Bill would cap insulin cost

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DIABETES IN OKLAHOMA

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  • Senator Jason Smalley
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OKLAHOMA CITY – The amount an insurance company could require its customers to pay for insulin would be limited to a maximum $100 for a 30-day supply, under a measure pending in the Legislature.

Senate Bill 1082 would “cap the total amount that a covered person is required to pay for insulin at an amount not to exceed $100 per 30-day supply,” regardless of the amount or type of insulin needed to fill
the patient’s prescription. Also, the bill would expressly authorize an insurance carrier to reduce the “cost-sharing of a covered person” to an amount less than $100. The legislation stipulates that no health benefit plan could reduce or eliminate coverage because of the requirement proposed in SB 1082. The state Insurance and Health departments would be tasked with enforcement of the measure. SB 1082 was filed by Sen. Jason Smalley, R-Stroud, chairman of the Senate Health and Human Services  Committee and the Senate’s Appropriations Subcommittee on Health and Human Services. More than 370,000 Oklahoma adults – approximately one of every eight adults in the state – reported having a diabetes diagnosis in 2017 (the latest year for which specific figures are available). The Oklahoma Health Care Authority said the number of SoonerCare (Medicaid) members with a diabetes-related claim in 2018 was 52,744. The prevalence of diabetes in southwest Oklahoma counties, according to the state Health Department’s “Diabetes Prevention Report 2019”, included:

• Comanche: 7.7% - 10.7%

• Stephens: 13.4% - 15.5%

• Tillman: 15.6% - 17.7%

• Jackson: 10.8% - 13.3%

• Kiowa: 13.4% - 15.5%

• Cotton: 13.4% - 15.5%

• Caddo: 10.8% - 13.3%

• Harmon: 17.8% - 22.5%

Type 2 is the most prevalent type of diabetes in Oklahoma, state Health Department Public Information Officer Tony Sellars said. “It would be difficult” to provide an accurate count of the number of Oklahoma diabetics who require insulin, he said.  According to the Health Department, diabetes is the seventh-leading cause of death in this state; almost 1,400 Oklahomans died from diabetes-related causes in 2017. The economic impact to Oklahomans with diabetes can be attributed to higher medical costs, both direct and indirect; economic instability because of lower rates of employment and higher rates of absenteeism; and a reduced quality of life. Diabetic patients often pay up to 2.3 times more for healthcare than their non-diabetic peers, research shows. Diabetes includes a group of conditions in which the body has too much sugar circulating in the bloodstream. Glucose (a type of sugar) is an important and necessary fuel for the body. Diabetes occurs when the body does not produce and/or use insulin properly. Insulin, a hormone made by the pancreas, assists with the transfer of sugar from the blood into muscles, liver, and fat tissues where it is used as fuel or stored for later use. Without insulin, sugar builds up in the body, resulting in diabetes. The Health Department’s 2019 diabetes prevention report can be accessed at https://www.ok.gov/health2/ documents/Diabetes%20 Prevention%20Report%20 2019.pdf.