Sen. Wiener has introduced a separate bill, SB 41, that could have a much bigger impact on the affordability of insulin and other drugs. It targets pharmacy benefit managers, or PBMs — healthcare middlemen who use their gatekeeping power to decide which drugs a patient’s health plan will cover — and what price they’ll pay.
California State Sen. Scott Wiener, D-San Francisco, recently introduced legislation that would cap cost-sharing for insulin at $35 a month, regardless of whether a patient has public or private insurance.
It’s a popular idea. But it may not be necessary. The cost of insulin has been falling due to market forces. Most insured patients already pay less than $35 a month. Six years ago, the average monthly out-of-pocket cost for insulin made by Eli Lilly was $38.64. It’s now $17.16, a 56% drop.
In other words, insulin manufacturers have been dropping their prices because of old-fashioned competition. And that’s largely solved the problem the proposed out-of-pocket cap is meant to fix.
Nothing contained in this blog is to be construed as necessarily reflecting the views of the Pacific Research Institute or as an attempt to thwart or aid the passage of any legislation.
Insulin prices are falling due to market forces — no price caps required
Sally C. Pipes
Sen. Wiener has introduced a separate bill, SB 41, that could have a much bigger impact on the affordability of insulin and other drugs. It targets pharmacy benefit managers, or PBMs — healthcare middlemen who use their gatekeeping power to decide which drugs a patient’s health plan will cover — and what price they’ll pay.
California State Sen. Scott Wiener, D-San Francisco, recently introduced legislation that would cap cost-sharing for insulin at $35 a month, regardless of whether a patient has public or private insurance.
It’s a popular idea. But it may not be necessary. The cost of insulin has been falling due to market forces. Most insured patients already pay less than $35 a month. Six years ago, the average monthly out-of-pocket cost for insulin made by Eli Lilly was $38.64. It’s now $17.16, a 56% drop.
In other words, insulin manufacturers have been dropping their prices because of old-fashioned competition. And that’s largely solved the problem the proposed out-of-pocket cap is meant to fix.
Read the op-ed here.
Nothing contained in this blog is to be construed as necessarily reflecting the views of the Pacific Research Institute or as an attempt to thwart or aid the passage of any legislation.