Here are Six Recent Moves to Curb Co-Pay Costs for Insulin

ere are Six Recent Moves to Curb Co-Pay Costs for Insulin

-Craig Idlebrook

As public outrage grows over the insulin pricing crisis, some legislatures and insurers have made moves in the past year to limit the out-of-pocket costs those with insurance pay for insulin. 

While these moves are patchwork in nature and do nothing to help those with type 1 diabetes who lack insurance, taken together they may represent a growing urgency by various players in the health insurance industry to apply downward pressure on the high price of insulin.   

Here is a roundup of the moves made to cap insurance out-of-pocket costs for insulin: 

April

-Cigna becomes the first major insurer to offer some of its customers a $25 cap on out-of-pocket costs for a 30-day supply of insulin. The insurance giant said that it would reduce those costs by an average of 40%, and the plan was available to Cigna and Express Scripts customers nationwide.

May

-Colorado becomes the first state to mandate a $100-a-month cap on insurance co-pays for insulin. Several other states are considering similar legislation. The legislation also mandates the Colorado Department of Law to investigate insulin pricing practices by pharmaceutical companies, pharmacy-benefit managers (PBMs), and insurers, with the goal of creating a public-facing report by November 1st, 2020.

August

-Medica becomes the first Minnesota insurer to offer a $25 monthly cap for out-of-pocket costs for some of its customers.

-Shortly thereafter, the U.S. government releases guidance allowing some high-deductible health insurance plans to cover preventative services and medications for diabetes and other chronic conditions before a plan’s deductible is paid off. 

-Two more Minnesota insurers soon announce their own caps. Blue Cross Blue Shield Minnesota announces it will offer the option of a $0 co-pay for insulin for some customers. UCare, another Minnesota-based insurer, announces it will offer a $25 monthly cap on out-of-pocket insulin costs for customers.

In the final quarter of 2019, it remains to be seen whether these steps taken will pressure other insurers to offer their own caps on out-of-pocket insulin costs. Ultimately, time will tell if such moves, along with a handful of moves made independently by insulin makers to offer new discounts, will be enough to curb how much the average person with type 1 diabetes pays for insulin. 

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