DEAL FOR DIABETICS
WH rolls out Medicare-based insulin coverage
WASHINGTON — Many Medicare recipients could pay less for insulin under a deal President Trump announced Tuesday in a pivot to pocketbook issues important in November’s election.
“I hope the seniors are going to remember it,” Trump said at a Rose Garden ceremony, joined by executives from insurance and drug companies, along with seniors and advocates for people with diabetes.
The deal comes as Trump tries to woo older voters critical to his reelection prospects.
Medicare recipients who pick a drug plan offering the new insulin benefit would pay a maximum of $35 a month starting next year, a savings estimated at $446 annually. Fluctuating cost-sharing amounts that are common now would be replaced by a manageable sum.
The insulin benefit will be voluntary, so during open enrollment this fall Medicare recipients who are interested must make sure to pick an insurance plan that provides it. Most people with Medicare will have access to them.
The cap on copays is expected to lead to a small increase in premiums.
Stable copays for insulin are the result of an agreement shepherded by the administration between insulin manufacturers and major insurers, Medicare chief Seema Verma said.
The three major suppliers, Eli Lilly, Novo Nordisk and Sanofi, were all involved.
“It was a delicate negotiation,” Verma said. Drugmakers and insurers have been at odds in recent years, blaming one another for high prices. “I do think this is a big step.”
Importantly for patients, the new benefit would cover a range of insulin products, including pen and vial forms for rapid-acting, short-acting, intermediate-acting and long-acting versions.
The cost of insulin is one the biggest worries for consumers generally concerned about high prices for brand name drugs. Millions of people with diabetes use insulin to keep their blood sugars within normal ranges and stave off complications that can include heart disease, blindness, kidney failure and amputations.
People with diabetes also suffer worse outcomes from COVID-19.
Insurers and drugmakers welcomed the announcement. The industry group America’s Health Insurance Plans called it an “excellent example of public-private partnerships where everyone wins.” The Pharmaceutical Research and Manufacturers of America said it’s pleased to see the administration focused on lowering out-of-pocket costs for patients.
One out of three people with Medicare have diabetes, and more than 3 million use insulin. At list prices, the drug can cost more than $5,000 a year.