A trip to the pharmacy, for many folks, has become an anxiety-ridden task. After approaching the counter and giving their name to the pharmacy tech, many are now finding themselves holding their breath as the drugs they once paid for comfortably now ring up well outside of their price range.

One of the prescription medications that has gotten the most attention for its price hike is insulin. With an estimated 30 million people in the United States diagnosed with diabetes, per the American Diabetes Association, the market for the medication is large.

Data from the ADA’s Insulin Affordability Survey, 2018 reported that the average cost of insulin per month went from $139.49 in December of 2017 to $192.05 just a few weeks later in January 2018. Additional data reported by the Health Care Cost Institute shows that between 2012 and 2016 the cost of insulin per unit went from 13 to 25 cents.

For some, this can prove to be a life or death decision: drain your bank account for these crucial medicines or try and get by on lower or rationed doses. The ADA included in its affordability survey that 26 percent of people surveyed admitted to taking lower doses than prescribed to make the insulin last longer. Others, about 23 percent of respondents, would skip doses all together on a weekly basis.

Insulin is not the only prescription medication that has seen a spike in price over the past few years. A report published by GoodRx, a company that provides data as well as discounts for prescriptions, shared data that illustrated an estimated 6 percent increase in list price for prescriptions, with diabetes medications seeing a 15 percent increase on its own.

Making house calls

Conversations about sky-high drug prices have since expanded outside of doctors’ offices and pharmacy counters to the floor of the Indiana General Assembly.

House Bill 1029, authored by Rep. Robin Shackleford, D-Indianapolis, is on its way to the desk of Gov. Eric Holcomb, and, if signed, will see the legislature conducting a study to determine where, how and why the prices of certain prescription drugs have reached such worrisome heights.

Shackleford stated that the study intends to interview people from every step of the supply chain from drug manufacturers to wholesale distributors to benefit providers and doctors’ offices all the way down to pharmacies and the consumers.

“We want to make sure we’re getting answers from everyone,” Shackleford said. “I think people think it’s just the manufacturers or insurers, so we want to actually see where the high price is coming from before we try to implement any specific legislation to eradicate some of these problems.”

Shackleford also advised that while much of the outcry she has heard from constituents has been pertaining to insulin prices, this study will take a broader approach to pricing practices.

“We’re looking at the methods of insurance and pharmacy benefit providers use, health care costs,“ Shackleford said. “We’re going to look at the functions of rebates and discounts … and we will also be looking at trends in health and pricing and what more can be done when it comes to transparency.”

This was not the house bill’s debut in the General Assembly, Shackleford pointed out. Last year, she had submitted almost the same bill calling for investigation into drug pricing, but it was met with opposition and reluctance from her fellow legislators.

“Anytime you’re going to try and open up that Pandora’s box like when we’re confronting manufacturers and insurance companies, our legislators tend to get a little hesitant,” Shackleford said.

This year, though, the voices of those footing the bill for these medications have grown louder and perhaps even a little angrier. A petition was presented with 800 signatures and more constituents were invited to the floor to share their personal testimonies. These folks would not be ignored.

“We came back with a vengeance,” Shackleford said. “We’re at a point that people were saying this is too much … A lot of my constituents have spoken about friends and family really stressing out and having problems with paying for prescription drugs. People were talking about skipping doses and sharing medications, or they just wouldn’t pick up a medication because it was so expensive.”

When even larger voices entered the conversation, including those at the federal level and those representing large companies such as Eli Lilly and Co., lawmakers who had wanted to turn a blind eye and bury the bill before were inclined to provide their support to its passage.

“I think with that added pressure and that fact that you have one of our biggest companies coming forward and agreeing that the study should take place, it made legislators less apprehensive,” Shackleford said.

Once the bill has been signed by Holcomb, the issue will go before the legislative council, which will ultimately decide if it will be heard. Should it receive the council’s approval, the General Assembly will then call upon representatives from companies at every level of the supply chain as well as constituents and users of these prescriptions to testify and explain their role and reasoning in the pricing process. Shackleford noted that she also intends to invite researches from IUPUI to gather data and give an academic perspective to the situation.

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