$35 insulin price cap goes into effect

January 4, 2024

Congressman Peters’ drug pricing reform package became law as part of the Inflation Reduction Act and capped insulin costs for seniors. Now, even more Americans will benefit from lower insulin prices thanks to pressure on the industry from this historic legislation.

Read more about it in this January 2nd piece from The Hill, posted below:

$35 insulin price cap goes into effect

By Joseph Choi and Nathanial Weixel 

January 2nd, 2024

The three major insulin manufacturers announced moves to slash insulin prices last year, but several of the price caps and savings were not scheduled to be implemented until Jan. 1, 2024.

Eli Lilly was the first of the companies to announce its price cuts last year, calling on other companies to do the same.

Danish company Novo Nordisk followed soon after, cutting the prices of four of its “legacy products” by 65 to 75 percent, effective Jan. 1. In September, it launched the MyInsulinRx program, which provides a 30-day supply of insulin for $35 to eligible patients.

French drugmaker Sanofi announced in March it would cap at $35 out-of-pocket costs for many patients getting its most prescribed insulin product.

The three manufacturers control the vast majority of the global insulin market.

The Jan. 1 effective dates coincide with a provision of the 2021 American Rescue Plan Act that changes the amount of the rebate drugmakers have to pay Medicaid. So the new, lower costs from the companies will save them money.

Under the newly effective changes, the rebate is based on how much a drug’s list price has increased compared with inflation and how deeply it is discounted in the commercial market. If a drug’s price rises higher than the rate of inflation, companies need to pay higher rebates. The rebate could end up being more expensive than the amount of money the drug makes from Medicaid.

Drugmakers have been under fire for years over the rapid rise of the price of insulin. According to the American Diabetes Association, the price increased 24 percent between 2017 and 2022, and spending on insulin has tripled over the past decade to $22.3 billion in 2022.

An analysis released late last year found that approximately 1.3 million people, or 17 percent of all adults with diabetes in the U.S., rationed their use of insulin in the past year.



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