ICYMI: Senators Shaheen, Collins Discuss Bipartisan Efforts to Lower the Cost of Insulin

(Washington, DC) –U.S. Senators Jeanne Shaheen (D-NH) and Susan Collins (R-ME) spoke with the Washington Post’s Health 202 Newsletter to discuss their bipartisan INSULIN Act as part of their recent efforts to lower the cost of insulin.

As co-chairs of the Senate Diabetes Caucus, Shaheen and Collins have led action in the U.S. Senate to advance priorities that will lower the costs of insulin, invest in treatment and prioritize diabetes research. Recently, the Senators penned a joint op-ed about the importance of lowering the cost of insulin. The Senators have worked to increase awareness of the threats posed by diabetes, invest in research and improve access to treatment options. They have consistently held insulin manufacturers, insurers and pharmacy benefit managers accountable for the skyrocketing cost of life-saving insulin. Earlier this year, Shaheen and Collins commended drug manufacturers Lilly, Novo Nordisk and Sanofi’s actions to lower their list prices for their insulin products.

Full text of the story can be found here and below:

Sens. Shaheen and Collins explain their work on insulin affordability

A growing share of the more than 7 million Americans with diabetes is enjoying lower out-of-pocket costs for insulin as states, Medicare and drug companies have moved to cap prices.

But some senators are pushing to address sky-high insulin costs for patients who continue to fall through the cracks. Sen. Jeanne Shaheen (D-N.H.) introduced legislation earlier this year alongside Sen. Susan Collins (R-Maine), who plans to tout it at today’s Senate Health, Education, Labor and Pensions Committee hearing on the diabetes epidemic.

Among other provisions, their bill would extend Medicare’s $35-per-month cap on insulin prices to individuals with private insurance, rein in the business practices of prescription drug middlemen and make it easier for new generic and biosimilar drugs to enter the market.

I caught up with the longtime co-chairs of the Senate Diabetes Caucus over the phone yesterday about their approach. This interview has been edited and condensed for length and clarity.

H202: There have been several steps in the public and private sector to lower insulin costs in recent years. Why is federal reform necessary at this point in time?

Collins: First of all, there’s no guarantee that the manufacturers keep their prices low, and we still have real problems in the marketplace.

What we have done, in my view, is a much more comprehensive approach. We’ve looked at why prices have gone up so much and we’ve looked at the role of pharmacy benefit managers (PBMs). Our whole intent is to reduce the perverse incentives in the insulin market that encouraged these high list prices. That includes mandating that the PBMs pass 100 percent of the insulin rebates that they negotiate to the plan sponsors.

Shaheen: As for why now, we’ve seen a PBM reform bill pass the House overwhelmingly. There’s also PBM reform that I think is very likely to get to the floor of the Senate. But we can’t address the high cost of health care unless we address the cost of insulin, and getting at that underlying list price is about the PBMs. It’s also about allowing biosimilar insulin to get to the market.

Collins: That’s a really important point. What we found is, a couple of years ago when a biosimilar was launched on the market at a very low, affordable price, PBMs would not choose it to be on the formularies for insurance plans because they didn’t get a big enough cut of the price because it was so low.

So what did the company do? It relaunched the biosimilar at a higher price, and then it was chosen for the formulary. I can’t think of a better example of a broken marketplace than that.

H202: Republicans jettisoned a proposed $35 insulin cap on private insurance from the 2022 Inflation Reduction Act. Sen. Collins, do you think enough members of your party would support the Insulin Act of 2023 to pass?

Collins: I think that there is support for a $35 cap, but a lot of people realize that there’s something wrong with the underlying insulin market and that we need to fix that.

Shaheen: We have seven Republican co-sponsors on the bill, and we’re talking to a number of other people who have expressed an interest, so we’re hoping to get more than that. And if you combine that with those people who voted to address insulin costs [previously], I think if this bill comes to the floor we will have a majority of senators supporting it.

H202: Other lawmakers have introduced legislation on this issue, including Sens. Raphael Warnock (D-Ga.) and John Kennedy (R-La.), who proposed a $35-per-month cost-sharing limit for insured and uninsured people. Can you comment on that effort?

Shaheen: We’ve met with Kennedy and Warnock to see if we could make sure we include all the provisions in both bills, and those discussions are still ongoing. It’s been something that the HELP Committee has also expressed an interest in. So I’m hopeful that we’re going to have something that everybody will support taking to the floor.

H202: We’re in a divided Congress, and for many Americans, Democrats and Republicans have never seemed so far apart. Why is bipartisanship important for lawmaking?

Collins: I’ve probably worked with Sen. Shaheen on more issues, and a wider range of issues, than any other senator, and frankly, I think that’s why we’ve been so effective in being able to get things done.

Shaheen: Two heads are better than one. Working together allows us to both pick up on any kinds of oversights that one person might have, but also to bring different perspectives to the issue.

Here in Congress that’s important because very little really gets done without having bipartisan support. A piece of that is being able to trust the people you’re negotiating with, and I think that is a really important aspect of my relationship with Sen. Collins.

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