Costa Votes to Cap Out-of-pocket Costs of Insulin for Medicare

Press Release

Rep. Jim Costa (CA-16) voted to pass H.R. 6833, The Affordable Insulin Now Act, which will ensure Medicare recipients and those with commercial health insurance pay no more than $35 per month for their insulin. Over 37 million people in the United States have diabetes, including one-third of Medicare beneficiaries.

Insulin is too expensive for millions of Americans

- 1 in 4 Americans who rely on insulin have cut back or skipped doses due to costs
- 34 percent of families nationwide with children dependent on insulin have been impacted by rising costs
- 26 percent of Americans with diabetes ration their insulin at least once a year because of cost, putting themselves at risk for serious health consequences

"No American with diabetes should sacrifice their health and put their life at risk simply because they are worried about the cost of their insulin," Rep. Costa said. "Diabetes affects a large number of our Valley residents, and this legislation will help them afford the medication that allows them to live more healthy lives. I urge my colleagues in the Senate to pass this legislation as soon as possible to help make a difference in the lives of millions of Americans who have diabetes."

In the 16th Congressional district, which includes Fresno, Madera, and Merced counties, there are 16,000 Medicare beneficiaries who have been diagnosed with diabetes. The 50 most popular brand-name diabetes medications used by these beneficiaries are available at significantly lower prices in other countries. For example, the cost of these drugs to the Medicare program in the district are 4.3 times the cost in Australia, 3.1 times the cost in the United Kingdom, and 2.2 times the cost in Canada.

Because Medicare beneficiaries may be responsible for a significant part of their drug costs until they reach catastrophic coverage limits, Medicare beneficiaries will experience substantial savings under this new legislation. For example, a Medicare beneficiary in the district with a 25 percent co-insurance requirement could incur up to approximately $1,100 in out-of-pocket costs for an annual supply of Novolog Flexpen, a popular brand of insulin. If the Affordable Insulin Now Act becomes law, this beneficiary would only pay up to $420 per year in out-of-pocket costs for Novolog Flexpen.

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