BILL NUMBER: S6505

SPONSOR: MARTINEZ
 
TITLE OF BILL:  An act to amend the public health law, in relation to
establishing a cap on the price of prescription insulin

 
PURPOSE OR GENERAL IDEA OF BILL:

Enacting policies to reduce the costs for New Yorkers with diabetes to
obtain life-saving and life-sustaining insulin

 
SUMMARY OF PROVISIONS:

Section 1 amends the public health law by adding a new section 280-d to
define the meaning of "prescription insulin drug," capping the total
cost a covered person under any health insurance carrier that provides
coverage for prescription insulin drugs at an amount of one hundred
dollars per thirty day supply of insulin, regardless of the amount or
type of insulin needed to fill such covered person's prescription.

Section 2 sets the effective date.
              

 
DIFFERENCE BETWEEN ORIGINAL AND AMENDED VERSION (IF APPLICABLE):

 
JUSTIFICATION:

According to the New York State Department of Health (DOH), almost 1.7
million New Yorkers have diabetes, with about 5% of this population
having type-1 diabetes. Insulin is a hormone that the body needs to get
glucose from the bloodstream into the cells of the body. In type-1
diabetes, the body does not produce any insulin at all, but with the
help of insulin therapy, children and adults can learn to manage their
condition and live long, healthy lives. Every New Yorker with type-1
diabetes and many with type-2 diabetes rely on daily doses of insulin to
survive.

Increases in the prevalence of diabetes are contributing to the growth
in health care costs for employers, consumers and taxpayers. In New
York, the DOH has estimated that diabetes accounts for $12 billion a
year in direct medical costs and lost productivity for all payers,
including Medicaid. Between 2002 and 2013, the cost of a vial of insulin
tripled in price, with this price has continued to increase at an alarm-
ing rate, resulting in one in four patients admitting to cutting back on
insulin, according to a recent study by Yale University. The conse-
quences of insulin rationing can be deadly for these patients who rely
on the hormone to stay alive.

It is critical to enact policies to reduce the costs for New Yorkers
with diabetes to obtain life-saving and life-sustaining insulin.  No New
Yorker should have to sacrifice daily necessities just to afford the
insulin they need to stay alive. This legislation will provide relief
for New Yorkers with diabetes by capping the total cost a covered person
under any health insurance carrier that provides coverage for
prescription insulin drugs at an amount of one hundred dollars per thir-
ty day supply of insulin, regardless of the amount or type of insulin
needed to fill such covered person's prescription.

 
PRIOR LEGISLATIVE HISTORY:  New bill.

 
FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS:

None.

 
EFFECTIVE DATE:
Immediately.