There has been a recent push from the diabetes community to find clarity and transparency in the way that insulin is priced and made accessible to the people who rely upon the essential medication to live.
There have been industry summits, non-profits, grassroot campaigns, and high-profile politicians who have been bringing the astronomical price hikes to light. While there is not a clear answer on how to make insulin affordable and accessible to all, there are efforts being made nationwide to take a step in the right direction. Nevada is the first state to bring forth, pass, and sign into law, legislation with insulin price and accessibility in mind.
What the bill includes:
- The bill, signed into law by Governor Brian Sandoval on June 15, 2017, requires insulin manufacturers including Novo Nordisk, Sanofi, and Lilly to annually disclose information about list price, profits made on insulin products, and discounts granted to middlemen also known as “PBMs” or pharmacy benefit managers.
- Manufacturers must explain to state officials, in writing, any insulin price hike above the previous year’s inflation rate within 90 days, and will be fined $5,000/day if they fail to comply.
- A requirement that pharmaceutical sales representatives register with the state and provide details about their interactions with healthcare providers.
- A stipulation that nonprofit groups must disclose when they get funding from drug companies, PBMs, and/or health insurers.
What the bill lost in the process of being passed:
- A previous provision that would have required insulin manufacturers to notify the public regarding price hikes, which was vetoed by Governor Sandoval amidst fears of potential supply manipulation.
- A price control that could have effectively capped insulin prices at the rate of inflation.
- A mandated disclosure by drugmakers on how they set their prices, as well as information about dollars spent on marketing and research.
- A requirement that refunds be issued by insulin makers to insurance companies and individuals who purchase insulin if annual price hikes surpass inflation.
Nevada’s insulin pricing transparency legislation, which advanced with bipartisan support, follows a trend of patient, nonprofit, commercial, and governmental outcry and inquiry into the exponentially increasing price of insulin. The life or death urgency of affordable access to insulin is beginning to attract attention across the country, with Ohio slated to vote on a similar proposal in the fall. Even with the changes to the original bill, the law contains the strictest regulations on pharmaceutical companies in the United States.
Opponents of the bill (and others like it) argue that the law will not help patients better afford their life-saving medication and may backfire. The industry representatives and organizations have been vocal critics of the movement and market experts say transparency alone is not capable of lowering patient costs. However, proponents are hopeful that the results of the law’s required disclosures will allow patients to acquire the knowledge necessary to fight back by asking questions and getting involved in the process.
If the momentum from the success of the Nevada legislation carries forward, patients can likely expect to see versions being proposed in their home states. At the very least, the conversation on the topic of insulin pricing transparency and financial accessibility has begun and will not be quieted. The next step in overcoming continued market manipulation at the cost of patient access, moving toward insulin price transparency and affordable access, will come from legislation such as this.
- New Nevada law requires manufacturers to reveal insulin profits
- Nevada just passed one of the strictest drug pricing transparency laws in the country
- Nevada Senate Passes Insulin-Price Bill Tough on Drugmakers