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Managing the cost of insulin without the White House
Jeffrey R. Lewis

President Biden has doubled down on the need for the federal government to manage prescription drug costs under Medicare. The President singled out insulin capping it at $35. While we all hope legislation passes, the private sector has already stepped up to create robust solutions. 

America’s Pharmacy Source (APS), a private Rx mail order vendor in Akron, Ohio, offers five different kinds of insulin for $19.95. They created this and many other programs because APS is tired of consumers and employers being ripped off by drug middlemen. 

The Eli Lilly Company, one of the largest manufacturers of insulin, also created a program where all Lilly insulins are available for $35 a month irrespective of the number of vials, whether an individual has commercial insurance or no insurance.  In addition, seniors can also receive Lilly insulin for $35 month in Medicare part D through the Senior Savings Model.

Precision Rx in northeast Ohio birthed one of the most intriguing programs created for employers. The “Precision” solution helps employers and employees find the least expensive solution to avoid skyrocketing insulin costs and other specialty medications. Precision Rx is a disruptor in the pharmacy world to find medications at the lowest price. Sometimes, this means it could be free. In addition, their solution helps self-funded employers avoid being financially ravaged by Prescription Benefits Managers (PBMs). 

And, with a $100,000 grant from EMC Health Foundation in Turlock Ca., Community Health Centers of America has partnered with a local pharmacy, Tin Rx, and the United Samaritans Foundation to offer Rx assistance to help families with insurance that cannot afford their Insulin or other medications.  

These solutions are helping middle-class families being devastated by rising prescription drug costs. Sadly, without these kinds of programs, for many insulin-dependent diabetics, this could be a death sentence. The program will also poke a stick in the eye of health insurers and pharmacy benefit managers, who decide how much employees and their families must pay for Insulin. With families spending more than $1,000 a year out of their own pockets, these solutions help working families. 

With many women, men and children often requiring one or more insulin shots a day, some choose to forego their Insulin or to ration doses, risking more significant health problems and even death; we decided to launch our program before the Christmas holidays to help families in need. While elected officials talk about solutions, we have created and launched a program. It is the best of businesses, both profit and nonprofit coming together to help people in need.  

Our goal is to help ensure that insulin-dependent diabetics have access to affordable medications and the test strips needed to test their blood throughout the day, so they don’t have to choose between paying rent and buying food or getting life-saving medications. Yet, it's a choice many people must make.

While Congress sleeps and other elected officials talk, we are taking action to help people. The need is great; the time for action is now.  

— Jeffrey Lewis is President and CEO of Legacy Health Endowment and the EMC Health Foundation in Turlock, Ca. the views expressed are his own.