Bill Would Limit the Cost of Prescription Insulin

WILMINGTON – As chronic diabetes continues to impact thousands of Delawareans every single day, House Democrats filed legislation Thursday that would cap the cost of their insulin – which can run thousands of dollars in annual out of pocket expenses – making this vital medication more affordable.

Under House Bill 263, people with individual, group or state employee insurance plans will pay no more than $100 per month for prescription insulin, regardless of the amount or types of insulin they need to fill. The bill also addresses affordability by requiring insurance plans to include at least one insulin medication on the lowest tier of the drug formulary developed and maintained by the insurance carrier. Drugs catalogued at this tier will typically cost less. 

“There’s no easy way to say this: There is no cure for diabetes. Patients can manage the disease for a better quality of life, but how can they do that if insulin prices continue to soar through the roof?” said Rep. David Bentz, House Health and Human Development Committee chair and lead sponsor of HB 263.

“Insulin is a vital medication, but its high cost often forces people to make risky choices, like skipping doses and rationing vials just to get by each day. These costs, which disproportionately impact those with less means, can be literally life-threatening. I’m proud that Delaware is taking a stand to limit the cost of insulin and make it more affordable to those that need the care.” 

Diabetes is a serious disease that impacts the way the body processes dietary glucose, causing changes to blood glucose levels within the bloodstream. Untreated, the disease can cause significant health complications from nerve and kidney damage to heart issues. Prescription insulin helps to treat the disease, but the rising cost can be a monumental barrier to a patient, impacting their day-to-day health, activities and finances.

One study from the Health Care Cost Institute, which dissected insulin costs for Type 1 diabetes patients, found that the cost of insulin nearly doubled from 2012 to 2016. Going further, those patients spent $5,705 per-person on insulin in just 2016.

“We should be ashamed that Delawareans - our neighbors and constituents - are having to decide whether to take their medication daily or pay for the clothes on their backs. We have to act to lower the cost of this critical, lifesaving medication,” said Rep. Andria Bennett, co-prime sponsor of HB 263

“The fact that insulin costs a person thousands of dollars of a year shows us that we’ve lost sight of the true meaning of health care. Limiting the amount of money a person has to pay out of pocket for their medication substantially impacts their quality of life. This legislation builds upon our efforts to make medication more affordable and accessible, so that trips to the pharmacy are not rife with anxiety and worry. We are putting Delawareans and their bottom lines first - which is how it should be.”

When it comes to measuring the impact the disease of diabetes has in Delaware, the numbers are staggering. About 24 percent of Delaware adults – nearly one-quarter – battle diabetes or are at risk of developing the disease, according to a recent state health report from the Delaware Department of Health and Social Services.

According to the Centers for Disease Control and Prevention, more than 30 million adults in the United States have diabetes, and the numbers go even further – one in four of them don’t even know they have it.

“Insurance companies are not doctors, and patients should not be forced to play Russian roulette with their health care just because an insurance company does not offer a lower cost medication. Delawareans deserve better access and pricing for their needed treatments,” said Rep. Melissa Minor-Brown, co-prime sponsor of HB 263.

“Managing diabetes takes an all-hands-on-deck approach, from preventive programming to access and affordability. We are taking aim at a major piece of this epidemic with this legislation, and hopefully lessening the burden that Delawareans will feel in their daily lives.”

HB 263 would impact insurance plans beginning in 2021. Illinois and Colorado also have passed similar legislation to address insulin costs.

“So many of our neighbors are facing impossible decisions about healthcare costs.  People with diabetes are among those losing out most. The cost of the insulin they need every day just to stay alive keeps rising, and there is no signal that the private sector is addressing this crisis,” said Sen. Bryan Townsend, Senate prime sponsor of HB 263. “People’s dire need for a basic substance should not justify sky-high prices.  I am proud to join my colleagues in saying enough is enough, and I look forward to passing this bill when we return to session.”

HB 263 will be formally introduced in Thursday’s pre-file legislation