January 1st Triggers Copay Caps but Local Media Outlets Misfire
As several states rang in the new year, they also instated copay caps on insulin. With the change came a flood of stories, mostly in local outlets, inaccurately labelling the laws as price or cost caps rather than copay caps. A few examples:
From Washington: King5: New Washington law caps insulin costs at $100 per month
Illinois: WJOL: Cap On Insulin Costs Go Into Effect Today
Virginia: 13NewsNow: New Virginia law capping insulin prices takes effect
There are two dangers lurking behind these misleading headlines: that people previously outraged by the cost of insulin will start to consider the issue resolved or now less urgent, and that people with diabetes will be surprised at the pharmacy counter to find that their insulin costs have not changed. In a time of high unemployment, as well as housing and food insecurity, not having an accurate budget for your insulin could be disastrous.
A similar sense of confusion sprang up surrounding President Trump’s executive orders this past Fall. While the Trump administration did take action to cap copays at $35 for some Medicare Part D recipients, disinformation about the impact of the rule spread far and wide ahead of the election. Social media users claimed they were paying less at the pharmacy before the rule was even enacted.
When it’s just a question of who deserves credit for what, it’s easy to pass all these conversations off as partisan squabbling. But here’s one small example of the danger in all this. In a recent post on an Insulin4All Facebook group, a Facebook user praised the new Medicare rule for solving their out-of-pocket expenses. Another user commented underneath that they had recently paid over $1100 for their insulin with a private health insurance plan and was planning to visit a pharmacy in Tijuana for cheaper insulin. After hearing the news of $35 copays they said they were now reconsidering their plan.
The confusion is compounded by state legislators eager to associate themselves with the caps. Take Virginia state Delegate Lee Carter (D), who’s riding the good will garnered from introducing the Virginia copay cap, as well his popularity in leftist social media circles, into a gubernatorial run. Carter is a socialist who supports Medicare for All and has stated that health care should be free at the point of use — a position that ultimately serves to make the issue of out-of-pocket insulin costs obsolete. However, in celebrating the victory of Virginia’s $50 copay cap, he has occasionally misrepresented its impact— such as saying it will help people on Medicare (it does not apply to Medicare recipients) and posting tweets that imply all people with diabetes in Virginia will be helped.
When Colorado first passed their copay caps on insulin, that legislation was also lauded by the media as a major victory against rising prescription drug costs. However, it’s now estimated that only about 1 in 7 people who use insulin are covered by the copay cap. Rep. Dylan Roberts (D), who introduced the legislation in that state, now says he’s looking at ways to lower the cost of insulin for people not covered by state-regulated insurance that the copay cap addresses.
It is a testament to the power of activists who pushed the insulin crisis into the spotlight that politicians are so eager to claim they solved it. But it’s also a testament to the entrenchment of industry power that no one has truly been able to yet.
Indiana Becomes 50th State to Allow OTC Human Insulin
A new law in Indiana, home state of Eli Lilly, went into effect on the 1st allowing pharmacies to sell human insulin (such as Humulin, Novolin, and the famous “Walmart insulin” Relion) over the counter. Since 2014, Indiana has been the only state to ban OTC insulin sales. DiaTribe offers this nugget of history:
The original law was passed to address controlled substances such as opioid treatment medication. Insulin was included in the legislation by the Indiana State Medical Association (ISMA) because it feared over-the-counter (OTC) insulin would allow people with diabetes to purchase insulin without consulting their physician or undergoing necessary medical evaluations. Additionally, the ISMA was concerned that people in certain occupations might use OTC insulin to “hide” their condition and pose a public health threat. For example, long haul truck driving companies require employees to submit a physical examination from a doctor; if drivers only use OTC insulin, the examination may not reveal an insulin prescription or diabetes diagnosis. However, the American Medical Association found no evidence of such diabetes-hiding behavior.
Small doses
FDA: FDA Approves First Generic of Drug Used to Treat Severe Hypoglycemia
Star Tribune: Minnesota has a new drug price transparency law. Here's what it does
Feelings on copay caps? Want more info on a particular subject? Want to tell me where to stick it? (“It” being my next insulin pump infusion site.) Get in touch with me >>> theshotnewsletter@gmail.com
-Emily Pisacreta