Insulin Access and Innovation
All people with type 1 diabetes (T1D) should have affordable access to insulin, a hormone that must be taken multiple times a day to survive. At the same time, people with T1D need the continued scientific innovation that has led, and will continue to lead, to more effective insulins that allow them to do better.
JDRF, as a leader in the fight to end T1D, has developed a set of principles and will be advocating to insulin manufacturers, health insurance providers, pharmacy benefit managers (PBMs) and employers to make sure that insulin is affordable to those who need it and this critical innovation can continue.
Insulin should be available to people with T1D at a low, predictable out-of-pocket (OOP) cost.
JDRF is concerned about the effect that increasing OOP expenses have on access to insulin and other tools needed to survive. To address these concerns, JDRF proposes:
Health plans and pharmacy benefit managers should ensure discounts and rebates that reduce OOP costs for people with T1D.
People with T1D usually do not receive the substantial discounts that insulin manufacturers offer to PBMs and health insurance plans. People with diabetes should receive these discounts at the point of sale to reduce their OOP costs. PBMs and health plans should ultimately eliminate the use of rebates entirely.
Insulin manufacturers should lower their prices to current net levels and restrict price increases to CPI thereafter.
JDRF has called on insulin manufacturers to lower their prices to the current net levels (taking out the amount currently used simply to pay rebates) and then restrict price increases to CPI thereafter. We acknowledge that curtailing the use of rebates will be necessary to permit this to occur.
Health plans, PBMs and employers should set copays/coinsurance for insulin that reflects its lifesaving role for people with T1D.
People with T1D cannot survive without insulin, and under-dosing can lead to severe and potentially fatal complications. Additionally, there are no alternative therapy options for people with T1D. They must use insulin. Cost-sharing for insulin should reflect these facts—insulin should be exempt from deductibles and provided at low, predictable OOP costs.
Health plans and PBMs should allow people with T1D access to the insulin that is most appropriate for them.
Type 1 diabetes is a unique disease that affects everyone who has it differently. The same is true for how the insulins used to treat T1D work on individuals. People with T1D should have access to the insulins that work best for them as determined by the individual and his or her healthcare team.
To achieve this, JDRF urges health plans and PBMs not to exclude any type or brand of insulin from health plans so that people can choose and use the insulin that keeps them the healthiest.
Research and Development of Next Generation Insulins
Improving access to insulin should not impede the development of next-generation insulins, such as faster-acting or glucose-responsive insulins.
As the leading global organization funding T1D research, JDRF is committed to the development of better and faster-acting insulins. Today’s insulin formulations can save lives, yet it remains incredibly difficult for people with T1D to achieve ideal blood-glucose control. We need better insulins.
As we work to make insulin more accessible for all, it is critical that any solution that ensures people with T1D have access to the insulin they need does not impede the innovation and development of newer and better insulins.
For more information about how JDRF plans to improve access to insulin, please read our Achieving Insulin Access and Innovation principles.