Senator Collins’ Bipartisan INSULIN Act Advances Out of Committee

Landmark legislation would cap monthly out-of-pocket insulin costs at $35 and create a pilot program to provide insulin at the same cost to those without insurance.

WASHINGTON, D.C. - Today, at a Senate Health, Education, Labor, and Pensions (HELP) Committee markup, the Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act advanced by a bipartisan vote of 17 to 5. This landmark legislation, introduced by U.S. Senators Susan Collins, Jeanne Shaheen (D-NH), Reverend Raphael Warnock (D-GA), and John Kennedy (R-LA), would cap the cost of insulin at $35 per month for Americans with private and employer-sponsored insurance. It would also create a pilot program to make insulin available at the same cost to uninsured Americans, removing barriers to care and expanding access to this critical medication for millions of patients. The bill now moves to the Senate floor for consideration by the full body.

"Beginning in 2015, I chaired eight hearings on prescription drug prices when I chaired the Senate Aging Committee. We heard countless stories from Americans who were struggling to afford the medicine they needed, and the unaffordable cost of insulin was featured prominently at almost every single hearing," said Senator Collins during the markup. "The bill we're marking up today is the culmination of these efforts. While recent decisions by manufacturers to cut their list prices on insulin are encouraging, there is still more work to be done."

"Our bill would cap the cost of insulin at $35 a month for individuals who are on commercial insurance plans. According to the American Diabetes Association, nearly 40 percent of people with diabetes have rationed or skipped insulin doses due to the cost," she continued. "One of my constituents, Bek Hoskins from Chelsea, Maine, skipped doses of insulin when she was unable to afford it, and ended up in the emergency room. The INSULIN Act would help people like Bek afford the insulin that they need to survive. The bill not only caps out-of-pocket costs for patients but addresses perverse incentives in the market and the lack of biosimilar competition that contribute to high list prices for insulin."

Specifically, the INSULIN Act:

1. Limits out-of-pocket costs for patients with diabetes by ensuring that group and individual market health plans must waive any deductible and limit cost-sharing to no more than $35 or 25% of list price per month for at least one insulin of each type and dosage form;
2. Prohibits pharmacy benefit managers (PBMs) from placing utilization management tools, such as prior authorization, on capped insulin products;
3. Promotes generic and biosimilar competition to lower costs to patients;
4. Creates a pilot grant program for 10 states to implement programs to identify people with diabetes who are uninsured and provide them with insulin at $35 per month; and
5. Establishes an insulin resource center and hotline for people with diabetes who are uninsured to connect them with resources about diabetes and programs to help them secure insulin.

The INSULIN Act is supported by the American Diabetes Association, Breakthrough T1D, the Endocrine Society, the National Kidney Foundation, and AARP.

Click here to read the complete text of the legislation.

As co-chairs of the Senate Diabetes Caucus, Senators Collins and Shaheen have long worked to strengthen investments in diabetes research, lower treatment costs, and improve access to care for patients. Earlier this year, they secured the reauthorization of the Special Diabetes Program at $200 million per year-a $40 million increase and the highest funding level in the program's history. Since 1997, the Special Diabetes Program has delivered meaningful research breakthroughs and resources for individuals with Type 1 diabetes and for Native American and Alaska Native communities.

Senators Collins and Shaheen have also introduced the Expanding Access to Diabetes Self-Management Training Act to expand Medicare coverage for diabetes self-management training (DSMT) sessions; the Promoting Access to Diabetic Shoes Act to improve care for patients with diabetes by allowing nurse practitioners and physician associates/physician assistants to prescribe therapeutic shoes; and the Strengthening Collective Resources for Encouraging Education Needed (SCREEN) for Type 1 Diabetes Act to improve early detection and screening by increasing public awareness of the signs and symptoms of Type 1 diabetes and supporting educational campaigns about the importance of early diagnosis.

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