American Diabetes Association CEO focuses on affordable insulin amid pandemic after White House Medicare announcement


(WRBL) – President Donald Trump announced on May 26 that he was working with insulin manufacturers and federal agencies to lower the monthly cost of prescribed insulin for seniors with diabetes to $35 regardless of supply needs for patients.

In a morning phone briefing for the press ahead of the President’s more formal announcement, Seema Verma, Administrator for the Centers for Medicare and Medicaid Services spoke about the President’s plans for addressing insulin costs.

“We recognize that about $50 is the price point at which many seniors stop taking their insulin or skip or lower the dosages so we wanted to make sure that we were hitting that by having this maximum, maximum of $35 copay for a month’s supply of each type of insulin,” said Verma.

The lower out-of-pocket cost of insulin for patients will only apply to Medicare Part D beneficiaries, a population of vulnerable seniors on fixed incomes. The administration said the move came as a way to help Medicare beneficiaries afford their insulin to avoid insulin rationing, when patients slow or stop their dosages due to the cost of the drug.

At a White House press conference that same afternoon, President Trump, pharmaceutical and insurance industry leaders, and American Diabetes Association CEO Tracey D. Brown spoke at the Rose Garden about managing the cost of diabetes care for elderly, vulnerable patients amidst a global pandemic.

In an interview with News 3 anchor Greg Loyd, Brown talked about how important this new step is for diabetic patients in the United States, especially during the COVID-19 pandemic. For Brown, the impact this step will have is huge.

“There are 34 million people in this country that live with diabetes. 7 million of which require insulin to live. we have data that tells us at least 25 percent of those folks have reported that they actually ration their insulin, or skip their dosage, or don’t take it at all because they simply can’t afford it,” said Brown.

The CEO says that for patients on fixed incomes, the change to a $35 monthly capped out-of-pocket cost is the key to preventing insulin rationing.

“We know that insulin can easily cost, depending on the type of insulin you have, how much you take, can easily cost $150 or more a vial,” Brown said.

To address the cost of insulin across the United States for all diabetic patients, Brown and the American Diabetes Association have sent letters to the governors of all 50 states asking them to work towards a zero copay on insulin and other necessary prescription drugs for diabetic care.

Brown said the coronavirus pandemic has made the cost issue warrant a bigger push as patients lose coverage due to lack of employment. Brown also says this is especially problematic when the cost of diabetic care in the U.S. currently has a national price tag of $327 billion.

“I will say that I think that one of the things that this COVID-19 pandemic has done is shine a brighter light on the issues that exist in this country that make it very difficult for people living with diabetes to get the things they need to thrive.”

Beginning in January 2021, beneficiaries will be able to select these newly adjusted plans for Medicare Part D during the enrollment period and benefit from the new Senior Savings Model. The new model will also provide coverage for therapeutic continuous glucose monitors (CGM), known as a sensor, as well as providing expanded coverage for telehealth visits.

Patients will be able to apply for the new plans during the open enrollment period from Oct. 15 to Dec. 7, 2020 and can use the Medicare Plan Finder on to choose the right plan to make use of the capped cost for out-of-pocket insulin payments.

Following the Tuesday announcement, Rep. Maxine Waters (D-Calif.) introduced legislation, praised by the American Diabetes Association, to combat the cost of insulin for diabetic patients across the U.S. during the ongoing health crisis called the Affordable Insulin for the COVID-19 Emergency Act.

The legislation introduced by Waters aims to ensure insulin-dependent Medicare beneficiaries would be able to obtain prescription for insulin and associated medical supplies with no copayments, coinsurance, deductibles or other cost-sharing for the rest of the coronavirus emergency.

As Americans fight to live through the pandemic, COVID-19 testing expands in each state, and the number of cases continues to rise globally, Brown believes making it through the coronavirus is a community effort.

“I know it’s hard because we’ve been doing this for so long now. We all have a responsibility to care for ourselves and care for others. So, if everyone would just follow the guidelines that have been outlined, I think everyone wins in that scenario,” Brown said.

You can watch the full, raw interview above.

Copyright 2021 Nexstar Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.


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