- WHEREAS, Diabetes Type 1 is one of the most common chronic diseases starting in early
- childhood in the United States that is fatal without lifelong insulin treatment1; and
- WHEREAS, the researchers who discovered insulin, Richard Banting, J. B. Collip, and Charles
- Best, sold their patent rights for only one dollar each because their goal was to ensure the quality,
- purity, and potency of insulin sold on the market rather than to profit2; and
- WHEREAS, the first license to manufacture insulin was granted for humanitarian purposes
- rather than for profit3; and
- WHEREAS, the cost of insulin has tripled over a mere decade from 2002-2013, despite only
- incremental added benefits of new insulin products on the market4,5,6; and
- WHEREAS, it costs uninsured patients ten times more for insulin treatment at $7,000 annually
- versus $700 annually with insurance7; and
- WHEREAS, the pharmaceutical industry has made these incremental improvements to keep the
- cost of insulin expensive after the original patent has expired, against the values of SOMA policy
- S-18-12 designed to combat pharmaceutical evergreening8; and
- WHEREAS, many uninsured and even some insured patients are rationing their insulin and
- taking less than prescribed because of the rising costs, resulting in preventable complications,
- emergency room visits, deaths, and financial burdens on the healthcare system6,8; and
- WHEREAS, patients are dying due to inability to afford insulin9; and
- WHEREAS, the Senate Finance Committee Chairman stated, as recently as January 2019, the
- Committee’s intent to investigate price spikes in the cost of insulin for people with diabetes and
- to schedule hearings on the high cost of prescription drugs10;” and
- WHEREAS, the Chairman of the House Committee on Oversight and Reform confirmed in
- January 2019 that “there is a strong bipartisan consensus that we must do something to rein in
- out-of-control price increases…” by the pharmaceutical industry11; and
- WHEREAS, in January 2019, a bill was introduced to the House Committee on Energy and
- Commerce aimed at eliminating cost sharing of insulin and instead providing full coverage of
- insulin under both Medicare Part D and Medicaid12; and
- WHEREAS, the expansion of Medicaid eligibility in some states addressing gaps in affordable
- access to diabetes medication and treatment has resulted in a significant increase in insulin
- prescriptions being filled13,14, and
- WHEREAS, Medicare coverage was extended in 1973 under the 31 End Stage Renal Disease
- (ESRD) Program to provide immediate full coverage of all necessary and life-saving treatments
- for those with Stage 5 renal disease, so that patients could have access to treatment without the
- burden of associated costs and without the delay of waiting to qualify for insurance
- eligibility15,16; now, therefore, be it
- RESOLVED, that both the Student Osteopathic Medical Association (SOMA) and the American
- Osteopathic Association (AOA) support legislation in Congress to eliminate cost-sharing of
- insulin, so that insulin would be fully covered by insurance for all patients; and, be it further
- RESOLVED, that SOMA lobby Congress for legislation classifying Type I Diabetes as a
- disability under Medicare, as was done for ESRD, so that uninsured patients with Type 1
- diabetes would immediately qualify for full coverage of insulin treatments; and, be it further
- RESOLVED, SOMA recommend to the AOA to lobby Congress for legislation classifying
- Type I Diabetes as a disability under Medicare, as was done for ESRD, so that uninsured patients
- with Type 1 diabetes would immediately qualify for full coverage of insulin treatments.
The goal of this resolution is to address gaps in insulin accessibility created by prohibitive pricing from the pharmaceutical industry. This would ensure that all Americans receive access, guaranteed by law, to necessary insulin therapy, regardless of their employment, income, or health care status. This resolution seeks to do so through the expansion of Medicare coverage to include Type I diabetes. Ensuring access to insulin would also alleviate healthcare cost burdens by reducing diabetes complications resulting from insulin rationing or lack of access to insulin.
- Imperatore G., Mayer-Davis E.J., Orchard T.J., & Zhong V.W. (2017). Prevalence and Incidence of Type I Diabetes Among Children and Adults in the United States and Comparison with Non-U.S. Countries. In Cowie C.C., Casagrande S.S., Menke A., Cissell M.A., Eberhardt M.S., Meigs J.B., Gregg E.W., Knowler W.C., Barrett-Connor E., Becker D.J., Brancati F.L., Boyko E.J., Herman W.H., Howard B.V., Narayan K.M.V., Rewers M., Fradkin J.E. (Eds.), Diabetes in America. (3rd ed., pp. 2.1-2.17) Bethesda, MD: National Institutes of Health. Retrieved from: https://www.niddk.nih.gov/about-niddk/strategic-plans-reports/diabetes-in-america-3rd-edition.
