Endocrine Society Endorses Bipartisan Bill to Address Insulin Affordability

The Endocrine Society today endorsed the Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act of 2023, a bipartisan insulin affordability bill.

Introduced by Sens. Jeanne Shaheen (D-NH) and Susan Collins (R-ME), this legislation would cap out-of-pocket insulin costs for those with private insurance, ensure patients can share in insulin rebates and discounts, and promote competition in the insulin market.

These measures would protect access to life-saving insulin for more than 7 million people nationwide who rely on the medication to manage their diabetes. According to the U.S. Center for Disease Control and Prevention, 37.3 million people nationwide — about 11% of Americans — have diabetes.

“People with type 1 diabetes depend on insulin to stay alive since their bodies cannot produce this hormone. Privately-insured individuals with diabetes cannot wait any longer for Congress to take action to address their insulin costs,” says Joshua J. Joseph, MD, MPH, Endocrine Society Clinical Affairs Core Committee Chair. “We are pleased to endorse this comprehensive legislation, which will make insulin more affordable for those who rely on it.”

Building upon a bill that was released last year, the INSULIN Act addresses the underlying problems in the insulin market that contribute to escalating prices. The INSULIN Act aligns with recommendations in the Society’s Insulin Access and Affordability Position Statement, which calls for lowering the price of insulin through rebate reform and limiting co-pays to no more than $35 per month for insulin.  The bill includes several policies to improve insulin access and affordability, including: 

  • Ensuring group and individual health plans waive any deductible and limit cost-sharing to no more than $35 per month or 25% of list price, for at least one insulin of each type and dosage form. 
  • Mandating Pharmacy Benefit Managers (PBMs) pass through 100% of insulin rebates and other discounts to insurance plan sponsors so that patients can share in any savings. 
  • Promoting competition from generic and biosimilar drugs.

To encourage competition in the insulin market, the bill calls for measures to ease the approval process for generic and biosimilar drugs, easing formulary access for biosimilar drugs in Medicare Part D, and requiring a report to Congress on issues and market dynamics.

Although the discovery of insulin occurred over a century ago, the price of insulin nearly tripled between 2002 and 2013, and the trend upward has continued over the past decade. In 2021 alone, nearly one in five American adults with diabetes — about 1.3 million people — rationed their insulin to save money, according to a study.

Progress is being made to improve insulin access. The Inflation Reduction Act, which was signed into law last year, included a provision to cap insulin prices for individuals insured by Medicare. Three major insulin manufacturers have recently announced plans to lower prices on insulin products.

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