Affordable Insulin For Seniors Presents The Playbook To Lower Drug Costs

As the coronavirus pandemic death toll in the U.S. surpasses the grim 100,000 mile-stone, we have some reasons to be cautiously optimistic about the road ahead. The biopharmaceutical industry has made considerable progress towards treatments and a vaccine. New cases in the U.S. have been declining slowly but steadily since the end of April.  Every state in the U.S. has begun the process of reopening in one form or another. 

The fight against the virus has a long way to go, but we are clearly finding some success in combating it.

It is important to keep in mind that the pandemic hasn’t affected all age groups equally. Clearly, older Americans have been the hardest hit by the coronavirus. Not only are older Americans more likely to have trouble fighting the virus, but they also have experienced the most significant impact to their lifestyles.

Older Americans are in a higher risk category for the coronavirus, so they have had to be especially cautious of in person gatherings with friends and family. Older Americans have been struggling with household budgeting, as many have had unplanned emergency expenses requiring them to draw from retirement funds.

Out of pocket costs for medicines are an issue that has been particularly hurting older Americans for years, and now more significantly during the pandemic.

But the good news is that on Tuesday, President Donald Trump announced a plan that will help significantly help seniors in the war against rising prescription drug prices.

President Trump introduced the Part D Senior Savings model, a plan that will considerably reduce the price of insulin for people on Medicare. In this agreement reached by insurers, drug manufacturers, and the Trump administration, Medicare recipients who pick a plan that offers the new insulin benefit would pay a maximum copay of $35 a month. According to the Centers for Medicare & Medicaid Services (CMS) beneficiaries who take insulin and enroll in a participating plan will save $446 a year in out-of-pocket-costs for insulin.

Tracey Brown, The CEO of American Diabetes Association, praised the Part D Senior Savings model saying it is “helping millions of seniors access insulin affordably.” The CEOs of the three major insulin providers, Eli Lilly, Novo Nordisk and Sanofi, also applauded the accomplishment.

Seniors are grappling with out-of-pocket costs for their treatments and this dynamic is particularly troubling during a pandemic when cash is especially tight. Older adults are much more likely to be taking prescription drugs and more likely to be taking multiple prescription drugs. According to a KEF study, more than half of adults 65 and older (54%) report taking four or more prescription drugs compared to one-third of adults 50-64 years old (32%) and about one in ten adults 30-49 (13%) or 18-29 (7%).

The Trump administration’s successful negotiations with insurers and insulin manufacturers underscores the positives that can come from patient-centric negotiations with industry leading the way. The achievement of lowering insulin prices through negotiations with insurers and drug makers could provide the playbook on how the Trump administration will focus on lowering the prices of other prescription drug prices.

This is a step in the right direction and will provide significant relief for the millions of people with diabetes in Medicare.

However, we know more can be done to increase access and lower costs for treatments. The administration previously proposed requiring a portion of the rebates and discounts given by drug manufacturers that currently get sucked up by middlemen make their way to patients at the pharmacy counter. This would provide out-of-pocket relief for millions of people.

As Congress and the administration consider proposals, what must remain at the center of any discussion is making sure that patients are better off and we continue to maintain incentives to innovate so that we can get past Covid-19 and other diseases that impact our nation’s seniors.