Senators Jeanne Shaheen and Susan Collins think they have a way to bring down the price of insulin without needing to pass legislation regulating its price. Stat News reports that their proposal takes into consideration that drugmakers must pay insurers to give their drugs preferential treatment, driving up drug prices. It also assumes that drugmakers would voluntarily lower their list prices if legislation frees them from paying insurers. Really?
The Shaheen-Collins proposal would forbid pharmaceutical companies from paying insurers for preferential treatment. It would also limit people’s monthly out-of-pocket insulin costs. It would impose an out-of-pocket limit if insulin makers lowered their prices to $68 a vial, its 2006 price. Insulin now costs $300 or so a vial.
Shaheen and Collins don’t know whether manufacturers would agree to their proposal. If not, some people with insurance would still benefit, as the proposal would require insurers to offer at least one insulin product for no more than $35 out-of-pocket a month. However, people with diabetes need to use different insulin products, so that backstop would only benefit people who needed the one insulin product with a $35 max out-of-pocket cap.
Today, people with Medicare already have the option of capping their monthly insulin costs at $35 through their Part D drug plans. That said, about one in four of them still paid more than $35 a month for their insulin.
Few people benefit from an out-of-pocket cap of no more than $35. Many people’s out-of-pocket costs with insulin each month can be more than $150. At least one in four people who need insulin are paying more than $35 a month for it.
The Shaheen-Collins proposal would only help people who are uninsured if manufacturers lowered their list prices. Most likely, they would only do so voluntarily if the amount they no longer paid insurers to include their products on their formularies exceeded the difference between what they charge now for insulin and what they charged in 2006.
Many large advocacy groups think the Shaheen-Collins proposal is ridiculous. Drug manufacturers are not going to lower their prices voluntarily. And, if they don’t, the Shaheen-Collins proposal would cost the federal government billions. It would also increase health insurance premiums for everyone. as insurers would not eat the cost of a $35 monthly out-of-pocket limit, they would shift it. Moreover, the proposal would encourage insulin manufacturers to raise their prices further since they would know that any price increase would not affect people’s out-of-pocket insulin costs.
Congress needs to pass legislation that lowers all drug prices for everyone. In the meantime, for lower drug prices, check out Mark Cuban’s cost plus discounted drug pharmacy. You might also check out pharmacychecker.com for verified pharmacies selling drugs at far lower rates than in the US. And, then, there’s always the opportunity to pick up low-cost drugs on a trip to Mexico, Canada, Japan or Australia, among many other countries.
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