The House on Thursday passed legislation to cap the cost of insulin at $35 a month. Cost sharing for beneficiaries in private plans would be limited to the lesser of either $35, or 25 percent of the health plan’s negotiated price for a 30-day prescription.
If you read past the headlines, and dig into the legislation, there are several important points that self-insured employers, health plans and insurers need to know.
While the bill would lower costs for many individual patients who take insulin, it would do nothing to reduce the prices paid to the manufacturer. Instead, self-insured employers and insurance companies would simply pay a larger share of the price.
It's important to remember that this bill does not solve the problem of skyrocketing drug prices. Instead, it would shift more of the burden of cost onto insurers and employers.
Scripta remains the premier option for self-insured employers to examine their insulin utilization and trends to determine which insulins, diabetic mediations and diabetic supplies is the most cost-effective, while keeping everyone healthy.