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Oct. 3, 2022

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Senators release bill targeting insulin prices

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WASHINGTON — Two key senators on Wednesday released a widely anticipated bill aimed at lowering insulin prices and capping monthly copays under commercial and Medicare insurance plans.

The move is the next step in advancing one of Democrats’ most popular provisions from a stalled reconciliation bill ahead of a tough midterm election. In March, the House passed its own standalone version sponsored by Democrats to cap insulin copays.

The bill, sponsored by Senate Diabetes Caucus Co-Chairs Jeanne Shaheen, D-N.H., and Susan Collins, R-Maine, aims to entice drug makers to lower their list prices to 2021 net Medicare rates by blocking pharmacy benefit managers from accepting drug rebates or other discounts. Drug manufacturers and critics allege the discounts, which are often a percentage of the list price, encourage higher prices.

The duo’s previous insulin bill aimed to reduce prices to 2006 list prices.

The bill would also cap insulin copays at the lesser of $35 or 25 percent of the list price per month in commercial and Medicare Part D plans.

“It is paramount that Congress act swiftly, which is why we are calling on Senate leadership to bring our legislation to the floor as soon as possible,” the senators said in a statement. “There is support on both sides of the aisle for this proposal and the American people cannot – and should not – have to wait a moment longer for relief.”

The bill effectively merges the duo’s rebate provisions with a separate bill to cap insulin copays from vulnerable Georgia Democrat Raphael Warnock. Senate Majority Leader Charles E. Schumer, D-N.Y., previously pledged to bring Warnock’s bill to the floor before deferring to Shaheen and Collins, whose bill also aims to lower prices for the uninsured.

It’s not yet clear how willing the industry would be to adhere to the bill or how much the bill is expected to cost, although the House bill to cap copays was estimated to cost $20.4 billion over a decade. A spokeswoman for Shaheen said the senators are still working with the Congressional Budget Office and plan to fully offset any projected spending.

It’s also unclear how many Senate Republicans will support the measure, though a Collins spokeswoman said the senator is working to brief her Republican colleagues on the bill. Just 12 Republicans voted to cap insulin copays in the House.

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