New Year New Laws: Illinois Places Cap on Insulin Prices

Post Authored By: Laura Wibberley

Illinois is now one of the few states that require caps on insulin prices for consumers. Senate Bill 667 was sponsored by Senator Andy Manar and passed by a 48-7 vote in the Illinois Senate followed by a 100-13 vote by the Illinois House of Representatives. Illinois Governor J.B Pritzker then signed this bill into law on January 24, 2020, which officially went into effect this year on January 1, 2021. See generally, 215 ILCS 5/356z.41.

The new law requires insurers that provide coverage for prescription insulin medications to limit the co-pay covered by an insured to $100 per 30-day supply, regardless of the type of insulin used. Id. The statute does allow for price increases yearly to adjust for inflation. Id. In addition, the Illinois Department of Insurance, the Department of Human Services, and the Department of Healthcare and Family Services are required to detail a report regarding insulin pricing practices and public policy recommendations. 215 ILCS 5/356z.42. This report is to be available to the public. Id.

The General Assembly found that there are 1.3 million people in Illinois with diabetes, which was the seventh leading cause of death nationally and in Illinois. (SB 0667, § 1). Individuals with diabetes mellitus require insulin medication in order to regulate one’s blood sugar levels, which is necessary to prevent life-threatening complications. Id. Further, the average cost of insulin had increased from 13 cents to 25 cents per unit over the course of only four years. Id. The purpose of the new law was to reduce the cost of insulin to allow Illinois citizens to have increased access to this medication. Id.

Senator Andy Manar reported, “The swift passage of the insulin bill, driven by ordinary people, shows that Illinoisans are united by the simple belief that no family should ever be forced to ration or go without life-saving medication.”

Interestingly, the new law does not place any cost restrictions on manufacturers of the drug. Rather, it only impacts the cost that a patient must be out-of-pocket.

Now that several other prescription medications are raising prices for consumers, such as Eliquis (apixaban), Marplan (isocarboxazid), Humira (adalimumab) among others, Illinois may continue efforts to address these and other prescription drug prices as well.

About the Author:

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Laura Wibberley was recently admitted to practice law in the state of Illinois. She concentrates her practice in the areas of medical malpractice and health care defense. Laura received her J.D. from The John Marshall Law School in 2017, where she graduated Valedictorian and summa cum laude.  While in law school, Laura was a student publications editor of the John Marshall Law Review and an associate justice board member of the Moot Court Honor Society. She received the CALI award in Evidence, Civil Procedure, and Contracts. She previously externed with The Honorable Robert E. Gordon of the First District Appellate Court of Illinois where she assisted with the research and drafting of several published opinions. Prior to law school, Laura worked as a senior paralegal for the Chicago Transit Authority in the civil litigation division where she actively participated in over twenty jury trials.

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