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Tuesday, September 29, 2020

Legislature addresses high cost of insulin

A watercolor painting of insulin done by Wilson Turk. // Painting courtesy of Wilson Turk

By Izzie Lund

The Washington state legislature passed four major bills on Wednesday, Feb. 19 that would address the high costs of insulin and other prescription drugs. 

The next step is to pass the bills through the House of Representatives, where it will then go to Gov. Jay Inslee’s desk, Sen. Karen Keiser said. Kaiser said the bills, if passed, would most likely take effect in July.

Two of the bills would cap the cost of a month’s supply of insulin at $100. The bills would expire on Jan. 1, 2023, and are meant to provide short-term relief while the legislature searches for a long-term solution. 

Another one of the bills would create a drug affordability board to identify prescription drugs at high prices and set price limits on these drugs for state purchasers. 

“[The drug affordability board would] look at the way that the different pieces of the market work together to increase prices and push back on the different players,” Keiser said. 

For example, people with multiple sclerosis pay $70,000 to $90,000 a year for their medications, Keiser said.

“Those are the kinds of really extraordinary costs that we could focus in on and put pressure on drug manufacturers,” Keiser said. 

The last bill would create a centralized insulin-purchasing program, modeled after the state’s current Childhood Vaccine Program. The program would try to use the state’s purchasing power to lower drug costs, Keiser said. 

Hannah Jones, a Type 1 diabetic and president of Western’s chapter of the College Diabetes Network, supports the bills. Jones said she often worries about what will happen when she ages out of her parent’s insurance program and has to pay for insulin herself. 

“I was paying $250 a month for insulin. For some people that’s like a paycheck,” Jones said. “You’re damaging your livelihood just because you can’t afford a simple drug to keep you alive.”

Megan Whitsell, the program coordinator for PeaceHealth’s Nutrition & Diabetes Clinic, said they have a lot of clients who cross the border to Canada to buy insulin at a cheaper cost. She also said there were a lot of clients who bought insulin at Walmart for about $25.

This can be problematic because the Walmart brand of insulin does not work as well as the insulin the doctor prescribes, Whitsell said. She added that taking a different kind of insulin can change the way a person manages their diabetes and there can be risks for some patients.

A study conducted at Yale Diabetes Center from June to August 2017 surveyed patients asking if they had rationed their insulin in the past six months. Out of the 199 people, 51 — around one in four — said they had rationed their insulin before.

“The more people have to ration their insulin and have their blood sugar not under very good control, it just sets them up for all these other health problems,” said Tracy Rabin, a researcher in the study and associate director of Yale’s Office of Global Health. 

Poor blood sugar can damage the eyes, kidneys and nerves, which can lead to blindness, kidney disease and foot pain, Rabin said. Uncontrolled diabetes puts people at a higher risk for having strokes and heart attacks.

Rabin said the data in the study does not necessarily apply to the general population. Demographics play a role and Medicaid benefits vary from state to state. 

“Something [in Medicaid] that is true for patients in Connecticut will not necessarily be the same as in another state,” Rabin said. 

Jones said while she supports the bill that would cap insulin at $100, she thinks more can be done by also fighting the cost of diabetes medical devices. 

She said without insurance, she would pay about $4,000 for an insulin pump and glucose meter, which both only last about 90 days.

Carly McGuire, a Type 1 diabetic, agreed with Jones and said she would like to see medical equipment costs go down as well, not just insulin.

“I think that people don’t really think about the other expenses that go into it,” McGuire said. “When you’re not helping with the cost of devices and needles, everything else that goes into it, it’s not going to be as effective as it could be.” 

McGuire said when she was on injections, she had to test her blood sugar a lot. The test strips that she used were $60 and only lasted about 10 days. 

“We, as a country, are not paying attention to pharmaceutical companies sort of raising the prices on these medications that are really necessary,” Rabin said. “Making them unaffordable for people is something that can cost a lot of people their lives.”

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