Every House Republican voted against a monthly insulin co-pay cap

A patient holds a vial of insulin during a news conference outside a Windor, Ont. pharmacy on July 28, 2019. (AP Photo/Carlos Osorio)

About a century ago, Dr. Frederick Banting patented the lifesaving drug insulin. Insulin is a hormone that controls blood sugar  levels by helping one’s body use and store glucose in the bloodstream. 

While insulin is naturally produced and secreted by one’s pancreas in healthy individuals, people with diabetes either cannot produce insulin, produce insufficient levels of insulin, or do not respond to the presence of insulin in the bloodstream and thus require alternative medication to control their blood sugar. 

Regardless of Dr. Banting’s good will, skyrocketing insulin prices have now put the drug out of reach of many across the globe that Banting sought to help. Back in the 1920s, Banting and his colleagues sold the patent for insulin to the University of Toronto for $1 each. Imagine...

For decades, the diabetes community in America has bore the exhausting weight of heavy insulin costs —  the price of which nearly tripled between 2002 and 2013, according to an American Diabetes Association study. In fact, Americans have paid more than 10 times as much for insulin than Canadians do, according to a commentary published in the Nov. 7, 2019 issue of the New England Journal of Medicine.

Since 2012, list prices of many modern forms of insulin have risen rapidly, with average annual increases cited at more than 15%. As a result, the United States is a global outlier on the amount of money spent on insulin products annually. The U.S. represents approximately 15% of the global insulin market, but generates nearly half of the industry’s insulin revenue.

As a result of high costs, one in four insulin-dependent Americans reported needing to ration their insulin on a monthly basis.

Without a doubt, this is absolutely despicable — and moreover, it’s just flat-out  wrong. 

Believe me, if my diabetic grandmother was still here, she’d have some choice words, that’s for darn sure. 

Sorry, Lucille. 

I hear enough medical dispatches over the scanner on a weekly basis about insulin-related incidents. It’s about time things change. Without a doubt, this is an issue that hits close to home for many Oswego County residents.

Insulin price-gouging and associated high costs in the United States are largely a consequence of the exact opposite of the definition of a “free market,” so much so that a monopoly exists on a lifesaving drug that, if not acquired, could amount to a massive death toll, especially among the senior citizen population of this country. 

U.S. laws have allowed “Big Pharma” and pharmaceutical manufacturers set their own prices and raise them without limit. Secondly, as the situation stands, a significant competitor in the U.S. insulin market has not come along to shift things up. It’s complicated to explain, for insulin is a complex compound, and there’s biological barriers that exist as well. 

According to Volume 7 of the Journal of Law and the Biosciences, Insulin is a biologic, which is a drug “derived from living materials, including viruses, therapeutic serums, toxins and antitoxins, vaccines, blood and blood products, and cells, tissues, and gene therapy products.” Most drugs are small molecule drugs, which are regulated under the Federal Food Drug and Cosmetic Act (FDCA) and approved under a New Drug Application (NDA) or associated accelerated pathway. Most biologics are approved through a Biologics License Application (BLA) under the Public Health Service Act (PHS Act). However, insulin was approved before the Food and Drug Administration (FDA) created the biologics approval process and was regulated as a small molecule drug under the FDCA until March 23, 2020. Only three companies — Novo Nordisk, Sanofi, and Eli Lilly — provide insulin to American dependents, despite the existence of several other manufacturers globally.

If you’re confused, that’s totally fine.

What you need to know is this: with multiple barriers to entry in existence, current insulin manufacturers have esentially blocked the introduction of such products by making it virtually impossible to obtaining new patents based on inventions such as insulin delivery devices and products that focus on less invasive measures, such as discreet insulin ports, tubes, etc.

How did any right-minded politician allow this to happen?

It’s too late to ask that question, ‘cause they downright did.

Thankfully, the American Diabetes Association® (ADA) hailed a major victory  recently when the U.S. House of Representatives passed the Build Back Better Act, including the most sweeping nationwide effort to date to put a cap on out-of-pocket co-pays for insulin. The national co-pay cap, which the ADA has aggressively advocated for and promoted, would apply to Medicare beneficiaries, individuals on private insurance, and those covered by other group health plans.

ADA-led efforts around the country advocated for co-pay caps. Thankfully, legislation has been enacted in 20 states and the District of Columbia. 

“These states paved the way for this week’s historic action in the House,” said Lisa Murdock, chief advocacy officer for the ADA. “We thank those members of the House of Representatives who supported a national insulin co-pay cap, building on the efforts of state leaders before them. Together, these leaders are working to ensure that millions of people with diabetes will be able to afford their insulin and will not have to skip doses or ration because they don’t have enough money to pay for this life-saving drug,” Murdock said.

Nevertheless, not a single House Republican voted for capping insulin costs in the Build Back Better Act. And you can damn well bet they know people ­— family, friends, coworkers — who are diabetic and dependent on insulin. Many of those people would benefit from a $35/mo. cap on insulin price. 

So whose financial interests are really being paid attention to? 

Oh, look! It’s yet another instance where House Republicans are seemingly and shamefully deaf to the cries of their own constituents... not that House Democrats don’t do the same exact thing, but that’s a story for another time.

What’s the excuse? 

Perhaps those are both rhetorical questions that I’ll let you readers answer.

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