Lawmakers eye lame duck for unfinished business on insulin – By Lauren Clason (Roll Call) / Sept 28, 2022
Bill would build upon new insulin affordability measure in Medicare by extending it to the commercial market
A bipartisan Senate duo is still working to pass a bill to overhaul insulin prices, but the outlook is complicated by the messy drug pricing system, politics and a busy congressional calendar.
Sens. Jeanne Shaheen, D-N.H., and Susan Collins, R-Maine, are working to update a draft bill that would cap consumer copays for insulin in the commercial market and incentivize drugmakers to lower list prices. One of the bill’s provisions capping Medicare copays at $35 a month was enacted as part of the Democrats’ budget bill in August.
But the hurdles that previously stalled the bill remain the same. The policy is complicated. The official cost is expensive. And Republican support is thin.
The bill would extend the $35 Medicare copay cap to the commercial market. It would also ban health plans from requiring doctors’ approval before prescribing a drug and prohibit manufacturer rebates when drugmakers freeze their list prices at 2021 Medicare net rates. Drugmakers negotiate the rebates with health plans and their pharmacy benefit managers — the middlemen who manage a health plan’s drug benefit — in part for preferential coverage, but also say the rebates encourage higher list prices.
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