To the Editor:

You have probably heard some of the heart-wrenching stories of individuals struggling to afford their insulin prescriptions, which can cost thousands of dollars per month. No matter what party you belong to, I think we can all agree that is not acceptable.

You might be wondering what the legislature did this year and what still needs to be done.

First, some background. Your pancreas produces a hormone called insulin. It is what allows your body to process the sugar in carbohydrates for energy use or storage. Insulin also helps regulate your blood sugar levels, so they don’t get too high or too low.

Type 1 diabetics don’t produce insulin at all, while type 2 diabetics are resistant to insulin or can’t use the insulin their body produces. Type 1 diabetics require an insulin injection to regulate their blood sugar levels. There are more treatment options for type 2 diabetics, but many need insulin as well.

Bottom line: there are a lot of people who need insulin to stay alive. You probably even know somebody who does.

Insulin prices have skyrocketed since the implementation of Obamacare. The urgency boiled over in Minnesota with the death of Alec Smith, a 26-year-old type 1 diabetic. Alec couldn’t afford his $1,300 insulin bill, so he rationed his insulin. He died within a few weeks. It was a horrible, horrible tragedy, but hopefully something good will come from it.

This session we took action:

• We required pharmacies to provide emergency access to insulin and other life saving drugs

• We prohibited health plans from making a profit on the sale of insulin

• We demanded better communication from health plans about the price of insulin prescriptions, including rebates and discounts that are available from drug manufacturers or pharmacy benefit managers

In addition, we have received great news from most of the major insurers that they will be proactively lowering the price of insulin.

• Blue Cross Blue Shield will eliminate copays for insulin

• Medica and UCare will cap out of pocket costs at $25/month

• Health Partners offers plans in all markets that cover insulin at a $25 copay and lower.

Thanks to Republicans’ successful reinsurance program, these insurers are absorbing the costs of price reductions, so premiums for other customers will not increase.

There is also a small band of activists supporting a bill named for Alec Smith. Their intentions are good, but their bill has a number of problems. It is complicated and unworkable, and will likely lead to lawsuits before it is even implemented. It also requires the program be managed by the Department of Human Services. Given that agency’s numerous issues with fraud, waste and mismanagement, this is an especially bad idea. Let’s let DHS get its house in order before giving them any more responsibilities.

The Alec Smith bill is only one option, though. We all share the same goal: to make sure every diabetic has reliable and affordable access to insulin. We have a dedicated team working with experts every day to figure out a plan that will solve the insulin problem, and they are getting close to a solution.

If you have any questions or feedback, please don’t hesitate to contact me. My office is 651-296-1508 and my email is Sen.Jason.Rarick@senate.mn

Senator Jason Rarick

Pine City

(1) comment

Sharon Gohman

While I was glad to see an article by Senator Jason Rarick (R) on the important topic of making insulin affordable for those in need, I was disappointed that he incorrectly placed the blame for the dramatic rise in the list price of insulin, on the “implementation of Obamacare”, and bragged that “Thanks to Republicans’ successful reinsurance program, these insurers are absorbing the costs of price reductions, so premiums for other customers will not increase”, when in fact this was a bipartisan effort for law makers.

What are the facts:

1. The increase in the list price of insulin started well before Obamacare. If you check the facts (Harvard Business Review article) from 2018, over the past 20 years the list price of Humalog insulin has gone from $20 a vile to $250 a vile .

2. The Minnesota Senate passed the bill introduced in the Senate by Tina Smith (D). The changes in insulin prices in MN would not have occurred without the bill introduced into the Senate by a Democrat. This was a success for our bipartisan system—and not just the work of Republicans.

3. The high price of insulin was caused by our complex U.S. Healthcare system where drug companies are able to inflate list prices on drugs without oversight.

a. While Pharmaceutical companies benefit from increases in the price of insulin, Pharmacy Benefit Managers (PBM’s) and insurance companies also benefit from these increases in list price.

b. In the 1990, drug manufacturers started using PBM’s to cut deals with insurance companies. PBM’s are middle-men whose job is to help negotiate discounts and rebates from pharmaceutical companies for the list of drugs covered by an insurance plan. The higher the list price, the higher the rebate received by the insurance companies and PBM’s for patients who pay full list price for the insulin.

c. Uninsured patients are charged list price for insulin, as are patients on a high deductible plan until they hit their deductible. The PBM’s get 10% of the rebate and the insurance company pockets the rest.

d. Insurance companies are financially motivated to prefer an insulin brand with a high list price and large rebates over a brand with a lower list price but smaller rebates.

e. Insulin has been a target for these rebates as the increase in generic drugs with lower prices has shrunk their profit margins.

f. Patients are the only ones who lose. The winners are PBM’s, insurance companies and Pharmaceutical Companies such as Eli Lilly, Novo Nordisk, and Sanofi the 3 largest manufacturers of Insulin.

g. Did you know that President Trump elected Alex Azar as the Head of Health and Human Services in 2018? And did you know that Azar was a pharmaceutical company lobbyist and from 2012-2107 and was President of the U.S. Division of Eli Lilly.

As we head into another Presidential campaign in 2020, I encourage everyone (including the editor of the Newspapers) to always review closely the facts when an editorial is written by a politician.

Sharon Gohman

Pine City Resident

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