Colorado Becomes the First State to Cap Monthly Insulin Costs for Those With Insurance

This week, Colorado Governor Jared Polis, D, signed the nation’s first bill that will cap insulin co-pays at $100 per month for people with health insurance. The bill also authorizes the state’s attorney general (AG) to investigate the rising price of insulin.

The bill was sponsored by State Representative Dylan Roberts, D, whose brother died at 22 of type 1 diabetes complications in August 2016.

The cap will go into effect on January 1, 2020. Insurance companies will pay anything above $100, regardless of how much insulin is used.

The attorney general may begin investigating insulin prices immediately. The law also instructs the attorney general to make recommendations to the state legislature.

In an email to The Center for Biosimilars^®, Roberts said the law applies only to those with private insurance.

“For those without insurance, that is still a huge problem that I will continue to work on. I also sponsored 2 successful bills this year to increase access to health insurance,” he said, referring to a bill that creates a public insurance option and another that allows the creation of health insurance cooperatives. The majority of Coloradans are insured, but 4% are not, he said.

“The second part of the insulin bill that was signed into law directs the attorney general to investigate pricing and make recommendations on what we should do next to get at the underlying problem of insulin prices, so I am looking forward to continue working on this issue with the AG and others,” he said.

In a statement, the American Diabetes Association said more than 400,000 people in the state have diabetes. “With the prices of insulin nearly tripling between 2002 and 2013, people with diabetes often face financial hardships affording their insulin,” said LaShawn McIver, MD, a senior vice president.

The ADA and others have been testifying at numerous hearings in Congress over the past few months about the rising cost of insulin.

In response, companies have started their own programs to cut insulin prices or limit co-pays, including Cigna and its pharmacy benefits manager Express Scripts; Eli Lilly, meanwhile, launched its lower-cost insulin lispro injection this week.