Diabetics and their parents concerned about rising prices of insulin

WAUKESHA - A $750 billion health care, tax and climate bill was signed into law by President Joe Biden a week ago. The bill would allow the Medicare program to negotiate prescription drug prices with pharmaceutical companies, according to the Associated Press.

The bill means lower costs for seniors on medications, including a $2, 000 outof-pocket cap for older adults buying prescriptions from pharmacies.

Seniors would also have insulin prices capped at $35 a dose. What about other Americans facing increasing medication costs? A provision to extend that price cap on insulin to Americans with private health insurances was stripped from the final bill, the Associated Press said.

Forty-three Republicans voted against the bill. Wisconsin U.S. Sen. Ron Johnson, R-Oshkosh, tweeted: "I voted for an amendment, that Dems blocked, to provide insulin at cost to low-income Americans. Dems ignore the average out of pocket cost in the commercial market was $23 in 2021. Increased competition has led to price declines. Price controls lead to reduced supply, availability & new drug development," Johnson said.

Wisconsin U.S. Rep. Scott Fitzgerald, R-Juneau, released a statement to the Enterprise: "The Inflation Reduction Act was a bloated bill that does virtually nothing to address inflation. To keep it simple, Democrats pretended to care about inflation to advance their agenda with a bill containing $745 billion in new spending, including $350 on Green New Deal initiatives. There was no way in which I could support the legislation. But even if I believed one positive proposal could outweigh 10 bad, I do not support Democrats' socialist price fixing strategy which will drastically reduce the number of life-saving drugs entering the market."

'It's the exact same insulin' Scott Liesch, an Oconomowoc dad, has private insurance. His daughter Jaden, 20, has type 1 juvenile diabetes. Jaden was diagnosed at 2 and needs insulin on a regular basis.

Both Liesch and his daughter are active with the Juvenile Diabetes Foundation Wisconsin Chapter. "The price has gone up a lot. It's the exact same insulin, same brand, same manufacturer. There has been no change to the formula and it has gone up a lot," Liesch said.

With his insurance, he used to pay $25 for a threemonth supply and now it is $500 for the same amount. "Nothing is different, they are making the same stuff," Liesch said.

Without insurance, a person is looking at spending $1, 800 for a three-month supply, according to Liesch.

"That is $1, 800 for something you need to live," he said. Jaden is on an insulin pump, which releases a small amount of insulin all day long. When she eats something she needs more insulin to compensate for the carbohydrates that go into her system, bringing up her blood sugar.

Liesch has followed the talk about insulin price reduction and found it disheartening. He believes there should be a cap placed on the cost of the medicine.

"Someone is getting rich off of it. Nothing has been changed. Where is all this extra costs coming from? They are taking advantage of a system.. She (Jaden) doesn't have a choice. She didn't choose to get diabetes, she wasn't eating unhealthy. It is a hereditary thing," Liesch said.

He added his daughter is stuck with the disease for the rest of her life and is a medication she has to have.

"If she doesn't take insulin.. she dies," he said. He has heard from other people impacted with diabetes who have had financial challenges with paying for insulin.

"Its unfortunate and it would be nice if the insulin cap was across the board. Why is it good for some people and not others? The people who are diabetic didn't have a choice," he said.

What people don't take into account, he said, is the amount of money outside of insulin diabetics pay to stay alive. There are also costs with testing strips, the pump system itself, doctor visits, a glucose monitor and other equipment and materials.

"It is all an added cost," Liesch said. When Jaden gets older she will have to take on the responsibility of paying for the medicine and items. It is something her dad has explained to her since she was 18.

"It is a concern. Will she work at an employer who offers good health insurance or will she be on some state-paid medical program? Right now she is a student working part-time. She doesn't have to deal with it. I made her aware of the potential costs in her future," he said.

'It should be fair across the board' Russ Winberg of Brookfield was diagnosed as a child with type 1 juvenile diabetes. He always needed insulin. Like Jaden, he also wears an insulin pump, but first he used syringes, then switched to insulin pens and then the pump.

"You have to focus on the disease at all times anyway; having a computer by your side helps me along the way," Winberg said.

Winberg is also active with the Juvenile Diabetes Foundation Wisconsin Chapter. As a child he remembered his parents frequently going to the pharmacy to get his insulin but didn't pay much attention. As a adult he has noticed the price increase of his medicine.

"The prices are increasing and shouldn't be. They should be staying stable or going down as they improve processes," he said.

He has good health insurance but it only pays so much, Winberg said. He gets two vials of insulin a month. The total bill amount is $530 for two vials, with insurance. Out of pocket is $300 for Winberg. It lasts him a month. Without the needed insulin, Winberg's blood sugar could go up to unhealthy amounts and could be deadly.

Not only is insulin a cost factor but so is other medication, pump supplies, and doctor visits to keep up to date on the disease, he said.

"It is great Medicare patients get the price cap, but to be fair it should be an across the board thing," Winberg said.