OKLAHOMA CITY — A bill set to be considered next session would cap the amount that insurance companies can require patients to pay for insulin.
Senate Bill 1082, by Sen. Jason Smalley, R-Stroud, would cap a 30-day supply of insulin at $100, regardless of the type or amount needed.
Smalley said the filing of the measure brought a lot of the parties to the table for a discussion.
Colorado drew national attention when it became the first state in the nation to cap insulin copays at $100 for a 30-day supply for those with private insurance plans.
Colorado state Rep. Dylan Roberts, D-Avon, was the author of House Bill 1216, which takes effect Jan. 1.
His younger brother, Murphy, was diagnosed with Type 1 diabetes at age 11.
In 2016, Murphy, 22, suffered a diabetic seizure while hiking and fell, sustaining a brain injury. He died the next day.
“With me growing up with a brother that had Type 1 diabetes, it certainly gave me special awareness of the issue,” Roberts said. “Nothing about this bill would have saved his life. He always had good insurance and was able to afford his insulin.
“It is more for the kids like Murphy who are not as fortunate and do struggle with the cost.”
He said initially insurance companies had some concerns, but those concerns got worked out.
Roberts said a turning point was during committee hearings when those with diabetes or their family members told about the struggles to deal with outrageous costs.
“That turned the tide and got the bill moving pretty quickly,” he said.
He said insurance rates have not gone up as a result of the bill.
“Blue Cross and Blue Shield of Oklahoma supports making insulin affordable and accessible to all who need it,” said J.T. Petherick, associate vice president for government relations and public affairs. “Unfortunately, significant price increases by the manufacturers have increased the burden on those who need this life-saving medication.
“Copay caps limit what insured consumers spend, but do not address actual drug costs or why they are rising at such a rapid rate. We would like to work with Sen. Smalley and the Oklahoma Legislature to examine solutions that would help shine the light on drug prices and how they are set.”
Those with Type 1 diabetes require insulin to live. Insulin helps manage blood sugar levels. Type 1 diabetes happens when the body does not produce enough insulin. Insulin, a hormone that is secreted by cells in the pancreas, allows the body to use sugar from carbohydrates for energy.
Those with Type 2 diabetes can require insulin, but patients can try to manage their condition with exercise, diet and nutrition. Type 2 is the most common form of diabetes.
Sen. Carri Hicks, D-Oklahoma City, has a young son who has Type 1 diabetes.
She said the family spends an average of $500 a month on all of his supplies. A three-pack of insulin pens runs about $200 after insurance. It lasts about three months, she said.
“Obviously, for individuals that don’t have good insurance, this will definitely help,” Hicks said of the bill.
Megan Quickle, 34, of Broken Arrow, is a development manager for a diabetes nonprofit who has Type 1 diabetes.
Without insurance, her insulin would be about $1,600 a month, Quickle said.
She said without enough insulin, a person can have an unquenchable thirst, have to use the restroom frequently, can feel dehydrated and sluggish.
“Your brain doesn’t work right,” she said.
Dr. David P. Sparling works in pediatric diabetes and endocrinology. He works with the Harold Hamm Diabetes Center in Oklahoma City and with OU Medicine.
During at least the last decade, the cost of insulin has skyrocketed, well beyond inflation, Sparling said.
“The price is increasing for reasons no one can really understand,” Sparling said.
He said he is aware of patients that actively ration their insulin.
“I have had children in here worried they are costing their parents money because insulin is expensive and they know it is expensive and have heard their parents talk about it,” Sparling said. “Maybe they take a little bit less.”
If complications arise, they can wind up in the emergency room or hospital, he said.
He said if a patient breaks a glass vile of insulin and has maxed out on the amount allowed for the week, the patient may have to pay out of pocket.
“People don’t realize how common it is, how exhausting it is and how expensive it is,” he said of diabetes.
Sparling said some patients actively change their jobs because they need a certain type of coverage to get insulin.
But a lot of individuals in his district, said Smalley, have reached out to him about the cost of insulin.
“When you look at a family that is dependent upon it, it is not like taking an Advil for a headache,” he said.