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Louisville diabetics praise Ky. insulin price cap for some, continue calls for affordability

Published: Mar. 23, 2021 at 9:35 PM EDT
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Beshear signs insulin cap bill.
Beshear signs insulin cap bill.(WAVE 3 News)
Those with diabetes continue to push for change.
Those with diabetes continue to push for change.(WAVE 3 News)

LOUISVILLE, Ky. (WAVE) - Diabetics rely upon insulin to stay alive, but for many that comes with a significant financial cost.

Governor Andy Beshear, (D) Kentucky, signed House Bill 95 this week.

The bipartisan legislation states “cost sharing for a covered prescription insulin drug shall not exceed $30 per 30 day supply of each prescription insulin drug.”

The law stipulates that is regardless of the amount or type of insulin required to meet a person’s needs, but only applies to certain types of insurance.

Many with diabetes, including Maggie Callahan, said HB 95 is a good start, but their fight for affordable insulin is not over yet.

“It’s honestly probably one of my highest expenses,” Callahan said.

She added, if uninsured, her insulin would cost $500 per month. Right now, her cost has gone down to $35 per month, but that’s only because she’s already spent thousands.

“To do that, I had to meet that $3,000 deductible,” Callahan said. “A lot of people can’t feasibly do that.”

Costs like that force people to get creative.

Mari Thompson, who found out she had type 1 diabetes in fourth grade, said when her or her friends’ insulin supply runs low, they crowdsource the life-sustaining resource from a group chat with other diabetics.

“So, it comes down to ‘Hey, does anyone have a Humalog pen that I could use to get through these next three days?’” Thompson said.

Thompson said that allows people to avoid high out-of-pocket costs for purchasing insulin outside of insurance coverage that only allows purchases at certain frequencies or amounts, even though needs may vary.

Kevin Trager, a Louisville man who was diagnosed with type 1 diabetes in 2001, said after doing some research, he found insulin that could cost hundreds of dollars in the U.S. was one-tenth of the price in Canada.

“$350 for a vial of insulin that costs just a couple dollars to make is cruel, unfair and it’s completely disgusting,” Trager said.

Trager said he used to help others get access to cheaper insulin across the border before government restriction on the practice tightened.

“They would just pay cash to this pharmacy in Canada that was shipping the exact same insulin that we have in America,” he said.

The newly-enacted law, born out of House Bill 95, places caps on those who have a state-regulated health care plan or a plan purchased on the marketplace exchange. It also impacts state employees and people under some group plans.

It does not cap costs for Medicare, Medicaid or self-funded plans.

Trager said the bill is a good start to making insulin more affordable, but wants to see healthcare and insurance become less costly as well.

“This is why we send our legislators to Frankfort,” he said. “To prevent the health insurance and pharmaceutical companies from being really greedy and price gouging us because we have to buy their insulin.”

Callahan said she hopes to see a national cap on insulin costs.

“It wouldn’t matter who you worked for, or what your financial situation was, what your insurance plan was,” Callahan said. “It would just cap that price. So, everyone could have equal access to something we need to live.”

Thompson said legislation related to reducing the costs of technology associated with managing diabetes, including insulin pumps and continuous glucose monitoring systems, would be helpful to her and many others.

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