A federal law capped the cost of insulin. Diabetic Kansans are already seeing crucial savings | KCUR

Julie Cogley has lived with Type 2 diabetes for years. For a long time, paying for medication was never an issue.

But three years ago, Cogley needed surgery and was forced to retire earlier than expected, moving her to a fixed income. Shortly after, she learned she needed to start taking insulin, which would cost up to $700 out of pocket a month, not including additional medication.

Cogley is covered by Medicare, but by June or July she would be paying out of pocket. She asked her doctor and pharmacists for samples and cut back on other areas of her budget to cover the high costs.

In August 2022, Congress passed the Inflation Reduction Act, which caps out-of-pocket insulin costs for Medicare beneficiaries at $35. In response, the top three insulin-making drug companies in the U.S. pledged to reduce insulin prices by up to 75% or cap out-of-pocket costs at $35 a month for those privately insured, as well.

“I think I actually cried when I found out it had gone through because for six months, I would have had to come up with all that and I definitely couldn’t have afforded that,” Cogley said.

More than 37 million people in the United States, including one in four seniors, have diabetes. Of 59,000 diabetic residents in Kansas 3rd Congressional District, about 17,000 require a daily insulin shot, according to a report released by the office of Rep. Sharice Davids — the only member of the Kansas congressional delegation to vote for the measure.

More than 80% of adults with diabetes rely on medications to manage their condition, and 34% rely on daily insulin injections to manage their diabetes. Had these caps been in place in 2020, 15,657 people in Kansas would have saved roughly $650 per year in lower out-of-pocket costs, according to the report.

“For too long, Kansans have been forced to pay extremely high prices for insulin while drug companies rake in massive profits,” Davids said. “By capping the cost of insulin at $35 a month through the Inflation Reduction Act, we are not only lowering a major cost burden for tens of thousands of Kansans — we are saving lives.”

The act also instituted a new inflation rebate under Medicare that means drug companies cannot raise drug prices higher than inflation and allows Medicare to begin negotiating lower prices for prescription drugs, including insulin.

In 2017, individuals diagnosed with diabetes had an average of $16,750 in medical expenses. In that same year, the total cost of treating all Americans with diabetes was $327 billion, which includes $237 billion of direct medical expenses and $90 billion in lost productivity.

In 2019, diabetes was the seventh leading cause of death in the United States with 87,000 deaths.

“If your doctor says your body needs this much insulin to maintain and be able to be healthy, then you can’t cut corners on that sort of thing,” Cogley said. “I think people that aren’t diabetic need to be aware that it is literally a life or death kind of thing to have financial relief.”

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