Biden makes strides on insulin affordability while Newsom stalls progress | Opinion

For two decades, I’ve relied on insulin to keep myself alive. There are millions of people just like me in California and tens of millions across the country.

But drug manufacturers know that diabetics like me can’t simply stop using insulin, so prices go up and up. The insulin that keeps me alive can cost hundreds or even thousands of dollars a month.

I’m lucky: Medicaid covers much of the cost of my insulin, but for many Californians, finding an affordable source of insulin is a daily struggle. Too many people ration their insulin when they can’t afford the next month’s supply, so I volunteer with T1International and #insulin4all, a grassroots, patient-led movement fighting for a world in which everyone has access to insulin and supplies. I also help crowd-source insulin for diabetics who can’t afford their medication, and nearly every month I meet someone in a parking lot or other public place to provide them with crowd-sourced insulin they need to survive.

Opinion

The price of insulin has shot up over the last two decades in part because when lawmakers instituted Medicare’s prescription drug program in 2003, a Republican-controlled Congress barred it from negotiating prices with drug companies. The federal government is the largest purchaser of insulin in the country, mostly for Medicare patients, but unlike any other entity buying almost any other good or service, it has one hand tied behind its back when dealing with drug companies.

That changes this year: President Joe Biden and Congressional Democrats fulfilled a longstanding campaign promise to free Medicare to negotiate prescription drug prices for seniors. The Department of Health and Human Services has selected ten drugs in a pilot program and will add more in the coming years. Novolog, one of two types of insulin I take, is among the ten drugs that will see cheaper prices, bringing huge savings for Medicare recipients and taxpayers in general.

Statewide, however, progress has stalled. Gov. Gavin Newsom just vetoed Senate Bill 90, which would have capped the copay for insulin at $35 per month for all patients — not just those covered by Medicare.

Fortunately, Biden’s Inflation Reduction Act has already capped monthly insulin co-pays at $35 for seniors on Medicare. (And after public pressure, some insulin manufacturers dropped their price to $35 per month for all users, not just seniors.) Starting in 2025, the Inflation Reduction Act will also cap annual prescription drug costs at $2,000 for seniors. For seniors with multiple medical conditions, these changes will literally save lives.

Still, there is much to be done; Medicare price negotiations so far affect only one type of insulin, and many diabetics rely on multiple types of insulin to stay alive. While spillover effects from the price negotiations will benefit all Americans, the most direct benefit will be felt by Medicare recipients.

Newsom, meanwhile, is working on another track to lower the cost of insulin by investing in a state-run pharmaceutical company (CalRx) that will produce and distribute insulin at an affordable price. I applaud this effort, but until it becomes a reality, all Californians deserve relief from unaffordable insulin prices.

The current copay cap for prescription drugs is $250 per month; SB 90 would have lowered that to a manageable $35 per month. Newsom and Big Pharma representatives contend that the bill would increase premiums, but an independent study by the state’s Health Benefits Review Program found that premiums would increase by a mere .02% while the average cost of the prescription would fall 67%, freeing millions of Californians being held hostage by exorbitant insulin prices.

Biden’s Medicare prescription drug negotiation program will save lives and help keep Californians from rationing this vital medication. Newsom’s CalRx program will do the same when it’s up and running, but in the meantime, our state must do more to make insulin affordable for all.

Kevin Wren is the chapter leader of California #insulin4all , a group of volunteer advocates working to raise awareness about the insulin price crisis.