With lives at stake, it’s time to cap insulin prices

For the vast majority of the millions of Americans with diabetes who depend on insulin, the prices are outrageous, and many die because they can't afford the costs. (Arkasha Stevenson/Los Angeles Times/TNS)

Two bills with overwhelming bipartisan support passed the Iowa House in 2021. HF262 and HF263 together would allow pharmacists to refill lifesaving medicines in an emergency and cap insulin costs at $100.

As ranking member of the Senate Human Resources Committee, I asked the chair of the committee, Sen. Jeff Edler, to bring these lifesaving bills up for a vote this session, but he refused.

One in 10 adult Iowans have been diagnosed with diabetes. Chances are you know someone who has diabetes.

Type 1 diabetes is an autoimmune disease which causes the pancreas to not produce insulin. For the 1.6 million adults and nearly 250,000 children with Type 1 diabetes in the U.S., not having a constant supply of insulin is a matter of life or death.

I’ve heard from my neighbors whose son Matt was diagnosed with Type 1 diabetes at age 11. Matt’s mother Deb and her husband lived in constant fear of insulin vials breaking, or damage to the insulin pump tubing which could waste several vials of insulin quickly.

Insurance companies won’t pay for extra insulin to have on hand for peace-of-mind and won’t replace insulin that is stolen, lost or damaged. This was the case when Matt went off to college, left his bag in the car and his three-month insulin supply froze.

Insulin now costs anywhere from $175 to $300 per vial, or around $1,000 per month on average. Replacing a $3,000 three-month supply is impossible for many working families.

According to JDRF, up to 25 percent of people with diabetes skip or ration their insulin because they cannot afford it. Bri Moss, a Type 1 diabetic from Dubuque, shared her fear and heartbreak of losing a friend who rationed their insulin and died as a result.

Bob Greenwood, owner of Greenwood Pharmacy in Waterloo, told me insulin only cost $8 a vial when he graduated pharmacy school in 1977, but prices started to escalate after the enactment of the Medicare Modernization Act (MMA) of 2003.

The MMA provided the Medicare Part D prescription drug benefit. When insulin manufacturers had to compete for formulary placement and rebate Pharmacy Benefit Managers (PBMs) in the Part D program, it further added to the price of insulin. Greenwood said Insulin prices continued to skyrocket when mergers between big companies such as CVS (acquiring Caremark and Aetna), and Cigna buying Express Scripts, reduced competition even further. Currently, three pharmaceutical manufacturers hold 95% of the insulin market share.

A study published in BMJ Global Health showed that pharma companies could manufacture and price a full year’s supply of insulin at $72 to $133 per patient, versus the $12,000 currently paid per patient on average, and still make a profit.

It’s time to take action on this type of price gouging that’s costing Iowans their lives. Since Iowa Republicans in the Legislature refuse to act, Congress must. In Congress, I will support legislation to cap the cost of insulin and allow Medicare to negotiate drug prices so that no American needs to choose between their insulin and their mortgage.

State Sen. Liz Mathis is a Democratic representing parts of Linn County. Mathis is running for Congress in the new 2nd District.