Minnesota’s small but fierce band of insulin activists continues to put on a virtual seminar on how to convert a political defeat into broader gains. Their cause: emergency access to this lifesaving medication for those who can’t afford it.
Mysterious, last-minute maneuvering in the Minnesota Legislature led to the surprise demise of the Alec Smith Emergency Insulin Act during the 2019 session. The eloquent outrage from Smith’s mother, Nicole Smith-Holt, and fellow advocates set legislators back on their heels. A special session is under consideration to fix what is widely — and accurately — viewed as a mistake.
Others outside the state’s borders may now stand to benefit from the spotlight these Minnesotans have put on rising insulin prices. U.S. Sen. Tina Smith, who said she was inspired and educated by the advocates, has introduced a bill to spur all states to set up emergency programs. It would tap insulin makers to help pay for it.
The measure is a welcome example of the aggressive federal action needed to help the millions of Americans who have diabetes, some of who must use insulin daily. The drug’s cost tripled between 2002 and 2012 and has risen 64% since 2014.
Whether or not someone can get lifesaving medication shouldn’t depend on where they live. Colorado has acted to cap insulin costs for those with insurance. Minnesota is weighing steps. But too few states are moving forward. A patchwork of price relief will leave far too many people at risk. Congressional action is a must.
While Smith’s legislation faces tough opposition from the drug industry’s mighty lobbyists, the name of one early cosponsor — Sen. Kevin Cramer of North Dakota — offers reasons for optimism. Cramer is a Republican, and his involvement signals the potential for the bipartisan appeal this bill will need to become a reality.
“It’s not a Republican or Democrat issue,’’ Smith said this week in an interview with an editorial writer.
The legislation stands out from other drug-price bills by tightly focusing on insulin costs. In contrast, other proposed major drug-price relief tends to take broader aim at industrywide practices (such as dubious deals that keep generics off the market) that lead to higher prices for all drugs. This latter approach is welcome, but less likely to deliver the short-term relief that diabetics need.
The bill, if passed, would encourage states to set up programs to provide short-term insulin supplies to uninsured and underinsured patients. Federal dollars generated by a tax on insulin makers’ profits would cover the bulk of the $1.7 billion annual price tag nationwide, though states would be required to contribute to their individual programs’ costs.
The University of Minnesota’s Stephen Schondelmeyer, a professor of pharmaceutical economics, praised the bill for also including longer-term cost relief. One key component: reducing a drug’s “market exclusivity” from 12 years to seven. This would allow generic versions to come to market faster.
Data suggests seven years is more than enough time for drug firms to recover and be rewarded for their development costs, Schondelmeyer said.
A “constellation” of changes is needed to make drug prices more affordable, the professor added. This bill is one of many necessary solutions. There will be challenges in getting it passed and in implementing it, but “doing nothing is worse than trying something,’’ he said.