State of the Union Address Focuses on Affordable Health Care, Cost of Insulin

During President Joseph Biden’s State of the Union address on Tuesday night, he discussed key concerns in health care, with a focus on drug pricing, COVID-19, and accessibility. In his comments on drug pricing, Biden discussed the recent $35 cap on insulin prices for seniors on Medicare and urged lawmakers to cap insulin at $35 a month for all Americans. He also discussed similar potential caps for oncology drugs.¹

“This law also caps out-of-pocket drug costs for seniors on Medicare at a maximum $2000 per year when there are, in fact, many drugs, like expensive cancer drugs, that can cost up to $10,000, $12,000, and even $14,000 a year,” Biden said.¹

He also said that he would veto any efforts to repeal the Inflation Reduction Act, which includes efforts to lower prescription drug prices for patients on Medicare. The law also allows Medicare to negotiate prescription drug prices, although those prices will not take effect until 2026.¹

“We’re finally giving Medicare the power to negotiate drug prices,” Biden said in the address. “Bringing down prescription drug costs doesn’t just save seniors money. It will cut the federal deficit, saving taxpayers hundreds of billions of dollars on the prescription drugs the government buys for Medicare. Why wouldn’t we want to do that?”¹

Pharmacy organizations have applauded Biden’s focus on drug costs during the address, although statements from National Association of Chain Drug Stores (NACDS) President and CEO Steven C. Anderson, FASAE, CAE, IOM, also urged Biden to address concerns about pharmacy benefit managers (PBMs).²

“America’s pharmacies applaud the bipartisan commitment to provide patients with access to more affordable medicines, and we urge the President and Congress to go further by stopping the manipulation by PBM middlemen that is increasing patients’ medication costs, limiting patients’ choice of pharmacies, and restricting access to medications that are right for them,” Anderson said in a statement. “Pharmaceutical benefit manipulation can no longer be tolerated, and policymakers should demand accountability, transparency, and fairness in how PBMs operate and impact patients and the pharmacy teams who serve them.”²

The address also focused extensively on insulin pricing, which Biden said costs just $10 per vial to manufacture but unfairly costs patients hundreds of dollars. In a fact sheet released by the White House before the State of the Union address, Biden called a $35 monthly cap for all Americans a “commonsense, life-saving protection.”³

Extending the cap to all Americans may not be entirely out of reach. A press release from the Endocrine Society praising Biden’s focus on insulin noted that an attempt in the Senate to extend the benefit failed by just 3 votes in August 2022.⁴

“We capped the cost of insulin at $35 a month for seniors on Medicare, but there are millions of other Americans who are not on Medicare, including 200,000 young people with type 1 diabetes who need insulin to save their lives,” Biden said in the address. “Let’s finish the job this time. Let’s cap the cost of insulin at $35 a month for every American who needs it.”¹

The high costs of insulin have major impacts on patients. In 2021, a survey found that nearly 1 in 5 American adults with diabetes rationed their insulin to save money. Rationing can cause patients with diabetes to become sicker and, in some cases, die, according to the press release from the Endocrine Society.⁴

“The Endocrine Society has championed measures to improve insulin access for years,” said Endocrine Society President Ursula B. Kaiser, MD, in the press release. “As physicians and researchers, it is heartbreaking to see our patients struggle to afford the medication that keeps them alive.”⁴

Finally, Biden celebrated the progress that has been made in the COVID-19 pandemic, as the White House plans to end the public health emergency on May 11. Although Biden acknowledged that the virus is not gone, he noted that COVID-19 deaths have dropped by nearly 90%.¹

“Two years ago, COVID had shut down our businesses, closed our schools, and robbed us of so much,” Biden said. “Today, COVID no longer controls our lives.”¹

The comments from NACDS President Anderson also celebrated the progress made with COVID-19 but urged Biden and Congress to keep pharmacies at the center of efforts moving forward.

“While we all want to move on from COVID-19, doing so should not mean leaving behind millions of Americans who have relied on their trusted, local pharmacies for testing, vaccinations, and care during the pandemic,” Anderson said in his statement. “America’s pharmacies serve as a health care lifeline, particularly for rural and historically-excluded communities, and the Administration and Congress should work with pharmacies to ensure continued access and service to those who need it most.”²

REFERENCES

1. Wolf M and Merrill C. Biden’s State of the Union address annotated and fact-checked. CNN; February 8, 2023. Accessed February 8, 2023. https://www.cnn.com/interactive/2023/02/annotated-fact-checked-president-biden-sotu/
2. NACDS Statement in Response to State of the Union Address. News release. National Association of Chain Drug Stores; February 8, 2023. Accessed February 8, 2023. https://www.nacds.org/news/nacds-statement-in-response-to-state-of-the-union-address/
3. FACT SHEET: The Biden Economic Plan Is Working. News release. White House; February 6, 2023. Accessed February 8, 2023. https://www.whitehouse.gov/briefing-room/statements-releases/2023/02/06/fact-sheet-the-biden-economic-plan-is-working/
4. Endocrine Society praises State of the Union attention to insulin affordability. News release. Endocrine Society; February 7, 2023. Accessed February 8, 2023.