Biden proposes $35 cap on insulin | CPT PPP Coverage

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With the Inflation Reduction Act, the cost of insulin in the U.S. is capped at $35 for seniors on Medicare starting this year. Now, President Joe Biden wants to extend that cap.

“There are millions of Americans not on Medicare – millions – millions – including 200,000 young people with Type I diabetes who need this insulin to save their lives,” he said Thursday. “Let’s finish the job – and cap insulin at $35 a month for everyone who needs it.”

According to correspondence published last September in the Lancet journal, the Biden administration already proposed a $35-per-month limit on insulin costs in the private market as well as the Medicare cap, but the U.S. Senate rules official decided it did not comply with the budget reconciliation process.

“Therefore, due to a maddeningly obscure and confusing rule, 60 votes were required for passage instead of a bare majority (51 votes),” said the publication. “The bill failed with 57 votes, as 43 Republicans voted against it. One of the senators who blocked the proposal has a research building named in his honor at a U.S medical school where diabetes research is done.”

That politician was identified as Roy Blunt, a former Republican senator from Missouri.

Insulin is a hormone made in the pancreas’ beta cells, per the American Diabetes Association.

“With each meal, beta cells release insulin to help the body use or store the blood glucose (blood sugar) it gets from food,” it explained. People with Type 1 diabetes do not produce insulin and people with Type 2 diabetes have bodies that do not respond well to it.

Biden said that insulin for people with diabetes costs drug companies around $13 per vial to make, including packaging. However, pharmaceutical companies have been charging patients hundreds of dollars per vial. Costs for some insulin products increased by 200% between 2007 and 2018, said the Lancet publication.

“One in 10 Americans has diabetes,” said Biden Thursday. “Millions need, every day, insulin to stay alive.  Insulin has been around for 100 years. As a matter of fact, the guy who invented it didn’t patent it because he thought it should be available to everybody.”

This is true, according to Diabetes UK. Sir Frederick G. Banting, one of the researchers who discovered insulin, said that it “does not belong to me, it belongs to the world,” and he wanted all in need to have access to it, the organization said.

In 2015, a Johns Hopkins study found that “a generic version of insulin, the lifesaving diabetes drug used by 6 million people in the United States, has never been available in this country because drug companies have made incremental improvements that kept insulin under patent from 1923 to 2014.”

Johns Hopkins internist-researchers, also found that “many who need insulin to control diabetes can’t afford it, and some end up hospitalized with life-threatening complications, such as kidney failure and diabetic coma.”

During his speech Thursday, Biden said that Americans pay more for prescription drugs than anyone else in the world.

“Bringing down prescription drug costs doesn’t just save seniors money, it will cut the federal budget by hundreds of billions of dollars,” he said. “Not a joke. Because instead of paying 400 bucks, they’re going to pay 35 bucks for it. That’s the government’s cost. So, this also brings down the deficit.”

This is backed up by the Congressional Budget Office’s estimate that the prescription drug provisions in the Inflation Reduction Act would reduce the federal deficit by $288 billion from 2022 to 2033.