This bill caps the out of pocket cost of insulin at $75 for a 30-day supply, and $225 for a 90-day supply. The Department of Consumer and Business Services (DCBS) would review the price annually and would be allowed to adjust the cap based on changes to the cost of living.
Personal Choice and Responsibility
Every person’s health care plan will increase to cover the difference in cost that a patient doesn’t pay out of pocket. Cost share is one thing, but $75 is extreme, even compared to other states trying a cap.
The average cost of insulin per vial in 2015, for the top 3 insulin makers, was $234 – $540. According to CDC, a vial must be discarded after 28 days, so how does a pharmacy issue a 3-month supply? Colorado was the first state to cap co-pay at $100 per month and Illinois followed at $100 per month. How reasonable is Oregon’s demand at $75 per month? It will drastic impact insurance rates to more insurance has to make up the difference.
In its 2015 Oregon Diabetes Report, the Oregon Health Authority’s Public Health Division estimated that diabetes affects approximately 287,000 adult Oregonians (may not all be insulin users), or nearly 1 in 10. The prevalence of diabetes has also steadily increased, more than doubling since 1990 and accounting for 3.5% of deaths in Oregon in 2012. Insulin therapy is used in the treatment of diabetes to help keep a person’s blood sugar within the target range. Failure to appropriately manage blood sugar levels can have serious health consequences, including impacting the heart, kidneys, and eyes.