Will Weekly Basal Insulin be Game Changer?

Vermont Governor Caps Insulin Costs at $100 Per Month


Great news in Vermont: Governor Phil Scott signed a law capping insulin costs at $100 per month.

An official press release from the American Diabetes Association explains:

“The law limits cost-sharing for insulin to $100 per 30-day supply for those with state-regulated commercial health insurance, a measure supported by the American Diabetes Association (ADA). The cap applies to the enrollee’s total insulin cost, so if someone requires more than one type of insulin, their cost-sharing would still not exceed $100 in total.”

Vermont joins a large and growing list of states to have taken action on insulin prices. Colorado was the first state in the nation to sign an insulin price cap into law, limiting monthly out-of-pocket costs to $100. The 2019 bill went into effect on January 1 of this year. In November 2019, Illinois passed a similar law to Colorado’s. The trend really began to snowball in March, when Virginia, New Mexico, Maine, West Virginia, and Washington all passed laws capping insulin co-pays.

March, however, marked a turning point in multiple ways, because that was also the month that the COVID-19 pandemic exploded within the borders of the United States. The insulin affordability crisis has understandably received much less attention in the time since, and it’s probable that legislative momentum in other states was slowed.

While the novel coronavirus may have grabbed the spotlight, insulin affordability continues to pop up as a national political issue. There was enough attention given to the issue and its heightened relevance during a stark recession that the major insulin manufacturers made efforts to expand affordability programs. In the recent presidential debate, President Trump brazenly claimed that he had made insulin “so cheap, it’s like water,” a claim that millions of Americans with diabetes would dispute.

A recent survey by team at Diabates Daily survey found that 18% of respondents reported that the pandemic had hindered their ability to afford insulin, a majority of whom lost some income or lost their job entirely. Only a minority of respondents were able to take advantage of one of the newly expanded insulin affordability programs. 47% were unaware that such discount programs existed; many others (about 25%) applied but were told that they did not qualify.

Colorado’s experience with its new law has been rocky: a variety of loopholes and exemptions at least initially kept prices sky high for some patients. And the author of the bill himself was surprised to see insurance companies limit costs to $100 per prescription, which left those prescribed multiple types of insulin paying multiple hundreds of dollars every month.

Vermont’s rule, which caps total insulin cost, indicates that lawmakers are learning from Colorado’s trailblazing but awkward experience. We can hope that more states continue to follow the leaders on this issue.

Stephen Habbe, the ADA’s Director for State Government Affairs, issued the following statement on the new Vermont law:

“With 57,000 people in Vermont living with diabetes, and 165,000 with prediabetes, this is one of the most urgent issues for the state. Insulin prices have skyrocketed, tripling in price between 2002 and 2013, and $360 million is spent treating diabetes and its complications in Vermont each year. It is critical that elected officials address the needs of their citizens with diabetes.”



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