A bipartisan bill filed last week by two Ohio House lawmakers would cap out-of-pocket costs for insulin and devices used in the treatment of diabetes. The move comes after the Biden administration in 2022 capped costs for Medicare patients, and after the big manufacturers themselves have begun taking steps to bring down prices.

The bill, cosponsored by Reps. Munira Abdullahi, D-Columbus, and Thomas Hall, R-Madison Township, would cap out-of-pocket insulin costs for all Ohioans at $35 a month. It also would cop the cost of related devices such as test strips, syringes and insulin pumps at $100 a month.

Hall and Abdullahi realized they’re both diabetic when they saw each other treating their conditions in the members’ lounge in the Capitol, Hall said during a press conference last week. That’s when they decided to work together to bring down costs.

“The cost of insulin in America is nearly 10 times the world average,” Abdullahi said, adding that the average price in the United States is $99 a month. In Ohio, those costs are shouldered by about 1 million diabetic adults and their families, she said.

Recent years’ prices for insulin seem high for a drug that’s been around for more than a century. One reason might be that drugmakers are selling to a captive market.

“Before insulin was discovered in 1921, people with diabetes didn’t live for long; there wasn’t much doctors could do for them,” the American Diabetes Association says on its website. “The most effective treatment was to put patients with diabetes on very strict diets with minimal carbohydrate intake. This could buy patients a few extra years but couldn’t save them. Harsh diets (some prescribed as little as 450 calories a day!) sometimes even caused patients to die of starvation.”

Drug prices typically come down the longer they’re on the market. Patents expire, generic alternatives are developed and the competition results in lower prices. 

But as in other parts of the health sector, concentration of insulin manufacturing to just a few players might have driven higher prices.

“The global insulin market is dominated by three multinational insulin manufacturers, Eli Lilly, Novo Nordisk and Sanofi, with these companies controlling 99% of the market by value and 96% of the market by volume,” University of Michigan researchers William H. Herman and Shihchen Kuo wrote in 2022. “The increasing use of more expensive insulin analogs to replace less expensive human and animal insulins has led to an increase in insulin prices and spending and negatively affected the affordability of insulin for health systems and individuals around the world.”

Also in 2022, Biden signed the Inflation Reduction Act, capping out-of-pocket insulin costs for Medicare patients at $35 a month. It the was the first on a growing list of drugs for which Biden is trying to bring down prices by using the bargaining power of the health program for older Americans.

The big insulin producers might have seen the writing on the wall.

Last March, Eli Lilly announced that it was capping out-of-pocket costs for its insulin products at $35 a month. Three months later, Sanofi announced that it would do the same thing. Novo Nordisk announced price reductions of its own that were to begin in January.

The measure introduced by Hall and Abdullahi has garnered more than two dozen cosponsors. Abdullahi said she doesn’t plan to stop there.

“This is just the first step in a process of making healthcare more equitable and more affordable to all Ohioans,” she said.