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Colorado Just Capped the Price That Insurers Can Charge Patients for Insulin. Who Will the Law Help?

A wide swath of Americans report using less insulin than they're prescribed because of cost concerns.
An empty bottle of Insulin lispro by French multinational pharmaceutical company Sanofi is photographed as an arranged illustration in London on February 21, 2019.

More than seven million people nationwide depend on insulin.

Colorado's governor signed a bill into law last week that caps how much insurance companies can charge Coloradans for insulin. The policy is one of several innovative new efforts, across the nation, to make prescription drugs more affordable. For Americans with insurance and Type 2 diabetes, out-of-pocket costs for insulin more than tripled between 2002 and 2013, one recent study found, while another analysis found that, in 2016, Americans with Type 1 diabetes had to spend twice as much on insulin as they did in 2012.

The Colorado law limits the price of a 30-day supply of insulin to $100, no matter how much of the medicine the patient needs. About 300,000 Coloradans are diagnosed with diabetes, according to the bill's text. Many of them likely need insulin every day to survive. Nationwide, 7.4 million Americans depend on insulin, according to the American Diabetes Association.

How immediately helpful is a law like Colorado's? Studies over the past decade have shown that people really do cut back on their insulin when they can't afford it, which hurts their health. Last year, one young man, recently diagnosed with Type 1 diabetes, died after trying to ration his insulin. But many folks are willing to take their insulin as prescribed once the price is lowered:

  • One study of more than 20,000 people with insurance found that, after their plan cut insulin copays—sometimes to $0—more people started insulin therapy and fewer people stopped taking their insulin.
  • Another study, published in 2009, found the same thing: Lower copays meant people more often followed their doctors' advice about insulin. That study also found that patients visited the emergency room less frequently after they began taking insulin more. However, that didn't result in any savings for the insurer overall: While it paid less for ER visits, it had to pay more for prescriptions.
  • In 2017, doctors at the Yale Diabetes Center surveyed their patients about their insulin use. They found that one in four had taken less insulin than they had been prescribed because of cost concerns. Patients of nearly all income brackets, ranging from $10,000 to $99,999 a year, commonly cut their insulin use. Only the very wealthy, with annual incomes of $100,000 or more, and the very poor, with annual incomes of less than $10,000, were less likely to do so.

Many advocates, including the American Diabetes Association, applauded the Colorado law when it was signed. There's still plenty more to be done, however. As Elizabeth Pfiester, executive director of T1International, an advocacy group for Type 1 diabetes patients, told Vox: "Any measure that helps only a portion of the population through opaque deals between the players responsible for this crisis is not a solution." After all, the law applies only to one state. It also doesn't help those who lack insurance, and doesn't tackle the list price that companies charge for insulin.