An area resident who depends on insulin for his diabetes recently wrote me a letter about a life-and-death matter.
He went to his pharmacy to re-order his three-month supply of insulin and was told that under his new insurance plan, he would have to pay $700 upfront before he could receive his medication.
“I cannot afford this mammoth deductible,” he said. “The government must regulate these prices or, unfortunately, many people may die, including me.”
My colleagues in the Minnesota Senate are also receiving letters like this. Some writers describe situations that are even more heartbreaking.
Americans spend more money on drugs than people in any other country.
According to a Kaiser Family Foundation Health Tracking Poll, one in four people say they or a family member has not filled a prescription, cut their pills in half, or skipped doses because of cost.
No one should have to choose between putting food on the table or paying for their prescriptions.
Why are prices so high? It isn’t a simple answer.
There have been some amazing breakthrough medications introduced over the last several years. These developments mean a better quality of life for many people living with serious conditions like Hepatitis C. However, many of these new specialty medications also have significant costs. At the same time, we are seeing examples of inexplicable cost increases for medications that have been around for years like insulin, or epinephrine used to treat severe allergic reactions.
There is also serious debate about the role of pharmaceutical industry players like pharmacy benefit managers. The question is whether they add value or simply drive prices higher.
In the case of regulating the cost of insulin, we can’t sit by while so many are in danger. The Minnesota Department of Health states that there are 320,000 Minnesotans with Type 1 or Type 2 diabetes. The price of their life-saving insulin has doubled since 2012.
A bipartisan coalition of Minnesota lawmakers recently introduced a package of bills that, hopefully, will help the situation.
One bill, the Alec Smith Emergency Insulin Act, would provide emergency economic help to individuals who cannot pay for their insulin. People who qualify would receive the insulin for free, and the pharmacies would be reimbursed by a fee imposed on insulin manufacturers.
A second bill (SF 366) requires price transparency among pharmacies, insulin manufacturers and customers. It calls for the insulin manufacturers to justify and explain each price hike they propose so customers can understand why they are being charged more. It also mandates the Minnesota Health Commissioner to analyze data and provide a thorough report to the Legislature. The American Diabetes Association cites this as an essential act to change the insulin industry.
A third bill (SF 365) works toward that same goal of accountability by creating transparency between insurance companies and their customers. It mandates that insurance providers disclose the brand of insulin and type of equipment provided under a healthcare plan. Minnesotans need to know that their needles, pumps and patches are covered just as much as their insulin.
The final bill (SF364) creates a long-term plan for keeping insulin prices low for customers. It imposes reimbursement charges on insulin manufacturers. The Commissioner of Health will collect and analyze data submitted from manufacturers, pharmacies and insurance providers to determine a reasonable price for insulin.
Another issue attracting much attention is the tragic rise in opioid overdose deaths. We must find a way to promote moderation and fund treatment. Last session’s “penny-a-pill” initiative did not win approval.
Curbing prescription drug prices won’t be easy, but it’s a battle worth fighting. The pharmaceutical industry is used to having things a certain way, but if we are going to bring down costs, we have to be willing to look at all the options.
Lack of federal action on prescription drug prices in recent years means states have stepped in to find solutions. We are seeing lots of good ideas springing up around the country like protecting consumers from sudden and unreasonable price increases and holding drug companies accountable for their actions. Some states have been successful in getting meaningful legislation passed while others are facing difficult legal challenges from the pharmaceutical industry. We need to continue applying pressure at the state as well as the federal level to get some of these good ideas going here in Minnesota.
This is a complex problem. It will require comprehensive solutions at the state and federal level. We should continue to put pressure on our representatives at the federal level to keep pushing for changes.
While I and my colleagues keep working toward reducing the costs of your prescriptions, here are a couple good things to know that might help you save time and money when it comes to your health care:
- Minnesota law requires health care providers to give you a good faith estimate of the costs of services you are receiving. You can request this information in advance, so you can plan for any expenses or even find a more affordable alternative.
- All Minnesotans have access to a website operated by the Minnesota Hospital Association that lets you compare their average costs for treating patients based on diagnosis as well as for certain outpatient procedures. http://www.mnhospitals.org/data-reporting/minnesota-hospital-price-check/hospital-report
For additional information and assistance, you can check out these resources:
The American Cancer Society https://www.cancer.org/treatment/finding-and-paying-for-treatment/understanding-health-insurance/if-you-have-trouble-paying-a-bill/prescription-drug-assistance-programs.html.
The Senior LinkAge Line- 1-800-333-2433 is operated by the Minnesota Board on Aging and can help you find programs that help pay for prescription drugs.
The Minnesota Department of Health: http://www.health.state.mn.us/clearinghouse/prescription.pdf. They include several resources including https://www.pparx.org/. This website is a free service that matches consumers with prescription assistance programs based on the medications you take.
As always, please contact me with questions or suggestions regarding any issue. I encourage you to visit me at the Minnesota Senate Building, Room 2219. Let me know if you would like me to stop by your home or apartment. I can be reached by email at email@example.com, and by phone at 651-296-6820, or 651-770-0283.