06.28.22

SCHUMER: WITH OUTRAGEOUS COST OF INSULIN SKYROCKETING AND 1.7M NEW YORKERS—OVER 45,000 IN THE NORTH COUNTRY—WITH DIABETES, SCHUMER REVEALS NEW BIPARTISAN PLAN TO CAP INSULIN OUT-OF-POCKET COSTS AT $35 A MONTH; SENATOR SAYS HE WILL PUT THE BILL ON THE FLOOR VERY SOON TO MAKE LIFESAVING DRUG AFFORDABLE FOR MILLIONS OF AMERICANS

Standing Alongside North Country Advocates, Schumer Reveals How Insulin Costs Are Rising Rapidly, With Average Increase Of 15 – 17% Per Year Since 2012; With A Horrific 1 In 4 NOW Rationing The Drug Because Of Cost

New Bipartisan Plan Will Cap Costs For Insulin At $35 Per Month And Crack Down On Bureaucratic Requirements That Can Force Patients To Jump Through Hoops To Get Insurers To Pay For Medications

Schumer: No North Country Family Should Ever Be Forced To Choose Between Insulin And Putting Food On The Table, We Must Cap The Cost To Save Lives

Standing with North Country residents with diabetes who need insulin daily and health officials, U.S. Senate Majority Leader Charles E. Schumer today revealed a new bipartisan agreement to reduce the outrageous cost of insulin and announced he will call for a Senate vote to bring the amount Americans pay out of pocket for insulin down from $200-$600 per prescription to a maximum of $35 per month. Schumer explained that the Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act would both cap the cost of insulin, while also limiting drug manufacturers’ ability to arbitrarily raise the price of these drugs and increasing consumer protections. The Senator said that no North Country family should never be forced to ration this critical drug due to unreasonably high costs.

“Every single day, too many Americans, including those here in Watertown and across the North Country with diabetes are being forced to make impossible decisions, paying more and more for their insulin or rationing it so it lasts longer, and this has got to end. No North Country family should have to go bankrupt just because they need insulin to survive and I am here to say that I will call for a Senate vote on capping this cost,” said Senator Schumer. “The current cost of this life-saving drug runs from $300-$600 per prescription; it is not just ridiculous it’s dangerous. Millions of Americans and too many North Country residents stand with me on this push to cap the cost of insulin at $35 so we can stop rationing this drug, and finally make insulin more affordable and accessible for all Americans.”

Schumer said that the new bipartisan agreement, announced by Senators Jeanne Shaheen (D-NH) and Susan Collins (R-ME), Co-Chairs of the Senate Diabetes Caucus, creates a unique moment for the Senate to now come together to pass this life changing legislation and it should do so without delay.

Specifically, the INSULIN Act would:

  • Limit out-of-pocket costs for patients with diabetes by ensuring that private health plans must waive any deductible and limit cost-sharing to no more than $35 per month, for at least one insulin of each type and dosage form.
  • Encourage insulin manufacturers to reduce their list prices by:
    • Ensuring that insurance plans and prescription drug middlemen cannot collect rebates – which drive up drug costs for consumers at the point of sale – on insulins that keep their prices in check.
    • Making such insulins eligible for cost-sharing protections, including waiver of any applicable deductible and limiting copays or coinsurance to no more than $35 per month.
    • Supporting patient access to such insulins by ensuring coverage and that insurers are not able to limit access to these life-saving drugs.

Schumer broke down the estimated percentage of adults with diagnosed diabetes according to the CDC, by county in the North Country below:

County

Percentage of adults (Age +20) are diagnosed with diabetes.

Estimated number of adults (Age +20) with diabetes

Jefferson

10.1%

8,191

Lewis

10.0%

2,435

St. Lawrence

9.9%

9,448

Oswego

10.4%

9,198

Clinton

10.3%

7,441

Essex

8.3%

3,310

Franklin

11.3%

5,035

Hamilton

8.1%

447

Schumer said in New York State alone, an estimated over 1.7 million people are diagnosed with diabetes, nearly 11% of the adult population, plus over 450,000 New Yorkers who have diabetes but don’t know it. Schumer said that patients and payers incur over $15 billion a year in direct medical expenses from diabetes in New York, and another $6 billion in costs due to lost productivity.

Diabetes is one of the leading causes of death in the United States, claiming over 100,000 lives in 2021, and is also the most expensive chronic condition in the nation, costing a total of $327 billion per year. According to the American Diabetes Association, people with diabetes account for $1 of every $4 spent on health care in the U.S.  The Health Care Cost Institute estimated that the average price for a 40-day supply of insulin increased from $344 to $666 in just four years. Between 2012-2016, the cost of an insulin prescription in New York nearly doubled to ~$690.

Because of these extreme fluctuations and high costs, Schumer explained that some studies estimate that as many as 1 in 4 Americans now ration the drug, which is potentially life threatening. In New York, Black adults with diabetes are almost twice as likely to die than their white or Hispanic counterparts. Diabetes is the eighth leading cause of death in the United States.

Overall numbers from the American Diabetes Association:

  • Prevalence: In 2019, 37.3 million Americans, or 11.3% of the population, had diabetes.
  • Nearly 1.9 million Americans have type 1 diabetes, including about 244,000 children and adolescents
  • Diagnosed and undiagnosed: Of the 37.3 million adults with diabetes, 28.7 million were diagnosed, and 8.5 million were undiagnosed.
  • Prevalence in seniors: The percentage of Americans age 65 and older remains high, at 29.2%, or 15.9 million seniors (diagnosed and undiagnosed).
  • New cases: 1.4 million Americans are diagnosed with diabetes every year.

Text of the legislation is available here. 

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