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Insulin bill passes with $100 cap instead of $25

CHARLESTON, W.Va.¬†—¬†Some state lawmakers wanted a $25 cap on the monthly cost of insulin, but settled on a $100 cap that part of a bill that passed the legislature in the final hours of the regular session Saturday night.

In addition to the $100 cap, HB 4543, requires insurance providers to cover diabetes equipment, but those costs are not capped.

Barbara Fleischauer

Delegate Barbara Evans-Fleischauer, D-Monongalia, helped organize a trip to Canada a few months ago to allow diabetic West Virginians the opportunity to purchase insulin at a 60 percent discount.

“It’s crazy to think a life saving medicine that was discovered 100 years ago would have dramatically increased in price for the co-pay,” Fleischauer said Tuesday during an appearance on WAJR Radio. “My co-pay is $5, $10 maybe $20 for something expensive, but these people are paying $300, $400 even $500.”

The bill passed the House earlier in the session with the $25 cap but the Senate changed it to $100. By the time the bill arrived at the House Saturday night there wasn’t much time to fight the change and maintain hopes the bill would pass this session.

According to the West Virginia Department of Health and Human Resources about 15 percent of West Virginians suffer from diabetes and depend on insulin.

On WAJR’s Talk of the Town, Fleischauer explained cost caps passed in other states have not effected insulin prices. Colorado passed insulin cost caps in 2019 and there was no price change in 2020.

Fleischauer said the cost of House Bill 4543 is absorbed throughout the layers of manufacturers, wholesalers and pharmacy benefit managers (PBM) and has safeguards for small pharmacies.

“It’s not just the manufacturers, but also these PBM’s and wholesalers, there are several different layers and I think we’re taking a piece of that money,” Fleischauer said. “So, we have said the small pharmacies at the bottom are not allowed to be penalized.”

Fleischauer had praise for the support of fellow lawmakers, West Virginia Chapter of #insulin4all and statewide supporters.

Gov. Jim Justice will have 15 days to decide what to do with the legislation once it reaches his deak.





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