Diabetes Caucus Co-Chairs Collins, Shaheen Release Bipartisan Legislation to Lower Insulin Costs

Press Release

U.S. Senators Susan Collins (R-ME) and Jeanne Shaheen (D-NH) -- Co-Chairs of the Senate Diabetes Caucus -- announced their new bipartisan legislation, the Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act, to lower the skyrocketing costs of insulin. The new, bipartisan legislation builds on Collins' and Shaheen's previous efforts, increasing measures to encourage insulin manufacturers to reduce list prices, while extending patient protections that will foster competition and broader access to desperately needed insulin products. Senators Collins and Shaheen held a press conference today with advocacy organization representatives and stakeholders to discuss the urgent need to lower insulin costs.

More than 37 million Americans live with diabetes, including an estimated one in every three seniors. Untreated diabetes can lead to vision problems, nerve damage, kidney failure, heart disease, stroke and ultimately death. It is one of the leading causes of death in the United States, claiming over 100,000 lives in 2021. Diabetes is also the most expensive chronic condition in the nation, costing a total of $327 billion per year. Medical costs for Americans with diabetes are more than double those incurred by individuals without diabetes, and one out of every three Medicare dollars goes to treating people with diabetes.

Insulin is one of the most expensive categories of drugs purchased by private and government health care payers. The rising cost of insulin presents a barrier to care for a growing number of Americans with diabetes. Out-of-pocket costs increase with list prices, and for people without insurance, the costs are untenable. Between 2012 and 2016, the average list price of insulin nearly doubled. According to the Health Care Cost Institute, the price of an average 40-day supply of insulin rose from $344 in 2012 to $666 in 2016.

"Access to insulin can be the difference between life and death for many Americans living with diabetes. For far too long, patients have stretched their budgets, rationed insulin and made difficult personal decisions to keep this drug within reach for themselves or those they love. Bringing Democrats and Republicans together to address the surging cost of insulin has long been a priority for us as co-chairs of the Senate Diabetes Caucus, and today, we're announcing a bipartisan proposal to deliver on that shared goal," said Senators Collins and Shaheen. "Our legislation would extend direly needed patient protections to Americans living with diabetes by encouraging manufacturers to reduce their list prices of insulin. This legislation is the result of months of good-faith negotiations and input from lawmakers, advocates and experts. It is paramount that Congress acts swiftly, which is why we are calling on Senate leadership to bring our legislation to the floor as soon as possible. There is support on both sides of the aisle for this proposal and the American people cannot -- and should not -- have to wait a moment longer for relief."

"The American Diabetes Association is proud to endorse the INSULIN Act introduced by Sens. Jeanne Shaheen and Susan Collins, legislation that stands to have a historic impact on the diabetes community by dramatically reducing the cost of insulin," said Lisa Murdock, the American Diabetes Association's Chief Advocacy Officer. "More than 37 million Americans have diabetes, and one-in-four insulin-dependent people with diabetes report rationing their insulin for economic reasons. We urge Congress to address the prohibitive and rising cost of insulin by passing the INSULIN Act."

"JDRF is tremendously grateful for Senators Jeanne Shaheen and Susan Collins for working tirelessly to find a bipartisan solution that would address the exorbitant cost of insulin and make this life-sustaining drug more affordable for those who need it -- whether they have insurance or not. We are very pleased that the Insulin Act includes several key provisions we have long been advocating for and are eager for the Senate to approve a finalized bill," said Aaron J. Kowalski, Chief Executive Officer, JDRF.

Senators Collins and Shaheen's legislation would:

Create a program whereby patients would receive lifesaving protections on insulin products with reduced insulin prices by:
Ensuring that insurance plans and pharmacy benefit managers cannot collect rebates on insulins that limit list price to the 2021 net prices for Medicare Part D or equivalent levels;
Making such insulins eligible for cost-sharing protections, including waiver of any applicable deductible and limiting copays or coinsurance to no more than $35 per month or 25% of list price; and,
Supporting patient access to such insulins by ensuring coverage and prior authorization, step therapy or other medical management requirements cannot be imposed to limit beneficiary use.

Limit out-of-pocket costs for patients with diabetes by:
Ensuring that group, individual market, Medicare Part D and Medicare Advantage health plans must waive any deductible and limit cost-sharing to no more than $35 per month or 25% of list price, for at least one insulin of each type and dosage form.

Senators Collins and Shaheen will formally introduce their legislation in the coming days. The Senators intend to fully offset the package pending a final score from the Congressional Budget Office.

A one-pager on the legislation is available here, and a section-by-section summary is available here.

As Co-Chairs of the Senate Diabetes Caucus, Senators Collins and Shaheen have worked to increase awareness of the threats posed by diabetes, invest in research and improve access to treatment options. They have consistently held insulin manufacturers, insurers and pharmacy benefit managers accountable for the skyrocketing cost of life-saving insulin.

Source