Legislature looks to cap insulin cost

Close-up Of Young African Woman Filling Medicine In Syringe

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Posted March 26, 2021 | News Service of Florida

In an attempt to limit high out-of-pocket costs for people with diabetes, a Senate panel on Wednesday approved a bill that would place a $100 cap on cost-sharing requirements for 30-day supplies of insulin.

The bill cleared the Senate Banking and Insurance Committee unanimously. Filed by Sen. Janet Cruz, D-Tampa, the measure (SB 786) would apply to employer-sponsored and individual health insurance policies that are not bought on the federal insurance exchange and that offer prescription drug benefits.

The bill wouldn’t restrict what drug manufacturers can charge for insulin, which led committee member Ray Rodrigues, R-Estero, to ask, “Is it possible we could be looking at increased (insurance) premium prices?”

Sen. Lori Berman, a Delray Beach Democrat who is co-sponsoring the bill with Cruz, said costs for the state employee health-insurance plan would increase by 75 cents to 90 cents a year per member.

Meanwhile, Sen. Doug Broxson, R-Gulf Breeze, asked whether the state needed to take action amid activity on the issue at the federal level. Berman said the Trump administration limited out-of-pocket costs for people who get prescription-drug benefits through what is known as Medicare Part D, but those protections don’t apply to people on employer-sponsored or individual plans not purchased on the federal exchange.

Diabetes is caused by the body’s inability to create enough insulin or properly use the insulin it does produce. Insulin helps people’s bodies use sugar for energy and then store the rest. Many diabetics must inject insulin to increase the amount their bodies make.

According to a 2019 study published by JAMA Internal Medicine, the average list price of insulin nearly tripled between 2002 and 2013, and cost sharing, or out-of-pocket, costs per prescription doubled over a 10-year period.

The American Diabetes Association estimates that 105,000 people in Florida are diagnosed with diabetes annually.

Cruz’s bill will next go to the Senate Health and Human Services Appropriations Subcommittee. A House version (HB 109), sponsored by Rep. Melony Bell, R-Fort Meade, has not been heard in committees.

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