Trump Administration Announces New Plan to Cap Insulin Costs in Medicare

High drug prices have been a focus of Congress and the Trump Administration for the past year, with insulin becoming the prime example of the negative impact increasing drug prices are having on patients.

The Endocrine Society has made addressing the high cost of insulin a priority for the past three years.  We have urged the administration to take steps to minimize the burden on patients and appreciate this effort to assist Medicare beneficiaries.

To minimize the burden on seniors, the administration released a plan to cap insulin costs at $35 per prescription/per month for Medicare Part D plans. The Administration estimates the plan will save seniors $466 per year, although research shows that this population pays much less for insulin over the course of a year than the administration’s analysis assumes and there is less saving than the administration expects. A recent report from the Kaiser Family Foundation found that in 2017 seniors spent approximately $600 annually out of pocket for insulin, on average.  If that is accurate, President Trump’s plan could mean only very modest savings – about $160 per year – for seniors.  While the actual cost savings are unclear, the administration’s plan will provide seniors with more predictability in their insulin costs across the year.

The plan will begin implementation January 1, 2021 and not all seniors will benefit from it.  As a demonstration project, insurers and drug manufacturers can volunteer to participate in the pilot.

We continue to work with the Congressional Diabetes Caucus on additional recommendations that include reforming patent laws, other Congressional leaders as they consider additional solutions to high drug prices, and drug makers to lower list prices and minimize the impact on people with diabetes.

The Endocrine Society has made addressing the high cost of insulin a priority for the past three years.  We have urged the administration to take steps to minimize the burden on patients and appreciate this effort to assist Medicare beneficiaries. We note that this plan will not solve the problem of insulin affordability. The administration’s plan will have no impact on some of the people most vulnerable to rising insulin costs, such as those covered by high deductible insurance plans or those who have no insurance at all and are forced to pay full price for their medicine.

We continue to advocate for policy changes to reduce out-of-pocket costs for people on high deductible health plans, the uninsured, underinsured, and 26-year-olds who are no longer covered by their parents’ insurance.  We continue to work with the Congressional Diabetes Caucus on additional recommendations that include reforming patent laws, other Congressional leaders as they consider additional solutions to high drug prices, and drug makers to lower list prices and minimize the impact on people with diabetes.

For more information on the Society’s advocacy on insulin pricing, please visit www.endocrine.org/insulin.

 

 

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