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Senator Baldwin Supports Bipartisan Bill to Cut Insulin Costs for Millions More Americans

Baldwin helped pass legislation to cap the cost of insulin for seniors at $35 per month, now working to address the cost for others

WASHINGTON, D.C. – U.S. Senator Tammy Baldwin (D-WI) joined a bipartisan group of colleagues in supporting legislation to comprehensively address the skyrocketing costs of insulin and lower prices for Wisconsinites. The Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act of 2023 would remove barriers to care, limit out of pocket costs for patients, and make insulin more accessible for millions of Americans.

“Americans should not have to choose between putting food on the table and the lifesaving medications they need to stay healthy. This bill builds on the historic gains we’ve made in capping the cost of insulin for seniors by lowering the out-of-pocket costs for all Wisconsinites living with diabetes,” said Senator Baldwin. “I’m proud to work with Republicans and Democrats to lower the price of insulin and give families some much needed relief.”

A new report from the American Diabetes Association that shows the cost of diabetes in America, including the cost of insulin, continues to skyrocket for patients and the federal government. More than 37 million Americans live with diabetes, including over 400,000 Wisconsinites. The disease is one of the leading causes of death in the United States, claiming over 100,000 lives in 2021. It is also the most expensive chronic condition in the nation, costing Americans a combined total of $412.9 billion per year. The rising cost of insulin presents a barrier to care for a growing number of Americans living with diabetes; 1 in 4 individuals report reducing insulin use due to cost.

The INSULIN Act would directly address the root problems in the insulin market causing high list prices, while simultaneously extending vital patient protections, fostering competition, and broadening access to needed insulin products. Specifically, the INSULIN Act of 2023 would:

  • Limit out-of-pocket costs for patients with diabetes by ensuring that group and individual market health plans must waive any deductible and limit cost-sharing to no more than $35 or 25% of list price per month for at least one insulin of each type and dosage form.
    • Pharmacy benefit managers (PBMs) would be prohibited from placing utilization management tools – prior authorization, step therapy, etc. – on products with capped out-of-pocket costs.
  • Mandate PBMs pass through 100% of insulin rebates and other discounts received from manufacturers to plan sponsors, reducing perverse incentives in the insulin market that encourage high list prices and helping patients in the form of reduced premiums. 
  • Promote generic and biosimilar competition to lower costs to patients by:
    • Creating a new expedited FDA approval pathway for biologic drugs lacking biosimilar competition, similar to FDA’s current Competitive Generic Therapies pathway;
      • This will improve the timeliness of resolving regulatory barriers slowing down market entry of lower cost products;
    • Ensuring adequate oversight of the Food and Drug Administration’s (FDA) citizen petition process, easing approval of generic and biosimilar drugs;
    • Allowing Medicare Part D plans to place biosimilar drugs on formulary immediately after entering the market, identical to other generic drugs; and,
    • Requiring the Department of Health and Human Services, in consultation with the Centers for Medicare and Medicaid Services and FDA, to issue a report to Congress on issues and market dynamics delaying or restricting biosimilar insulin competition.

The legislation was led by U.S. Senators Jeanne Shaheen (D-NH) and Susan Collins (R-ME), and also co-sponsored by Senators Debbie Stabenow (D-MI), Katie Britt (R-AL), Jon Tester (D-MT), Tommy Tuberville (R-AL), Mark Kelly (D-AZ), Roger Wicker (R-MS), Jacky Rosen (D-NV), Lisa Murkowski (R-AK), Angus King (I-ME), Mike Braun (R-IN), and Chuck Grassley (R-IA).

Senator Baldwin has long advocated for holding big drug companies accountable and expanding access to affordable health care for Wisconsinites. Last year, she helped pass the Inflation Reduction Act, which for the first time allows Medicare to negotiate lower drug prices and caps the cost of insulin at $35-a-month for Medicare recipients. Earlier this year, Senator Baldwin’s bipartisan legislation requiring pharmaceutical companies to be transparent with their customers and explain to the public why they are raising drug prices on working families passed out of the Senate Health, Education, Labor and Pensions committee.

A full text of this legislation is available here.