New plan provides access to insulin for those unable to afford the high cost of the life-saving medicine
ST. PAUL, MN – Senator Rich Draheim (R-Madison Lake) and his colleagues on the Senate Health and Human Services Committee held a hearing on the Minnesota Insulin Patient Assistance Program, a new plan to provide access to insulin for Minnesotans unable to afford the high cost of the life-saving medicine.The informational hearing allowed for testimony from healthcare professionals, diabetes advocates, and questions from Senators as they learn more about the proposal.
“Access to affordable prescription medications, including insulin, has been a problem throughout our state,” said Senator Draheim, a member of the Senate Health and Human Services Committee. “While there is more work to be done to not only lower the price of insulin but all prescription medications, this new plan provides a framework for avoiding insulin crises for Minnesotans struggling with diabetes. Through a comprehensive, bipartisan solution, I will continue to champion legislation that lowers health care costs across the board, including prescription drugs.”
Beginning in 2020, Blue Cross Blue Shield, UCare, Medica, and Health Partners will all have at least one plan with a $25 insulin co-pay available to individual and group markets in Minnesota. Additionally, Senator Draheim championed into law several measures during the last legislative session that aim to lower the cost of prescription medications, including:
- Emergency Refills – The Health and Human Services (HHS) comprehensive budget bill required pharmacies to provide emergency access to insulin and other life-saving drugs even if a prescription runs out. Pharmacists can now fill up to a 30-day supply of insulin for patients even if their prescription is not current.
- Patient protections for mail-order pharmacies – The Senate passed into law protections that ensure prescriptions are filled in a timely manner so that individuals are not left without essential medications due to a delay in order processing.
- Transparency in Insulin Pricing – The HHS budget bill required Pharmacy Benefit Managers (PBMs) to communicate regularly with all pharmacies the cost for prescription drugs including any rebates or discounts available from a drug manufacturer.
- Lower prices for Consumers – The HHS budget bill required health plans to lower the price so it does not exceed the net price of the prescription drug, meaning the health plans cannot make a profit on the sale of insulin.
- Reinsurance – Passing an extension of the reinsurance policy stabilized the individual and small group insurance market and allowed major insurance plans such as Blue Cross Blue Shield, UCare, Medica, and Health Partners to offer insulin at prices Minnesota families can afford.
The Minnesota Insulin Patient Assistance Program requires insulin drug manufacturers to provide insulin to Minnesota doctors on behalf of their eligible patients. To qualify, Minnesotans with diabetes must have a family income less than 400% of the federal poverty level and not be covered by another state or federal healthcare program such as Medicare, Medicaid, or MinnesotaCare. A key provision of the plan requires patients to work through their doctor’s office to acquire free insulin from the manufacturers, fostering stronger doctor-patient relationships that will improve care. Doctors will use the patient eligibility statement to order a 120-day supply of insulin from the preferred manufacturer. Patients remain eligible for the program for one year and can reorder insulin during that time. To help get the word out, the bill includes funding for a public awareness program and requires a 90 days’ notice to young adults before their 26th birthday so they can plan to manage their care if they are phasing off their parent’s insurance plan. The legislation contains a sunset, forcing the Minnesota legislature to continue working on the broader challenge of making all prescription drugs more affordable.