Editorial: Insulin costs need to be capped now, not on a gamble years from now

Reasons given by two Oklahoma lawmakers for opposing federal caps on the exorbitant costs of insulin fall short. The state's congressional delegation voted against efforts to limit prices on the life-saving medication.

It recently played out in the U.S. Senate as part of the Inflation Reduction Act, which sought to limit the cost to $35 a month for Medicare patients. Democrats wanted to extend that to patients on private insurance.

The bill went through budget reconciliation to avoid a Senate filibuster. But the Senate parliamentarian determined that the insulin price cap for private insurers violated rules. Sen. Lindsey Graham, R-South Carolina, led a group of 42 Republicans to pull it from the bill. Sens. Jim Inhofe and James Lankford voted against the cap.

In March, the U.S. House passed HR 6833, the Affordable Insulin Now Act, without any votes from the Oklahoma House members.

Patients are being harmed by the unaffordability of insulin. About one in four patients ration the medication, which makes the treatment less effective and possibility dangerous. Or they are going without — the worst possible option.

There is a direct line between the lack of insulin access to the more expensive and serious dialysis treatments.

People who are not able to treat their diabetes risk having kidney failure. For most patients on dialysis, the government picks up 80% of the cost. Medicare is expected to pay about $8.8 billion for renal dialysis services, according to the Centers for Medicare and Medicaid Services.

It is better medical practice and smarter economically to ensure that the 9 million Americans who need insulin get it.

The marketplace has failed to do this, with costs tripling in the past decade. With insurance, depending on the type of coverage and deductible, the cost can range from about $100 to $1,000 monthly.

Sen. James Lankford and 1st District Rep. Kevin Hern pointed to potential drugs, called biosimilars, in the research phase as the solution to the skyrocketing prices of the life-saving insulin.

Insulin has no generics, which are chemically similar to the original medication. Biosimilars are "highly similar" but modeled after drugs that use living organisms as important, but different, ingredients from the name brand.

Generics cost 40% to 50% less, while biosimilars run about 15% to 20% less, according the Cancer Treatment Centers of America.

"The more biosimilars in the market, the lower the price. Competition between brands always has been the most effective tool to lower prices and increase quality," Hern said.

Only it could be years for those generics to hit the market. Even then, there is no guarantee how the prices will react. It's a gamble that's not worth risking lives right now.

Politics has interfered with the government's doing the right thing in reining in the cost of this medication. We urge Oklahoma's lawmakers to find a bipartisan way to help patients.