Insulin Prices: Are They Low Enough?

Health & Gender Policy Brief #159 | By: Geoffrey Small | April 5, 2023

Header photo taken from: nbcnews.com

Policy Summary

As the U.S. healthcare system continues to fall short, when compared to other peer countries, the battle for insulin prices highlights just one of the major issues the country is facing. Congress recently passed The Inflation Reduction Act, where the cost of insulin was capped for senior citizens on Medicare Part D starting in 2023. President Biden also announced that major drug manufacturers of insulin are also capping their prices to meet the demand. Despite the efforts of legislation, the Biden administration and major drug company manufactures, critics are calling on Congress to pass a uniform law which mandates that the price of insulin be capped for all Americans.

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Photo taken from: insights.bu.edu

Policy Analysis

On August 16th, 2022, President Biden signed The Inflation Reduction Act. A major component of the bill, which was sponsored by Democratic Senators Chuck Schumer and Joe Manchin, required all insulin prices for senior citizens on Medicare Part D to be capped at $35.  This news was welcomed from advocacy groups like the American Diabetes Association. In their press release, they stated that “$1 in every $3 spent on prescription drugs in the U.S. is spent on someone with diabetes, and this out-of-pocket cost limit will benefit people with diabetes who rely on more than just insulin to survive.” The new law also caps all prescription drug costs for senior citizens on Medicare Part D at $2000 per year.

It is well known that critics believe The Inflation Reduction Act does not do enough to reduce the cost of prescription drug prices for all U.S. citizens. That is why on March 2nd the Biden administration announced that Eli Lilly, the largest U.S. insulin manufacturer, is lowering their cost of insulin by 70%. Other major drug companies are also following their example. Capping the prices for insulin will also reduce health inequality for minorities. According to studies, conducted in-part by the CDC, Native Americans, African Americans, and Hispanic groups are being diagnosed with diabetes at proportionally higher rates than other ethnicities. 

Despite all of the efforts to reduce the cost burden for individuals diagnosed with diabetes, critics still believe States and Congress can do more. A recent Yale Study  concluded that 14% of people on insulin used at least 40% of their available income to pay for the prescription. The study indicated that insulin prices have more than doubled in the past decade. Kasia Lipska, an associate professor at Yale School of Medicine, stated “this is not inflation, there’s much more going on.”

National and State Diabetes Trends

Photo taken from: cdc.gov

In Iowa, AARP State Director Brad Anderson explained that “there are still around a quarter of a million Iowans on health insurance plans that are regulated by the state, where their insulin is not capped at $35 per month.”  Anderson believes the recent caps are a move in the right direction, but emphasizes that companies can change or eliminate the caps at any time. That is why uniformity at the state or federal level is needed to avoid the confusion on who benefits from the recent changes.

Efforts are being made to reduce the cost of insulin at the federal level. However, more cost control needs to be mandated to ensure healthcare equality . That is why donating to advocacy groups like the American Diabetes Association are instrumental for advocating more uniform federal and state laws. We need laws on  insulin costs that benefit everyone in the U.S. who has been diagnosed with diabetes.

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