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NEW YORK (AP) \u2014 Two-year-old Bain Brandon has type 1 diabetes and needs insulin to survive. However, even with health insurance, the price is not cheap.<\/p>\n
Mother Marley Brandon, 29, said it cost her parents $194 last week to buy a month’s supply of insulin vials and a three-month supply of back-up pens for her Mississippi toddler. Although she can afford it now, she is worried about the future.<\/p>\n
clock:<\/strong> New law caps insulin prices for some diabetics, but remains costly for others<\/p>\n “One day Bain will reach adulthood and will no longer be covered by our insurance,” she says. “I feel like a lot of people don’t realize how much it costs and how expensive it is.”<\/p>\n A bipartisan group of senators aims to ease that cost burden for Americans with private insurance plans with the Insulin Act, a bill that would cap the cost of the life-saving drug at $35 per month. The bill, introduced last week by Sen. Jeanne Shaheen (D.N.H.), Sen. Raphael Warnock (D-Ga.), Rep. Susan Collins (R-Maine), and Sen. John Kennedy (R-La.), would also launch a pilot program to make insulin more affordable to uninsured Americans in 10 states. A nearly identical bill was passed in 2022 as part of the Biden administration-era Inflation Control Act. This was a sweeping Democratic policy that capped drug costs for seniors on Medicare at $35 a month.<\/p>\n The bill is the latest in a long effort by some lawmakers in both parties to rein in insulin prices, and faces numerous hurdles, including concerns about cost and other competing congressional priorities. Still, with President Trump in control of the White House and Congress, there is a chance for a rare bipartisan victory on health care affordability in a year when Republicans are in control and rising health care costs are a concern for voters of both parties.<\/p>\n Approximately 8.1 million people in the United States use insulin, according to the Centers for Disease Control and Prevention. This includes more than 2 million people with type 1 diabetes who will die if they are unable to take insulin regularly. This medication also helps control blood sugar levels in people with other types of diabetes.<\/p>\n However, the price of insulin can vary widely. Some people with private insurance pay nothing or very little, while others pay hundreds of dollars each month on top of other costs for their diabetes, such as pumps, blood sugar sensors, and other necessities.<\/p>\n In addition to the 2022 law lowering insulin copays for Medicare beneficiaries, more than half of states in recent years have passed their own insulin copay caps of $25 to $100 per month for patients enrolled in state-regulated insurance plans.<\/p>\n Major insulin makers Eli Lilly, Sanofi, and Novo Nordisk are also working to reduce the cost of insulin through various combinations of lower list prices, caps on out-of-pocket costs, and increased affordability.<\/p>\n Still, not all patients can take advantage of lower prices. About 57% of Americans with private health insurance have self-insured plans that cannot be regulated by states, said Matthew Fiedler, a senior fellow at the Brookings Institution Health Policy Center. That means it would be exempt from the state’s cost cap bill. Some patients may not have insurance or may have difficulty taking advantage of manufacturer cost reduction programs.<\/p>\n “I think the onus is on the patient to try to manage and reduce costs,” said Dr. Leslie Eil, an adult endocrinologist at the University of Nebraska Medical Center who is sponsoring the latest bill with the Endocrine Society.<\/p>\n “No one should have a hard time affording insulin,” Oliver Boguillot, Sanofi’s head of generic medicines in North America, said in a statement, touting the company’s savings program, which includes people without health insurance. Novo Nordisk spokeswoman Flavia Blackling said expanding affordable access to medicines is a priority, noting that the company is not increasing the list price of its insulin products for 2026.<\/p>\n Shance Jones, a spokesperson for PhRMA, the main pharmaceutical industry trade group, said pharmacy benefit managers and insurance companies are creating barriers to access and affordability for patients, even as manufacturers seek to expand access.<\/p>\n “I look forward to working with policymakers to ensure that middlemen no longer stand between patients and medicines,” he said.<\/p>\n The new insulin law has bipartisan support, but it’s not the first time such a bill has seemingly gained momentum and failed.<\/p>\n In 2022, the House of Representatives passed a $35 monthly insulin cap for Americans with private insurance, but the Senate did not.<\/p>\n A similar attempt to include the bill in the Democratic Inflation Control Act that year ultimately failed, with Republicans objecting that it was attempted in a way that violated Senate rules.<\/p>\n Breanna Glover, 23, a restaurant worker in Houston, moved to Texas from California because she needed a lower cost of living to cover the high medical costs associated with type 1 diabetes.<\/p>\n Paying for her insulin and other supplies is a balancing act. To pay the $50 co-pay for four vials of insulin, she limits her carbohydrate intake. By doing so, you can reduce your daily insulin use and make it more effective for longer.<\/p>\n Glover said the $35 per month cap would not only help cover expenses like groceries and gas, but would also be “a small step toward making everything more accessible.”<\/p>\n Manny Hernandez, CEO of Diabetes Link, a national nonprofit organization for youth with diabetes, said advocates expect young people to particularly benefit from the bill. That’s because many people struggle to get quality health insurance plans or insurance at all if they don’t have access to a plan through their parents.<\/p>\n Hernandez said he was encouraged by recent meetings with Republican lawmakers from his home state of Florida, but worries that other priorities will drown out the bill, as has happened in the past.<\/p>\n “There are a lot of distractions and a lot of important things going on,” he said. “But I haven’t lost hope.”<\/p>\nCopays for insulin, an essential drug for millions of people, vary widely<\/h2>\n
Efforts to pass similar legislation have been unsuccessful.<\/h2>\n
Diabetes patients and their advocates remain hopeful<\/h2>\n