With Big Pharma Exploiting Diabetics, Baldwin Supports a Cap on Patients’ Insulin Costs. GOP Sends Mixed Signals.

The cost to produce a vial of insulin is roughly equivalent to a cup of coffee and yet, pharmaceutical companies doubled insulin prices from 2012 to 2016, with the average price for a 40-day supply of insulin increasing from $344 to $666. 

Wisconsin Sen. Tammy Baldwin this month joined a coalition of Democrats in introducing a bill that would limit out-of-pocket costs for insulin to no more than $35 a month. 

The Affordable Insulin Now Act, introduced by Sen. Raphael Warnock (D-Georgia), would require Medicare, private group, and individual insurance plans to cap patients’ out-of-pocket costs, an effort that is intended to combat skyrocketing costs driven by greedy pharmaceutical companies. 

“No one should lay awake at night wondering if the health care they have today will be gone tomorrow, and no one should go bankrupt just to get the medication they need to live a healthy life,” said Baldwin in a statement. “We need to lower costs for people and cap the price of insulin at $35, so millions of Americans have the medicine they need at a price they can afford.”

More than a half-million Wisconsinites—roughly 1 in 10 adults in the state—suffer from diabetes, including roughly 135,000 who are unaware they suffer from the disease, according to various estimates. An additional 6,500 children and adolescents in the state also suffer from diabetes, according to the Wisconsin Department of Health Services.

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Patients with type 1 diabetes–about 5 to 10% of the overall diabetic population—experience high blood sugar levels caused by the body’s inability to produce the hormone insulin, while patients with type 2 diabetes can’t effectively use the insulin their body does create. The condition is controllable and treatable, but all type 1 diabetics and many type 2 diabetics rely on insulin to survive—and drug companies have dramatically increased prices over the past two decades, even though the product has remained exactly the same. 

Insulin prices nearly doubled from 2012 to 2016, with the average price for a 40-day supply of insulin increasing from $344 to $666 during that span, according to a report from the Health Care Cost Institute. On average, type one diabetics paid $5,705 for insulin in 2016, according to another report from the Health Care Cost Institute. 

While the price of a vial of insulin has surged to absurd levels, the cost to make a vial of the drug is roughly the cost of a cup of coffee. Manufacturers spend somewhere between $3.69 and $6.16 to produce each vial of insulin, according to a 2018 study. That means that in some cases, pharmaceutical companies are selling the life-saving drug at a markup of 10,000%. As a result, American diabetics now pay 10 times as much as those in other developed countries. 

These exorbitant prices have forced many diabetics to choose between insulin and other medications, or choose between insulin and housing or utilities. Roughly one in four insulin users have also rationed their insulin—which in some cases, has led to their deaths.

Wisconsin diabetic Mary Jonker is among those who have struggled to afford the cost of insulin. Jonker, who relies on Medicare for coverage, fell into the so-called Medicare “donut hole,” or coverage gap, forcing her to spend a lot of money out-of-pocket on insulin.

“I was told that my copay for my insulin after I went into the donut hole would be $850 for a three month period,” Jonker said in a statement. “So many people around this country are having the same problem. They’re deciding between insulin or food. They’re deciding whether to take their insulin every other day. I would like to thank Sen. Baldwin and Sen. Reverend Warnock for helping to ease the financial burdens on Americans purchasing insulin.” 

Baldwin has spent years fighting to lower insulin costs. Gov. Tony Evers and other Democrats have also proposed plans to reduce the cost of insulin and other prescription drugs at the state level, though those efforts were stymied by the Republican-led Legislature.

The Affordable Insulin Now Act is just the latest Democratic effort to address the growing crisis. But the bill—which is supported by the American Diabetes Association and several other healthcare advocacy organizations—will require Republican support to pass the Senate. Not a single Republican has signed onto the bill yet, putting its passage in jeopardy. This comes despite past GOP-led initiatives to cap insulin prices from lawmakers who are now strangely silent on the Democratic-led proposal.

The stakes of addressing the insulin cost crisis grow greater with each year, as somewhere between 34,000 and 40,000 Wisconsinites receive new diabetes diagnoses annually. By 2050, one in three American adults is expected to have diabetes, according to the American Diabetic Association.