On July 24, the White House released three Executive Orders related to drug pricing. While these policies will take time to implement, we want to share how these relate to our fight for insulin affordability for everyone. At a high-level the Executive Orders:
- Direct Federally Qualified Health Centers (FQHC) (or community health centers) to make insulin and injectable epinephrine available at the same discounted price they pay for people with low incomes, who are uninsured or who have a high deductible or high cost sharing health plans;
- Continue the rule-making process to pass drug rebates through to Medicare patients at the point-of-sale without increasing costs elsewhere; and
- Focus on the importation of prescription drugs from other countries.
Today, FQHCs can help you access insulin at reduced cost. You can learn more about them in our resources for low-cost insulin. This Executive Order may reduce the cost of insulin even further at these facilities once implemented, improving a pathway to affordable insulin.
Breakthrough T1D has long supported ending the rebate system, which is the biggest obstacle to immediately reducing the cost of insulin. Passing rebate savings through to customers at the point-of-sale, as the Executive Order directs be done in the Medicare program, is an important step and will likely help lower the price people in Medicare pay for insulin. This Executive Order follows on the tail of an earlier program announced by the Centers for Medicare & Medicaid through which certain participating insurers will offer prescription drug plans for Medicare beneficiaries providing insulin for $35 per month.
Regarding importation, Breakthrough T1D feels strongly that the cost of insulin should be resolved within the U.S. healthcare system without broad-scale importation of drugs from other countries. We also, however, recognize that for some individuals obtaining insulin from other countries is what’s best for them.
While these are all steps in the right direction for insulin affordability, we know they are simply not enough. Breakthrough T1D continues to work tirelessly for comprehensive, long-term solutions to insulin pricing at the Federal level. Through our Coverage2Control campaign, we’ve rallied our community to call for insulin manufacturers, health plans, employers and the Federal government to take action to lower the cost of insulin. Breakthrough T1D executives have met repeatedly with the leadership of each of the three major insulin manufacturers and called on them to lower costs for insulin. Breakthrough T1D President and CEO, Aaron Kowalski, Ph.D, has testified before Congress and met with senior Administration officials. Breakthrough T1D advocates from across the country have met with hundreds of Members of Congress and more than 50,000 people have petitioned their health plans.
And this work has shown progress: the recent Executive Orders, Medicare announcing a new initiative to offer insulin coverage at $35 per month, multiple manufacturers and insurer programs capping monthly out-of-pocket costs for insulin and IRS guidance now enabling high deductible health plans to treat insulin as a preventive drug.
More needs to be done, and Breakthrough T1D will continue to fight until insulin is affordable for everyone. Advocate today!
