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Montanans rejoice over cap on the price of insulin

Mackenzie Gordon
Posted at 9:19 AM, Jan 05, 2024
and last updated 2024-01-05 11:32:41-05

Starting this week, more Americans can now buy insulin for just $35 per month, thanks to new pricing implemented by major insulin manufacturers.

Last year, Sanofi, one of the three major insulin companies globally, announced price cuts following news that Novo Nordisk and Eli Lilly had already announced plans to lower prices by up to 75% and 70%, respectively, but some of these price cuts didn’t go into effect until January 1, 2024.

According to the American Diabetes Association, in 2022, insulin costs reached $22.3 billion. Despite over 8 million Americans relying on insulin for survival, up to a quarter of these individuals have been unable to afford the medication, often resorting to dangerous rationing of doses.

Under pressure from Congress, the White House, and new market players, insulin manufacturers committed to implementing $35 caps shortly after President Joe Biden urged such actions in his State of the Union address last year.

While the Inflation Reduction Act caps Medicare enrollees' monthly insulin costs at $35, Sanofi set a $35 monthly limit for Lantus, its widely prescribed insulin, for insured and uninsured patients.

Meanwhile, Novo Nordisk's MyInsulinRx program offers a $35 30-day supply, and Eli Lilly established a $35 monthly cap for insured customers and is providing an Insulin Value Program for uninsured individuals.

On January 1, 2024, a bill passed by the 2023 Montana Legislature putting a cap on the insulin prices for insured patients went into effect, bringing relief to thousands statewide.

For many families, including the Gordons in Billings, the change alleviates one of the many burdens of living with the condition. Their 11-year-old daughter Mackenzie found out she has Type 1 diabetes when she was nine.

"I just really didn't know how to react," Mackenzie said Thursday, remembering the day she received her diagnosis. "I just really didn't even think that was possible."

Mackenzie Gordon

Her next few days were filled with concern.

"Definitely fear because I thought that everything would be way different," Mackenzie said. "I thought that maybe people wouldn’t want to talk to me anymore."

Mackenzie's mother Jen was understandably distraught when they received the diagnosis.

"The hardest thing in the world is seeing your child go through something and not being able to fix it," Jen said.

Jen added that it completely changed the day-to-day schedule of their lives.

"I just remember I would wake up in the morning, and think, 'Oh well, it was all a dream,'" Jen said. "Then I'd realize it wasn't a dream."

That reality for the Gordons is much like many other residents around the state. According to family medicine physician Ben Wilde, the number of cases of the disease has risen significantly.

"Overall, the prevalence of diabetes has doubled in the past 20 years," Wilde said.

Wilde added that along with the rise in cases, the price of insulin has increased.

"Things changed, and the prices went up exponentially for several years," Wilde said. "Whereas someone would pay $30-40 a month for their insulin, it now would jump over $300 and really became inaccessible."

But fortunately, those struggles will soon be made more tolerable. Montana state Sen. Jason Small, a Republican who represents Big Horn County and the surrounding area, helped put together a bill that capped the insulin price.

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"It's not every day you get the opportunity to help save lives," Small said. "This helps make something better for somebody, so I was all over it."

Small said he was approached by a group about passing the legislation and was thrilled by the opportunity to make a difference in the lives of many.

"Either you can afford to buy the stuff that's going to save your life, or you can't," Small said. "We just made it to where, gee whiz, pretty much everybody can."

Even at the age of 11, Mackenzie understood the significance of the bill being passed.

"I'm pretty happy because I didn't know how expensive this stuff was when I first received my diagnosis," Mackenzie said. "I looked up the price and figured out how much it was and I was a little bit worried that other people with diabetes like me couldn't get their insulin."

And Dr. Wilde said he can't wait to see the impact in his own patients.

"This will improve care and as a result will improve my patient's outcomes," Wilde said. "It's a huge deal."


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