Congress, take action now to make insulin affordable

Type 1 diabetes is a fatal disease without insulin treatment. Yet, the price of this life-sustaining drug doubled between 2012 and 2016. 

As insulin prices have soared, insurance often covers less. Increasingly, Americans have enrolled in high-deductible health plans, in which they pay the full cost of health care until they reach their deductible. From 2007 to 2017, the percent of people with employer-sponsored insurance covered by high-deductible plans rose from 14.8 percent to 43.4 percent, with less than half having a health savings account to help pay for costs of care during the deductible phase. 

ADVERTISEMENT

Right now, our system is failing people with diabetes. We need systemic change, change that Congress can help make happen.

A recent study from Yale found up to 25 percent of people with diabetes are actually taking less insulin than what they need, just to save on costs.

No one should suffer or die because they cannot access insulin.

At a time when new innovations can enable people with Type 1 diabetes to live longer, healthier lives than ever before, the dramatic rise in the cost of insulin is undercutting this progress. People with Type 1 diabetes need access to affordable insulin and diabetes management tools all the time, not just after they’ve met their deductible.

Without this access, they run the risk of being unable to manage their blood sugar, threatening their health and driving up costs. This includes costs for complications, doctor’s visits and hospitalizations that the entire health system must bear. 

How can we make insulin more affordable?

True change will require the federal government, health insurers, drug manufacturers, pharmacy benefit managers and employers to take steps to lower out-of-pocket costs.

First, drug manufacturers need to lower the list price of insulin. To do this, rebates must be eliminated from the drug reimbursement system. In the current system, companies give discounts to pharmacy benefit managers and health plans, while increasing prices at the pharmacy counter. That’s why the Trump administration’s proposed anti-rebate rule change warrants support. The proposal asks Congress to stop this cycle and end rebates in the commercial sector as well. Subsequently, manufacturers must lower list prices.

Second, insurers and employers must provide affordable coverage that reflects insulin’s role as a life-saving drug. We need policies that remove insulin from the deductible and provide it with a flat-dollar co-payment, rather than a co-insurance, so that people with diabetes are not hit with unexpected fluctuations in out-of-pocket costs. At the same time, the public and private sector need to do more to help those who are uninsured obtain the insulin they need to stay alive.

ADVERTISEMENT

Third, we must continue to invest in research. We believe affordability, accessibility, and innovation go hand-in-hand to improve outcomes. Thanks to Congress’ strong, bipartisan commitment to the Special Diabetes Program, we are making progress on glucose-responsive and faster-acting insulins, artificial pancreas systems, and beta cell and immunotherapies to ultimately cure this disease. 

While we work toward a brighter tomorrow, we need to ensure that, today, Americans can obtain the insulin they need to stay alive.

Aaron J. Kowalski, Ph.D., is the chief mission officer of JDRF, a global organization funding Type 1 diabetes (T1D) research. Founded and governed by families affected by Type 1 diabetes, JDRF engages Congress, federal agencies, healthcare providers, insurers, biomedical and device companies and others to develop a cure for T1D and to help patients remain healthy until then. Kowalski testified this week before the Subcommittee on Oversight and Investigations of the House Committee on Energy and Commerce about the impact of rising insulin costs.