“It’s scary to have your life tied to a single drug:” January to bring relief for diabetics in Virginia

New copay cap will limit the cost of insulin for many
Published: Dec. 30, 2020 at 10:41 PM EST
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DANVILLE, Va. (WDBJ) - For Joshua Hearne, a Type 1 Diabetic, popping by the pharmacy is a monthly ritual.

But a trip in 2018 was anything but routine.

“[The pharmacist] came back over the intercom and she said ‘do you know how much this is going to be?’ and I said, ‘I have a bad feeling about it,’” said the Danville resident.

In total, his bill was nearly $900 for a drug Hearne needs to survive.

“And I was struck, just frozen,” said Hearne. “Cause what she’s asking is, do you want to pay this or do you want to get really, really sick and maybe die?”

Hearne isn’t the only person in Virginia who’s faced that choice. According to the Virginia Department of Health, as of 2018, more than 631,000 Virginians have diabetes. It’s the seventh leading cause of death in the state and “is the leading cause of kidney failure, lower-limb amputations and adult-onset blindness in the United States.”

Those statistics drove the General Assembly to make a change earlier this year. House Bill 66 caps the copay for insulin at $50 for a 30 day supply. The law takes effect January 1. Notably, it will have no impact for those without insurance.

Eleven other states have approved caps on insulin co-pays in the last two years. The reason is a stark rise in prices.

Since 1996, the cost of a single vial of insulin has ballooned nearly 1200%, according to the American Journal of Managed Care. Eli Lilly’s Humalog, which Joshua Hearne uses, has gone from costing $21 in 1996 to $271 in 2020.

“It’s scary to have your life and wellbeing tied to a single drug,” said Hearne.

Hearne counts himself as lucky. Though it’s been tricky at times, he’s been able to afford his insulin.

He says now, more states, and the federal government, need to step up to help.

“We have to look into the systemic problems behind this,” he said.

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