The Rhode Island General Assembly is close to passing legislation that will cap out of pocket costs for insulin, a costly drug that is the lifeline for thousands of insulin dependent diabetics in Rhode Island.
Rhode Island will join several other states that have capped out of pocket insulin costs, for a drug that has tripled in cost over the last decade, according to the verywellhealth website. It has become so costly that one in four insulin users ration their usage because they can’t afford it, according to the Yale School of Medicine.
In Rhode Island, there are more than 80,000 diabetics, says Matt Netto, director of advocacy for AARP in Rhode Island. Nationally there are 34 million diabetics, with 20 percent of those insulin users, says the verywellhealth website. If 20 percent of Rhode Island diabetics use insulin, that means some 16,000 people are insulin users. Many diabetics control their disease through medications, and/or diet and exercise.
Netto says insulin costs have been a “hot” issue since the beginning of the General Assembly session, with proposals suggesting caps for out-of-pocket costs ranging from $25 to $100 a month. Both the Rhode Island House and Senate settled on a $40 a month cap, but the House and Senate language differs slightly, which Netto is confident will be resolved and sent to the governor for his signature.
If approved Rhode Island will join a growing number of states that have enacted insulin out-of-pocket caps. The offset ranges from $25 (New Mexico) to $100 (several states). Here’s a rundown of 10 states we found that have enacted insulin out of pocket caps: Colorado, Illinois, New York, Washington, and West Virginia, $100; Virginia, $50; Maine and Minnesota, $35; Utah, $30; and New Mexico, $25.
Netto says that for diabetics the cost of insulin is significant, rising from $2,909 annually for the drug Lantus in 2013 to $4,702 five years later. The Healthcare Institute says diabetics spend nearly $6,000 annually on insulin, and the verywellhealth website says diabetics spend 2.3 times the cost on healthcare than Americans without the condition.
Most diabetics, the website says, need two vials of insulin per month, at a cost of $175 to $250 per vial, or one or two packs of insulin pens, at a cost of $375 to $500.
The high cost of insulin, and other drugs, forces many individuals to make difficult choices, according to those in agencies serving populations in need. Lee Eastborne, executive director of Westerly’s Jonnycake Center, says the agency sees many individuals who are regularly deciding between paying housing costs (mortgage or rent), utilities, food, or medications.
Some diabetics change insurance plans, when those plans refuse to cover certain insulin drugs, forcing users to use less costly and sometimes less effective generics, according to Pew Research.
Also, according to Pew Research “between 2012 and 2017, drug spending in the United States increased nearly 29 percent while overall health spending rose less than 25 percent. Since 2013, the growth in prescription drug spending has exceeded GDP growth, which means the industry is consuming an increasingly large share of the U.S. economy.”