House Bill 4543 calls for a cap on costs for insulin.
It is estimated over 240,000 West Virginians are diagnosed and living with type 1 or type 2 diabetes and another 65,000 are undiagnosed. Every West Virginian with type 1 diabetes and many with type 2 diabetes rely on daily doses of insulin to survive.
The annual medical cost related to diabetes in West Virginia is estimated at $2.5 billion annually, and persons diagnosed with diabetes will incur medical costs approximately 2.3 times higher than persons without diabetes.
The cost of insulin has increased astronomically, especially the cost of insurance co-payments, which can exceed $600 per month. Similar increases in the cost of diabetic equipment and supplies, and insurance premiums has resulted in out-of-pocket costs for many West Virginian diabetics in excess of $1,000 per month.
Cost sharing for a 30-day supply of a prescription insulin drug shall not exceed $25 for a 30-day supply of a prescription insulin drug, regardless of the quantity or type of prescription insulin drug used to fill the covered person’s prescription needs, according to House Bill 4543 proposed by lawmaker.
A drug manufacturer, drug wholesaler or pharmacy benefit manager may not pass through the costs of the prescription insulin drug to the pharmacist or pharmacy.