- Rosenfeld, L. (2002, December). Insulin: Discovery and Controversy. Clinical Chemistry, 48(12): 2270-88. Retrieved from: http://clinchem.aaccjnls.org/content/48/12/2270.full#sec-21.
- Woodfield, J. (2016, February 3). What is the price of profit? The true cost of insulin in the United States. Retrieved from: https://www.diabetes.co.uk/in-depth/what-is-the-price-of-profit-the-true-cost-of-insulin-in-the-united-states/.
- Freed, S. (2016, May 7). What is the Actual Cost of Insulin for Your Patients?. Retrieved from: http://www.diabetesincontrol.com/actual-cost-of-insulin-for-your-patients/.
- Hua, X., Carvalho, N., Tew, M., Huang, E.S., Herman, W.H., & Clarke, P. (2016). Expenditures and Prices of Antihyperglycemic Medications in the United States: 2002-2013. The Journal of the American Medical Association, 315(13): 1400-1402. doi:10.1001/jama.2016.0126.
- Silverman, E. (2016, April 5). Insulin prices have skyrocketed, putting drug makers on the defensive. Retrieved from: https://www.statnews.com/pharmalot/2016/04/05/insulin-prices-skyrocketed-putting-drug-makers-defensive/.
- Johnson, CY (2016, October 31). Why treating diabetes keeps getting more expensive. Washington Post. Retrieved from: https://www.washingtonpost.com/news/wonk/wp/2016/10/31/why-insulin-prices-have-kept-rising-for-95-years/?noredirect=on&utm_term=.459be0df0a11.
- Randall L., Begovic J., Hudson M., Smiley, D., Peng, L., Pitre, N., … Umpierrez, G. (2011, September). Recurrent Diabetic Ketoacidosis in Inner-City Minority Patients Behavioral, Socioeconomic, and Psychosocial Factors. Diabetes Care, 34(9): 1891-6. doi:10.2337/dc11-0701.
- Higgs, M.M. (2017, April 5). The High Price of Insulin is Literally Killing People. Retrieved from: https://tonic.vice.com/en_us/article/ezwwze/the-high-price-of-insulin-is-literallykilling-people.
- Alonso-zaldivar R. (2019, January 29). GOP senator pledges insulin probe as Congress holds hearings. AP News. Retrieved from https://apnews.com/56f383814d124b53a59a8dc044bcbfa1.
- Pear R. (2019, January 29). On Both Ends of Capitol, Both Parties Warn Big Pharma on Drug Prices. The New York Times. Retrieved from https://www.nytimes.com/2019/01/29/us/politics/drug-prices-congress.html. Accessed February 2, 2019.
- Insulin Access for All Act, H.R.366, 116th Congress (2019).
- Gordon, Serena (August 6th, 2018) Access to Diabetes Drugs Improved Under Affordable Care Act: Study, Retrieved from: https://consumer.healthday.com/public-health-information-30/affordable-care-act-obamacare-955/access-to-diabetes-drugs-improved-under-affordable-care-act-study-736519.html
- Myerson, R., Lu T., Tonnu-Mihara I., & Huang E. (August 2018) Medicaid Eligibility Expansions May Address Gaps In Access To Diabetes Medications. Health Affairs. Accessed from https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2018.0154. Accessed February 2nd, 2019.
- Eggars, P. (2000, Fall) Medicare’s End Stage Renal Disease Program. Health Care Finance Review. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4194691/. Accessed February 2, 2019.
- Norris, L. (2018, October 1). Medicare Eligibility for ALS and ESRD Patients. Medicare Resource Center. http://www.medicareresources.org/medicare-eligibility-andenrollment/medicare-eligibility-for-als-and-esrd-patients/.
Jennifer S. Lee, OMS II – Touro College of Osteopathic Medicine – Middletown
Nicholas Bills, OMS I – Touro College of Osteopathic Medicine – Middletown
Oksana Levchenko, OMS I – Touro College of Osteopathic Medicine – Middletown
Naomi Isaac, OMS I – Touro College of Osteopathic Medicine – Middletown
Katie Goebel, OMS I – Touro College of Osteopathic Medicine – Middletown
Abigail Dominguez-Trujillo, OMS I – Touro College of Osteopathic Medicine – Middletown
Sachelle Martin, OMS I – Touro College of Osteopathic Medicine – Middletown
David Chen, OMS III – Touro College of Osteopathic Medicine – Middletown
Marrian Sedrak, OMS III – Touro College of Osteopathic Medicine – Middletown
Jesse McIlwaine, OMS II – Touro College of Osteopathic Medicine – Middletown
Natasha Wu, OMS IV – Touro College of Osteopathic Medicine – Middletown
J. Devin Stephenson, OMS IV – Touro College of Osteopathic Medicine – Middletown
Effective Time Period: Ongoing
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