A bipartisan pair of Kentucky lawmakers are for the second year in a row seeking to provide provisions for diabetics facing financial struggles to continue receiving insulin.
Based on the Alec Smith Insulin Affordability Act that passed in Minnesota in 2020, BR 53 would establish a program to provide relief to eligible Kentucky residents who are struggling to pay for and are in urgent need of insulin. The prefiled bill is sponsored by Democratic State Rep. Patti Minter of Bowling Green and Republican State Rep. Danny Bentley of Greenup County.
“We need to make sure that the Kentuckians who live with Type 1 or Type 2 diabetes can live a happy life and a long life without having to worry about access to a drug that costs the manufacturer $6 a bottle to manufacture,” Minter said. . “That crosses party lines; that goes from Paducah to Pikeville.”
The proposed legislation would let a pharmacist provide an individual with a 30-day supply of insulin after receiving a prescription, proof of residency, and an approved application form for the new program. The pharmacist would be limited to charging up to $25 from a copayment for the prescription.
The bill would establish two programs managed by the state Board of Pharmacy. Through the Continuing Access To Insulin program, individuals can apply to obtain insulin through the program for up to 12 months. Through the Urgent-Need insulin program, eligible individuals can receive a free one-month supply of insulin once during a 12-month period, but may also receive an additional free month’s supply of insulin during this period if they have applied for the Kentucky Medical Assistance Program or the Children's Health Insurance Program.
If passed, insulin manufacturers would be fined a maximum of $200,000 — with the fine increasing for each month of noncompliance — for refusing to participate in the program. This bill also has an emergency clause that would put it into effect immediately.
Smith, the namesake of the Minnesota bill, died at age 26 in 2017 because he was not able to afford insulin at $1,300 per month after he was no longer covered by his mother’s medical insurance. Insulin vials are considered notoriously expensive, despite containing an essential hormone for regulating blood sugar in Type 1 diabetics.
Bentley and Minter said they’re sponsoring the prefiled bill to improve the livelihoods of diabetics across the state, many of whom may find themselves stringing along less-than-necessary supplies of insulin when unable to pay for additional vials.
“We have people dying of ketoacidosis,” Bentley said. “Ketoacidosis means that their sugar is so high that it’s getting to the muscle or mitochondria. You start breaking down fat, and when you break down fat, you give off ketones.”
Ketones are chemicals created by the body when it breaks down fat to use for energy, and a build-up of ketones can make the blood more acidic and create a life-threatening situation.
Diagnosed diabetes in Kentucky adults has doubled from 6.5% in 2000 to 13.7% in 2018, according to a fact sheet by the Kentucky Diabetes Prevention and Control Program. The fact sheet also states people with diabetes have medical expenditures 2.3 times higher than those who don’t have diabetes.
A study in BMJ Global Health estimated the cost of production for a vial of human insulin is between $2.28 and $3.42, and for a vial of most analog insulins is between $3.69 and $6.16. Analog insulin is laboratory-altered to be more rapidly or uniformly acting.
This coming session will mark the second year in a row Minter has sponsored a version of the Alec Smith Insulin Affordability Act, known last year as HB 122. The previous bill only had Democratic co-sponsors and did not receive a committee hearing.
She said the proposed legislation is especially important to her because her own son has Type 1 diabetes.
“Access to insulin is a basic human right and is something that will benefit all Kentuckians because, if you’re not living with Type 1 or Type 2 diabetes, it’s very likely that you have a family member who is or loved ones who are,” Minter said. “We don’t want to lose anybody else because they don’t have access to the life-saving drug that they need.”
Bentley and Minter are also the sponsors of the prefiled bill BR 125, which would require state-regulated insurance plans place a cap on the copay for diabetes-related supplies to make it easier for diabetics to get blood glucose monitors, injection aids, syringes, medication infusion devices and pharmacological agents.
Another bill request by Bentley aims to proclaim April 26, 2022, as Diabetic Ketoacidosis Awareness Day in Kentucky.
