INSULIN Act: $35 Insulin Cap and Faster Generic Drug Competition.
This legislation sets a maximum monthly out-of-pocket cost for insulin at $35 for most insured Americans, while also eliminating deductibles for this life-saving medication. These changes aim to reduce diabetes treatment costs and ensure patients have easier access to necessary treatment. Furthermore, the act increases transparency regarding rebates paid to Pharmacy Benefit Managers (PBMs) and speeds up the market entry of cheaper, generic versions of insulin.
Key points
Cost Cap: Starting January 1, 2024, health plans cannot charge more than $35 per 30-day supply of selected insulin products.
No Deductibles: Insurance plans must cover selected insulin products without applying any deductible, meaning patients get immediate access to the drug.
Rebate Transparency: Pharmacy Benefit Managers (PBMs) must remit 100% of insulin-related rebates back to the health plan.
Faster Generics: Measures are introduced to expedite the approval and market entry of cheaper biosimilar and generic drugs, making it harder for pharmaceutical companies to block competition.
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