Insulin just became much more accessible - even in New Jersey - NJ.com

By Elise Amez-Droz

In the wake of the COVID-19 pandemic, the last thing people with diabetes need to worry about is how they’ll pay for their insulin, but that’s a growing reality for millions of people. Sixty years ago, just one in 100 Americans had diabetes. Today, more than 100 million Americans have diabetes or pre-diabetes — with the Center for Disease Control and Prevention (CDC) estimating that a third of Americans will be diabetic by 2050. And, with almost 1 million diabetic patients, New Jersey’s rate is even higher than the national average.

It makes sense, then, that insulin prices would be a serious concern for New Jerseyans. We hear story after story of patients rationing their insulin intake and dying because they’re unable to purchase the drug. And a few months ago, insulin prices made headlines after then-Democratic presidential candidate Senator Bernie Sanders (D-VT) took a dozen diabetic patients on a trip to Canada to take advantage of the nation’s lower insulin prices. After all, it’s true: insulin prices are higher in the United States than in other industrialized economies. But the government has played a major role in that.

Thankfully, a recent update in regulations might be a game-changer for patients in the Garden State and across the country.

On March 23, the U.S. Food and Drug Administration (FDA) switched insulin’s status from “drug” to “biologic.” Essentially, this means that it’s now much easier for drug manufacturers to put insulin off-brands (in this case, called biosimilars) on the market. There’s already a route for drug manufacturers that want to make insulin generics, but it’s been used by very few companies. It’s simply got too much red tape.

So, this policy change is a move in the right direction. Competition drives down prices, and, up until this point, the monopolistic status quo has allowed certain manufacturers to pocket large sums to the exclusion of other, cheaper alternatives.

That said, the change in policy isn’t the silver bullet that solves the problem entirely. It will make it easier for more manufacturers to enter the insulin business, but it’ll take several years for new applications to get approved.

In the meantime, people in need of insulin would do well to remember that there are already affordable options out there. Older forms of insulin, for instance, are much cheaper than the more current versions of the drug. In fact, Walmart sells one of them for just $25 a vial, making a month’s supply of the drug just $75 out of pocket. The state-of-the-art insulin Lantus, by comparison, goes for as much as $280 a vial without insurance.

Even so, the most surprising part in all of this is that, for many patients, insulin isn’t actually expensive. New Jersey mandates all private healthcare plans to cover insulin, and its Medicaid program covers insulin and other treatments for diabetic patients, as do Medicaid programs in all 50 states. What’s more, President Donald Trump recently announced plans to cap copay costs for insulin to $35 a month for Medicare beneficiaries. Thanks to mounting public pressure, private insurers are also proactively capping copays on insulin. Cigna offers a month’s supply for $25, and Oscar’s offer goes as low as $3. And in this time of the pandemic, manufacturers themselves are lowering prices to ensure that no patient, insured or not, is priced out.

But even in normal times, when the list prices are extremely high, lots of options exist for insured and uninsured patients alike. In fact, over the past two years, an estimated 12 patients died from insulin rationing. That’s still too many, but it’s a far cry from constituting a public health crisis.

But there’s one key difference between Walmart’s $25 vial and the insurance manufacturers’ out-of-pocket caps. With the former, the full price of the drug is reflected in the price tag, and buyers are well aware of what they’re paying. With the latter, it’s a different story — insurance beneficiaries pay very high premiums, which means they pick up a much larger share of the drug’s price than their out-of-pocket payments indicate.

Yes, competition is coming to the insulin market, and insulin, as it turns out, isn’t quite as unaffordable as the media would make us believe. But much like it is for other healthcare issues, the way we pay for insulin often prevents patients from taking advantage of the choices they have. The best way to provide better access to affordable care for all patients, then, is to let them shop around for what works best for their health — without government regulation getting in the way.

Elise Amez-Droz is a healthcare policy manager in the Washington, D.C. metro area. She is a graduate of the Fuqua School of Business at Duke University.

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Insulin just became much more accessible - even in New Jersey - NJ.com
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