One of the many issues President Joe Biden addressed in his State of the Union address was to make insulin more affordable.
The Inflation Reduction Act, which Biden signed into law in 2022, lowered the cost of insulin to $35 a month for Medicare patients. But the president made clear last night that he's thinking much more broadly.
“I want to cap the cost of insulin [at] $35 a month for every American who needs it. For every American,” he said.
Deidre Waxman was watching from her home in Brookline. She has Type 1 diabetes and she says she immediately felt a sense of relief upon hearing the news. Now that she’s on Medicare, she can afford her insulin, but she used to go to extreme measures to get her medication.
“I certainly don't have to go to Canada, and I certainly don't have to borrow insulin from anybody else," she told GBH News. "And I certainly don't ration insulin anymore. ... I used to use old insulin, like expired insulin, and I don't have to do that anymore.”
In the United States, more than eight million diabetics need insulin to survive, according to the American Diabetes Association. As many as one in four patients can’t afford their medicine, often leading them to ration doses. The direct and indirect medical cost of diabetes in the United States totaled $412.9 billion in 2022, according to the association.
Biden is also campaigning for reelection, and presidents have promised action on drug pricing for decades, said Dr. Vikas Saini, president of the Lown Institute medical think tank in Needham. Saini said Biden’s capping of insulin pricing for Medicare patients was substantial, and what he’s proposing now is ambitious — if it comes to pass.
“It is pretty clearly a campaign promise. And so I think at the end of the day, we have to judge campaign promises, for what they are at this moment," he said. "They're part of the launch of the electoral season.”
If he is able to cap insulin prices for all patients at $35, he said that would be a huge win for the American people.
Dr. Leigh Simmons says Biden's promise jumped out at her last night because, as a primary care physician at Massachusetts General Hospital, she prescribes a lot of insulin. The devil will be in the details, she says.
“How does a patient going up to a pharmacy make this work? How does a prescriber know how to make this work for their patient?" she asked. "And does this limit the range of options?"
She also notes it was unclear whether Biden meant that $35 price would be for someone paying out of pocket, who doesn’t have insurance, or doesn’t want to use their insurance.
“When he said that, I asked the screen, 'What about people without insurance?'” she said.
The White House did not immediately respond to a request for clarification.
Chris Noble is a diabetes patient who lived in Cambridge until he moved to California in 2021. He said he's thankful he can get affordable insulin through his employer’s insurance and he sometimes redistributes it to others in an emergency.
He said Biden’s plan is a step in the right direction, but believes a long term, sustainable solution would be a national list price of $35 or less, so that regardless of insurance, no one would have to pay more than that.
“It's completely unjustified when, [pharmaceutical companies] have made billions in dollars off of patients struggling to afford their medicine," he said. "And it just needs to come to an end.”
