019 aimed at ensuring federally funded health centers were passing along discounted rates of insulin — but it was not implemented by the Biden administration.
  • The Trump administration also negotiated with drug manufacturers and insurers the option for Medicare enrollees to sign up for prescription plans that set the maximum copy for insulin at $35 a month, an experimental program that remains today.
  • Warnock's legislation codifies it into law.

By the numbers: A recent Peterson-KFF Health System Tracker analysis found a $35 cap on insulin would benefit more than one-in-four insulin users in the individual and small group markets.

  • The benefit would apply t0 one-in-five insulin users in large employer-sponsored plans.

But, but, but: Other Republicans, including Rep. Kevin Brady of Texas and Sen. Rick Scott of Florida, favor alternative approaches.

  • They told Axios they see creating competition in the insulin markets as the key to driving down costs, and are unlikely to vote for any legislation that involves price controls.
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