HARTFORD, Conn. (AP) - Connecticut lawmakers on Thursday announced bipartisan support for new legislation that would place limits on out-of-pocket costs for insulin-dependent diabetics, many of whom have seen the price of the life-saving drug skyrocket in recent years.
A group of Democrats and Republicans have been working for months on the bill. The latest version of the proposal, which still needs to go through the legislative process, caps total out-of-pocket costs for insulin and diabetic supplies, such as test strips and glucose testing monitors, at $100 a month. Individual prescriptions for insulin would be capped at $50 month.
If such a cap is ultimately enacted, proponents said Connecticut will have among the lowest insulin costs in the U.S. Similar legislation that caps just insulin costs has recently been enacted in Colorado and Illinois.
“The people of Connecticut are fed up with the high cost of insulin and they’re demanding and begging us to do something about this,” said Rep. Sean Scanlon, D-Guilford, House chairman of the General Assembly’s Insurance and Real Estate Committee. It’s estimated about 355,000 people in Connecticut have diabetes.
The average price of insulin nearly tripled in the U.S. between 2002 and 2013, according to the American Diabetes Association.
With key Democratic and Republican state legislators looking on, insulin-dependent diabetics and their family members spoke Thursday at a news conference about the financial challenges of covering the cost of the drug. Samantha Merwin of Haddam said her family is lucky to have private health insurance to help cover the high medical costs for her diabetic son Logan. But she estimates still having to pay at least $700 a month out-of-pocket.
“Out-of-pocket costs and our high deductible plans have been really difficult and they continue to get higher every year with insurance coverage,” she said. “We still spend thousands of dollars every year keeping Logan alive.”
Merwin said she’s never rationed Logan’s insulin but she has held off paying certain bills on time to cover the cost. She said she’s also part of a Facebook group of families with diabetic children who trade diabetic supplies.
“That happens constantly out there on Facebook and other avenues because that’s how we all have to survive and get the things that we need for our children,” Merwin said.
Three companies currently manufacture insulin for the U.S. market: Eli Lilly, Novo Nordisk and Sanofi. A spokesman for Sanolfi said the pharmaceutical company is reviewing Connecticut’s legislation but “as a matter of policy” it “supports capping patient out-of-pocket costs for insulin because of unjustified cost shifting from health plans to patients who need insulin to manage their diabetes.”
A spokesman for Novo Nordisk said the company was also evaluating Connecticut’s bill but noted it has some new options for patients struggling to afford their insulin, including a program that allows eligible people to buy three vials or two packs of pens for $99. A message left with Eli Lilly was not immediately returned.
In an online statement, Lilly said it offers several insulin affordability programs to fill the financial gaps for people likely to pay higher out-of-pocket amounts for their medicines, such as those in high-deductible health insurance plans, the uninsured, and seniors or people with disabilities on Medicare Part D. Of the 1.4 million people in the U.S. who take Lilly’s most commonly prescribed diabetes medicines, the company said one in 20 people pay more than $95 month, while 90% pay $50 or less a month.
Novo Nordisk’s website also lists various programs that “may help reduce the cost of your insulin or provide it at no cost, depending on your situation.”
A public hearing on Connecticut’s bill is scheduled for Feb. 25. State Sen. Kevin Kelly, R-Stratford, the ranking Senate Republican on the Insurance and Real Estate Committee, said “by no means” is the current bill the final version, but he called it a “good starting point.” Besides the out-of-pocket cap, state Sen. Matthew Lesser, D-Middletown, the committee’s Senate Democratic chairman, said it would allow patients to go to a pharmacist up to three times a year in an emergency to obtain insulin without a prescription. The bill also calls for a new program to help low-income type 1 diabetics obtain insulin.
“No one in Connecticut should die because they need insulin,” Lesser said.
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