Equal access to lifesaving pharma should be a priority in Iowa

Longtime Sen. Chuck Grassley, R-Iowa, sends mixed messages about his loyalty to Iowans and their access to affordable insulin

America has a pharmaceutical problem — this we know from the countless stories of Big Pharma monopolizing medication with high prices, disadvantaging everyday Americans who might not have health care coverage or even the ability to afford the copay for essential prescriptions. Despite significant governmental assistance with publicly funded research and tax breaks, pharmaceutical companies are continuing to charge exorbitant amounts for their medication.

In the United States, over 37 million people have diabetes, according to the 2022 National Diabetes Statistics Report by the Centers for Disease Control and Prevention. In Iowa, over 242,000 people have diagnosed diabetes, according to the American Diabetes Association. And the AMA reports there’s an additional 70,000 people in Iowa who have diabetes but don’t know it yet. It’s clear diabetes poses health risks to a significant portion of the population in both Iowa and the United States at large. But what’s even more dire is the amount of money people are expected to pay for life-sustaining, sometimes lifesaving, medication.

Insulin treats diabetes by helping blood sugar enter the body's cells so it can be used for energy. One vial of fast-acting insulin today, though, can cost upward of $300, according to the Mayo Clinic. And even then, some high-deductible plans require patients to spend up to $8,000 out-of-pocket before their insurance will spend a dime. In Iowa alone, medical expenses for diabetes are estimated to cost $2.6 billion — annually — according to AMA.

The obvious solution is for Congress to put a cap on the cost of insulin — and other essential medications — so all Americans can adequately treat their diabetes — or other afflictions. And the House came through when they passed the Affordable Insulin Now Act back in March, capping a month's supply of selected insulin products at $35 under private insurance and Medicare — or 25 percent of a plan's negotiated price (after any price concessions), whichever is less, beginning in 2023. However, the Senate crushed the hopes of millions of Americans this month when it voted to block the insulin cap for privately insured patients. One the deciding votes? Our very own Sen. Chuck Grassley.

Despite claiming he is for the $35 insulin cap in a recent Wayne County town hall, Grassley was one of the votes against the cap. He wasn’t alone in his vote as Sen. Joni Ernst joined him. Who are we if we do not hold out elected representatives accountable? Who are we if we cannot demand that the words they speak in local town halls ring true in the chamber, where their decisions affect our lives everyday?

In our recent past, we’ve seen how such exorbitant costs can lead to a lethal outcome as a result of rationing. And in a new 2022 Yale study, researchers found 14 percent of people who use insulin in the United States face “catastrophic” levels of spending on insulin and found those people spent at least 40 percent of their post subsistence income — money after food and housing — on insulin. Yale researchers even say those estimates are conservative with the “extreme financial toxicity” that people with diabetes experience.

My great aunt died from diabetic ketoacidosis because she couldn’t afford her insulin medication, leading her blood sugar to become highly acidic, her cells dehydrated and her body to stop functioning. It’s a terrible way to die — and completely avoidable if everyone had equal access to affordable medication. You probably know someone who has diabetes. Imagine the catastrophic outcome if they couldn’t afford their prescription — medication necessary for their livelihood and survival. They could end up like my great aunt easily.

Pay attention to the words and subsequent action — or lack thereof — of our leaders right now, because midterm season is coming up. And though there are issues with our voting system, your vote still matters, as does your civil action. Show up for people. Help them out when you can. And demand better from the people who have a significant impact on how you live your life.

Nichole Shaw is a Gazette editorial fellow. Comments: nichole.shaw@thegazette.com

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