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Prescription drug prices on the negotiating table with debate on federal bill

Tucsonans living with conditions wait to see if legislation will set cap on necessary medications
Posted: 6:45 AM, Nov 17, 2021
Updated: 2021-11-17 12:01:03-05
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TUCSON, Ariz. (KGUN) — In this look at Two Americas, we talk to people about the financial stress they face in choosing to pay for life-saving drugs or sacrificing a prescription to have food on the table.

Far from Arizona, a debate on legislation in Washington D.C. could lead to the approval of new price maximums, which would provide some Americans relief.

A normal day for Nikki Campbell, 22, means getting her supplies ready on her kitchen table. Each piece of equipment — pump, continuous glucose monitor, syringes and insulin — is crucial for managing her Type 1diabetes.

"As a seven-year-old, that is a lot to take on," Campbell said, "and it's a lot for any kid that has to learn how to manage a disease like that." Campbell said she often thinks about the financial burden diabetes puts on her and her family.

"I'm disabled, I can't work full time," she said. "My parents have had to continue to work to be able to give me access to their insurance until i get kicked off." Without her parents' insurance, Campbell said she would have to pay close to $1,500 for one month's worth of pump and monitoring supplies.

"The burden is put on us to manage our own health care," she said.

A study done by the Health Care Cost Institute shows that upward trend. Between 2012 and 2016, the average yearly cost of insulin per patients was nearly $2,900. By 2016, it almost doubled to $5,700.

Graph showing escalating costs of managing type 1 diabetes

A 2018 medical journal article published by the American Diabetes Association said newer, faster-acting insulin can cost $174 to $300 a vial.

"Capping the price of insulin would be a huge, huge relief," Campbell said, "and (a) safety for all diabetics regardless of insurance coverage."

That cap could come as a specific protection written into the nearly $2 trillion Build Back Better Act.

A recent White House newsletter outlined that the bill would also let Medicare negotiate prices for high-cost prescription drugs. This, per the Biden administration, would include drugs seniors get at the pharmacy counter, through Medicare Part D, and drugs that are administered in a doctor’s office through Medicare Part B.

In one case, the White House said, insurers would have to limit a patient's cost for insulin to no more than $35 for a 30-day supply.
Arizona AARP state director Dana Kennedy said she has worked to persuade lawmakers to make sure that benefit, as well as Medicare's ability to negotiate drug prices, stays in the bill.

"Anytime you infuse some competition, it's going to lower prices for everybody," she said. Kennedy said one example already helps regular Americans pay for life saving drugs: Veterans Affairs (VA) negotiates lower prices for its patients.

Kennedy said, in a survey done by the group's members, "94% of Arizonans, people in Arizona, believe that make medicare should be able to negotiate lower cost drugs."

"This seems like such common sense reform," Campbell said. "There is no reason that we should let people keep dying because they can't afford their insulin."

The Build Back Better plan's future remains undecided as Congress continues to debate its approval. Campbell said she hopes at least her elected officials follow through on the reform.