Diabetes advocates frustrated after insulin cost cap is dropped from drug pricing bill

·3 min read

Senate Democrats are working on a prescription drug pricing reform proposal aimed at lowering the cost of prescription drugs by allowing Medicare to negotiate certain drug prices.

But concerns are growing about what is not included in the package anymore: a proposal to cap the cost of insulin at $35 a month.

Staff for the Democrats on the Senate Finance Committee said the provisions were removed because a separate bipartisan Senate bill includes the monthly $35 insulin cost cap for people with Medicare or private insurance.

But that separate measure faces an uphill battle because it would need at least 60 votes in the Senate to pass.

For diabetics like Mindy Salango, who relies on insulin to treat her Type 1 diabetes, the move to remove the insulin cost cap from the broader drug pricing package was a major blow.

“Our lives are on the line,” said Salango. “Just incredibly frustrating. Incredibly disheartening and I’m extremely concerned … I have to defend the rights of diabetics to live and I don’t understand this disconnect. I don’t understand what they’re not hearing. I don’t understand why they don’t feel the urgency.”

A group of advocacy organizations pushing for lower drug costs sent a letter to Sen. Majority Leader Chuck Schumer (D-N.Y.) urging the Senate not to exclude the insulin cost cap from the broader legislation.

“Excluding insulin from drug pricing reform would be a slap in the face for the millions of Americans who rely on this lifesaving medicine to manage their diabetes,” said Peter Maybarduk, Access to Medicines program director at Public Citizen. “Insulin typifies the price abuse and treatment rationing that drug price reform must begin to fix, so it’s particularly shocking that Congress has dropped it.”

The insulin price cap was also part of a Democrat-backed bill that passed in the House earlier this year and it’s something President Joe Biden included in his broader economic proposal.

“There is nothing more broken in our health care system as the way America pays for lifesaving medicines like insulin,” said Sen. Ron Wyden (D-Ore.) during a March 2022 hearing for the Senate Finance Committee.

Certain drug pricing caps have faced Republican opposition over concerns about government interference with the free market and critics argued the Democrats’ proposals didn’t do enough to address the underlying problem of high drug costs.

“These proposals would impose bureaucratic government price controls with a host of bad consequences for consumers, patients and small businesses,” said Sen. Mike Crapo (R-Idaho) during the March hearing about the bill that passed in the House.

But an insulin cost cap has received some bipartisan support.

In the March hearing, Crapo pointed to a proposal he introduced that would have capped insulin out-of-pocket costs at $50 a month for certain Medicare recipients.

Democrats are pushing to pass the broader drug pricing bill through a process known as reconciliation in order to pass it with a simple majority instead of needing at least 60 votes in total in the Senate.

Staff for the Senate Finance Committee said the proposal is now under review by the Senate Parliamentarian to determine if the bill’s language is compliant with the Senate rules to move forward with that process.

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