Billings Gazette: Sen. Tester addresses prescription drug prices in Billings

With age usually comes more prescription drugs from doctors. In Montana where the Silver Wave is swelling the pool of retirees, the cost of health care is of particular interest to many.

Senator Jon Tester arrived in Billings Thursday to discuss a rare bit of legislation that could reduce the cost of some of the highest cost drugs covered under Medicare by phasing in a $2,000 cap on co-pay spending for certain drugs and limiting premium increases.

Under the Inflation Reduction Act passed in August, in 2023 Medicare beneficiaries with diabetes will see an insulin co-pay cap that will limit spending to $35 a month.

The cost of insulin, the medication used to manage the disease, has increased exponentially since it was invented in 1921. Inflation is expected, but now a single vile of insulin can cost up to $450 while the product itself hasn’t changed significantly over the years, said Lisa Ranes, manager of the Diabetes Endocrinology and Metabolism Center at Billings Clinic.

“We see that our patients will stretch that insulin to meet their monthly budget. So they skip doses, they reduce their doses…that leads to their diabetes not being well-managed which leads to complications and leads to hospital admissions,” said Ranes.

High insulin cost means Montanans with diabetes spend about 2.3 times more on medical expenses than those who do not have diabetes, according to the American Diabetes Association. In 2017, Montanans with the disease spent about $682 million in direct medical expenses.

There are nearly 80,000 people in Montana diagnosed with diabetes and an additional 24,000 who don’t yet know they’re diabetic. Another 282,000 Montanans are pre-diabetic, according to data from the American Diabetes Association.

Great expanses of thinly populated country means most towns in Montana are considered frontier communities, where residents don’t have access to the same amenities, wages or affordable health care as those living in more urban settings.

Medicaid beneficiaries, primarily people 65 years old or older, with diabetes will see the immediate changes with caps to insulin copays taking effect in 2023, but the average senior likely won’t see impacts from this legislation for a few more years.

For the first time ever, the federal government will be required to negotiate costs of prescription drug prices under the law, a significant factor in the push towards universally decreasing costs for medication.

Limits to inflated prescription costs will also impact the average Montanan. 

“The advantage for this is that if Medicare can negotiate better prices, it will filter down that way,” Tester said. “And I think that with negotiation, we’re not going to put anybody out of business. We’re not going to stop that kind of research that needs to be done.”

Medicare beneficiaries make up more than 22% of the state’s population and over the next three years, the time it will take for negotiated drug prices to take effect, the number of Medicare receiving Montanans will only grow.

While Tester’s original aim was to implement more monthly spending caps, in order to secure the votes needed to pass the legislation, some sacrifices were made.

“I hate to say this…but it was reconciliation. We would never have gotten 60 votes for this piece of legislation,” Tester said.

While the new law targets a very specific portion of the population, Tester sees it as a first step towards decreasing prices in a number of other ways.

“This is a giant step forward,” Tester said.

Sen. Tester addresses prescription drug prices in Billings | Health & Fitness | billingsgazette.com