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Drug prices: Colorado's $100 insulin cap draws other states' interest

By Jean Lotus
Between 2014 and 2017, the cost of insulin spiked by 45 percent, and over the last 14 years, the price of insulin has risen by 555 percent, adjusted for inflation, according to language in the Colorado law. Photo by jwskks5786/Pixabay
Between 2014 and 2017, the cost of insulin spiked by 45 percent, and over the last 14 years, the price of insulin has risen by 555 percent, adjusted for inflation, according to language in the Colorado law. Photo by jwskks5786/Pixabay

DENVER, June 7 (UPI) -- A new law in Colorado capping the price of insulin for insured patients at $100 per month has generated interest in other states because the price of the life-saving diabetes drug has spiked, lawmakers said.

Gov. Jared Polis signed HB 1216 in May, declaring "[T]he days of insulin price-gouging are over in Colorado." Soon afterward, Colorado lawmakers received inquiries from lawmakers in California, Minnesota and Pennsylvania asking about the new law, sponsor state Rep. Dylan Roberts, D-Avon, said.

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Roberts' brother, Murphy, died in 2016 at age 22 of complications caused by Type 1 diabetes.

"This is a first step, for [affordable] insulin. I know it's a short-term Band-Aid for some people, and we're going to continue to work for long-term solutions," Roberts told UPI.

The new law, which goes into effect Jan. 1, does not cover Medicaid patients or people who do not have insurance. But it does help those patients who haven't met a high health insurance deductible or out-of-pocket costs and face insulin bills that can exceed $1,600 per month.

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Between 2014 and 2017, the cost of insulin spiked by 45 percent, and over the last 14 years, the price of insulin has risen by 555 percent, adjusted for inflation, according to language in the Colorado law.

Insurance companies are expected to absorb the extra costs of the medication for those patients who qualify.

The insurance industry was officially neutral on the bill, Jessica Morgan, legislative director of the Colorado Association of Health Plans, told UPI. But insurance companies had concerns that the bill doesn't address the actual costs of insulin and "hides the cost from the consumer," Morgan said.

She also said insurance companies worried the new law could set a precedent that would require mandatory price caps for other life-saving medications to treat chronic conditions such as Parkinson's disease or multiple sclerosis, and that would drive up the cost of insurance for everyone.

More than 30 million Americans have been diagnosed with diabetes, and 1.5 million are diagnosed every year. Complications from diabetes can lead to blindness, amputations of feet and hands and problems with the kidneys and heart. Diabetes is the seventh-most-common cause of death in the United States, according to the American Diabetes Association.

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Although the drug has been manufactured for almost 100 years, no generic version is on the market. Insulin no longer is derived from animals, but created in labs as a "biosynthetic" made with recombinant DNA technology and is indistinguishable from human insulin.

As the price of the drug has skyrocketed, national attention has focused on three companies licensed by the Food and Drug Administration to sell insulin in the United States: Indianapolis-based Eli Lilly and Co., Danish pharmaceutical maker Novo Nordisk and France's Sanofi.

Executives from all three companies were called to testify before Congress in April, and asked to justify the price spikes in insulin.

"The people who are suffering are the people who need insulin every second of every minute of every day or they will die," said U.S. Rep. Diana DeGette, D-Colo., who presided over the hearing, as reported in The New York Times. DeGette has a 25-year-old daughter with diabetes, the Times reported.

In October 2018, then-Minnesota Attorney General Lori Swanson sued the three drugmakers in New Jersey District Court for price gouging, deceptive trade practices and consumer fraud. The new Minnesota attorney general, Keith Ellison, is continuing the suit, and has created a prescription drug task force to investigate the rising prices of insulin and other life-saving medications.

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In Minnesota, state Sen. Matt Little of Lakeview praised the new Colorado law as affecting a "large number of patients" who earn just enough money to purchase insurance but whose insurance is "not that great and they have a high deductible for pharmacy drugs," he told UPI.

Little is one of the supporters of Minnesota's proposed Alec Smith Insulin Emergency Act, named after a 26-year-old Minneapolis man who died in 2017 of diabetic ketoacidosis after rationing his insulin while waiting for payday because he could not afford a $1,300 pharmacy bill. The act would allow patients to buy an emergency supply of up to 90 days worth of insulin at a discount when faced with unaffordable costs for the medication.

A recent study showed young adults in the United States are hospitalized often for complications from diabetes because of poor insurance coverage.

Thousands "die each year because they're uninsured, and millions skip their medications because of costs," Steffie Woolhandler, a researcher at Harvard Medical School, told UPI.

The new Colorado law has a second provision that directs Democratic Attorney General Phil Weiser to investigate the high costs of insulin and make recommendations on actions the state legislature can achieve, such as creating an emergency supply of insulin for patients in crisis or mandating price transparency requirements, Roberts said.

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That provision of the Colorado law interested California state Assemblyman Jim Wood, D-Santa Rosa, who chairs the California Assembly Health Committee.

"There has been a huge spike in the cost of insulin, which has had runaway cost increases, and I'd like to have our attorney general, or any attorney general investigate that," Wood said. "Drug companies don't like to be investigated by attorney generals, and our AG [Democrat Xavier Becerra] is a force to be reckoned with."

Pennsylvania state Rep. Rosemary Brown, R-Monroe/Pike, also reached out to Colorado lawmakers after the insulin law passed as part of an exploration of high drug prices, Roberts said.

In May, after congressional hearings, Eli Lilly rolled out a cheaper version of insulin drug Humalog after it was shown that the price of a vial of the drug had increased by 585 percent from $35 in 2001 to $234 in 2015. The new, cheaper product, called Lispro, sells for $137.35 for a single vial or $265.20 for a five-pack of KwikPens, the company said.

Pharmaceutical companies offer special patient assistance programs for people on low incomes or without insurance to be able to afford daily insulin. The American Diabetes Association lists those programs and others at https://www.insulinhelp.org.

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