Colorado Caps Insulin Prices, but There’s a Catch

Activists are cheering as Colorado has announced it will be capping insulin prices at a $100 monthly copay, a huge benefit for patients. The problem is the only patients who will see this benefit are those on private insurance. Meanwhile, pharmacies and drug companies can continue charging insurance companies whatever they like because there’s no incentive to do otherwise.

Insulin has become the poster child for wildly overinflated prescription drug prices. The medication form of this compound naturally produced in the body was developed in 1921 by researchers who charged just $1 for the patent. They wanted to keep the medication accessible.

It’s since become a major moneymaker for pharmaceutical companies. The cost for insulin can exceed $5,700 annually. And because of the rising drug prices, roughly a quarter of Type 1 diabetics has reported skipping or shorting doses. Some people have died because of insulin rationing.

Over 7 million people across the United States rely on daily insulin injections to survive. If they do not receive this medication or the dosage is too low, it can cause health complications very quickly. Those without good insurance or the money to cover the cost can get into serious trouble without this lifesaving medication. Some may also require specific formulations, something drug companies leverage with their pricing practices.

For patients who are not insured or those relying on benefits, such as Medicaid and Medicare, the Colorado copay cap won’t apply. Nearly 20 percent of Colorado residents rely on Medicaid for health coverage, 15 percent use Medicare coverage and a little under 7 percent of the state is uninsured.

That makes this development of limited utility to some residents, who will continue to face price gouging. Many of these patients are also least able to afford hundreds of dollars a month on insulin, as that’s why they’re uninsured or receiving Medicaid coverage in the first place, while older adults tend to have lower incomes.

Getting costs down for a chunk of Colorado’s diabetic population is definitely better than doing nothing, even if the implementation is imperfect. Insurance companies may try to recoup costs in other ways now that they are being asked to swallow high prices for insulin. Hopefully Colorado legislators will think about how to fill these gaps as they move forward into 2020. The law takes effect in January, which gives them several months to consult with experts on the best way to ensure that patients can safely access this vital medication at an affordable cost.

The added mandate in the bill that state officials investigate how and why drug prices are climbing is excellent news. Drug companies have also recently answered to Congress on the same subject, with a growing number of Americans upset about the high costs for necessary prescription drugs. As individual states investigate, they can add to the body of evidence on the subject, while legislation to fight price-gouging can have a ripple effect in other states.

If you’d like to see your own state take on the subject of insulin affordability, contact your lawmakers to make your case. You may wish to note that the high cost of the drug is driving people to make poor health care decisions, while drug companies have yet to come up with an adequate explanation for the drug’s skyrocketing price. A comprehensive law that extends to people who are not on private insurance would also likely be a welcome development, especially if you live in a state that declined the Medicaid expansion.

Photo credit: Samara Heisz/Getty Images

41 comments

Chad Anderson
Chad Anderson7 days ago

Thank you.

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Paula M
Paula M13 days ago

Thank you for sharing

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Richard B
Richard B13 days ago

Thank you for sharing

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Ruth S
Ruth S14 days ago

Thanks.

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Ruth S
Ruth S14 days ago

Thanks.

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Maria P
Maria P16 days ago

Thanks

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Tabot T
Tabot T17 days ago

Thanks for sharing!

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Toni W
Toni W18 days ago

TYFS

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Toni W
Toni W18 days ago

TYFS

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Susanne R
Susanne R18 days ago

According to the article: "The medication form of this compound naturally produced in the body was developed in 1921 by researchers who charged just $1 for the patent. They wanted to keep the medication accessible."

I wonder what these good people would have thought if they had been able to foresee the greed that has taken over this country.

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