New Insulin Patient Assistance Program

The Minnesota Insulin Patient Assistance Program was unveiled last week by a Senate Republican work group. They have worked with health plans, manufacturers and physician groups to keep patients provided with insulin and complete patient care. The program would be initiated at the doctor’s office that prescribed the medication. It can be implemented within a few months and does not require additional government funding. Too often solutions offered focus on just the medication. This is a thoughtful, comprehensive and more patient-doctor centered proposal.

The program requires insulin drug manufacturers to provide insulin to Minnesota doctors on behalf of their eligible patients. To qualify, Minnesotans with diabetes must have a family income less than 400% of the federal poverty level and not be covered by another state or federal healthcare program such as Medicare, Medicaid, or MinnesotaCare.

A key provision in the plan requires patients to work through their doctor’s office to acquire free insulin from the manufacturers, fostering stronger doctor-patient relationships that will improve care. Patients will use the MNsure web portal to receive an eligibility statement for the program that can be brought to their doctor’s office.

Doctors will use the patient eligibility statement to order a 120-day supply of insulin from the preferred manufacturer. Patients remain eligible for the program for one year and are allowed to reorder insulin during that time.  Health Plans also announced earlier this summer that they will cap insulin costs and not increase premiums to cover the cost.

This is in addition to what we passed earlier this year and was signed into law to help lower the costs of insulin and all prescription drugs during the 2019 session:

• Emergency Refills – The HHS Omnibus Budget bill required pharmacies to provide emergency access to insulin and other life-saving drugs even if a prescription runs out. Pharmacists can now fill up to a 30-day supply of insulin for patients even if their prescription is not current.

• Transparency in Insulin Pricing – The HHS Omnibus Budget bill required Pharmacy Benefit Managers (PBMs) to communicate regularly with all pharmacies the cost for prescription drugs including any rebates or discounts available from a drug manufacturer.

• Lower prices for Consumers – The HHS Omnibus Budget bill required health plans to lower the price so it does not exceed the net price of the prescription drug, meaning the health plans cannot make a profit on the sale of insulin.

• Reinsurance – Passing an extension of the reinsurance policy stabilized the individual and small group insurance market and allowed the major insurance plans such as Blue Cross Blue Shield to offer insulin at prices Minnesota families could afford.

With this additional proposal and all the above positive changes, we have a comprehensive approach focusing on all prescriptions and fostering closer doctor-patient relationships.

As always, feel free to contact me with your thoughts and concerns regarding any issue at 651-296-5655 or sen.mary.kiffmeyer@senate.mn.