In the last year or so, a small number of states have imposed caps on what insurance providers can charge as copayments for insulin. The dollar amount of these caps varies from state to state, but each law was proposed and passed in response to the rising cost of insulin in the United States over the last decade and beyond.
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While all of the insulin manufacturers with a U.S. presence have introduced new cost-saving programs in the last few months, eligibility requirements vary, and many people are still strained financially by insulin copays in the majority of states that don’t have laws capping them. So any new state-based law doing so is likely to be welcomed by the diabetes community, and seen as evidence that there is momentum to pass these laws in even more states — or even at the federal level.
New Hampshire insulin copays cap
The latest state to pass a law capping insulin copays is New Hampshire, where Gov. Chris Sununu recently signed a bill limiting monthly costs under insurance plans to $30 — the lowest cap in the country so far, tied with a Utah cap that takes effect in 2021. As noted in a Healio article on the law, the measure is also broader and goes further, in other ways, than similar laws that states like Illinois, Virginia, and New York have passed starting in May 2019.
The New Hampshire law, which goes into effect on September 14, contains provisions to allow prescription drug importation from Canada similar to those passed in the neighboring states of Maine and Vermont. This means that not only insulin, but potentially many other prescription drugs that meet safety and cost criteria, may be imported in a state-based program pending approval by the U.S. federal government. New Hampshire must file a request for the program with the federal government by February 2021 under the new law, as noted in an AARP article.
States seek approval for drug importation programs
So far, the AARP article notes, five other states — Colorado, Florida, Maine, New Mexico and Vermont — have passed laws that seek federal approval for starting drug importation programs. According to an article by the Commonwealth Fund, current U.S. federal law allows both wholesale and personal importation of drugs from Canada with the permission of the Secretary of Health and Human Services. For about a decade, the U.S. Food and Drug Administration (FDA) has facilitated the importation of drugs that are in short supply or in cases where domestic competition is lacking, and about 40% of all prescription drugs sold in the United States are now manufactured in other countries.
The New Hampshire law is receiving praise from groups that advocate for patients and consumers, including the American Diabetes Association (ADA) and AARP. “With 9% of Granite Staters living with diagnosed diabetes, and 7,000 more diagnosed every year, it is critical that elected officials address the needs of their citizens with diabetes,” said Stephen Habbe, director for state government affairs at the ADA, in a statement that thanked the governor and legislators for their efforts. The ADA has also urged the governor to eliminate all cost-sharing for insulin until the COVID-19 pandemic is over.
“This critical prescription drug legislation is a major step forward to reduce drug costs for New Hampshire’s 50-plus population,” said Doug McNutt, AARP’s New Hampshire associate state director for advocacy. “We know that 22% of Granite Staters are rationing their drugs because of cost and that the average older American takes 4.5 prescription drugs. This bill will make an impact in controlling those costs.”
So far, only Colorado has a cap on insulin prices that is currently in effect, according to the AARP article. New Hampshire’s cap will be the second to take effect, followed by others starting in 2021 in Illinois, Maine, New York, Utah, Virginia, Washington and West Virginia.
Want to learn more about saving money on insulin? Read “Eli Lilly, Novo Nordisk Introduce Savings Programs in Wake of Pandemic,” “Sanofi Offering Insulin at $99 Per Month,” “Insulin Prices: Four Ways to Pay Less” and “Cheaper Insulin: Older Insulins May Be Answer to High Prices.”
