[Congressional Record Volume 169, Number 69 (Tuesday, April 25, 2023)] [Senate] [Pages S1332-S1334] From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
Date: 2023-04-25
Chamber: SENATE
Mrs. SHAHEEN: I am really pleased to be able to come to the floor today with my cochair in the Diabetes Caucus and friend and colleague Senator Collins to discuss an issue that is near and dear to both of us and to the entire Diabetes Caucus, and that is what Congress can do to improve the lives of those living with this chronic disease. More than 37 million Americans live with diabetes, and millions more are at risk for developing it. I think most people in this Chamber probably know someone who has been affected by this chronic disease, and they get a chance to see very briefly the challenges that those with diabetes face every day. I understand those personal struggles all too well because my granddaughter Elle was diagnosed with type 1 diabetes in 2007, shortly after her 8th birthday. As a type 1 diabetic, she needs daily access to insulin. Maintaining healthy glucose levels is a worry that has kept her and her mother--her whole family--up too many nights. Without insulin, Elle would not be here because there is no alternative treatment. There is no cure that can free her from those daily injections. Insulin truly is a lifesaving drug, and it has been for over 100 years. The 100th anniversary of insulin was 2 years ago. When the Canadian researchers who discovered insulin realized what they had--a drug that would turn a death sentence into a manageable, chronic condition--they decided to sell the patent for $1 each. They knew the drug they had was revolutionary, and they chose not to chase profits over the good of humankind. Unfortunately, that is not the reality that we live with today. Over the last several decades, insulin prices have skyrocketed beyond the reach of too many Americans. I hear from far too many people about how they have to ration their needed insulin until the next paycheck or until their insurance coverage kicks in. Let's be clear about what this means. Americans are literally risking their lives to stretch their insulin as far as possible because the costs are so great. And the cost burden is even heavier for uninsured Americans who have to pay fully out of pocket. These costs quickly number into the thousands of dollars. The challengesaren't new, but, fortunately, we are making some progress. Congress last year capped Medicare beneficiaries' insulin costs at $35 a month. And, recently, the three largest insulin manufacturers announced they will finally lower their list prices. Now, Senator Collins and I have commended those manufacturers for finally taking steps to make their insulins more affordable. But until patients are given true financial security and certainty with insulin pricing, the work remains unfinished. Those manufacturers could, at any time, decide again to raise the price of insulin. There have to be mechanisms in place to systemically address the full scope of this issue. We need to lower costs, and we need to be able to keep those costs down. Insulin costs must be addressed across the board. We must address the root causes of the high cost of insulin. That is what brings me to the floor today, to discuss legislation that Senator Collins and I recently introduced: the Improving Needed Safeguards for Users of Lifesaving Insulin Now--or INSULIN--Act. First, I want to thank my friend and colleague Senator Collins for her longstanding partnership and leadership. Senator Collins and I cochair the Diabetes Caucus, but it was Senator Collins who founded the caucus in 1997, years before I got here, and there is no more fearless and relentless advocate for those living with diabetes than Senator Collins. We began working on the INSULIN Act in 2019, recognizing that without a comprehensive bill to address the root causes of skyrocketing insulin prices, patients would never have long-term relief. At that time, unfortunately, there weren't a lot of people in Congress who were advocating for comprehensive insulin pricing reforms. Since then, more and more Members of Congress have begun pressing for insulin reform legislation. That is encouraging. And it is a message of the commitment in this Chamber to finally get something done on this issue. I am glad the issue is finally getting the attention it deserves, because we are long past time for Congress to act. Our INSULIN Act takes an across-the-board approach to insulin pricing. First, our bill caps insulin out-of-pocket costs at $35 or 25 percent of list price monthly. That means that a patient could see monthly costs capped for as little as $15 to $20. And that provision, which we did for Medicare last year, was actually something that has been promoted by the diabetes community, the JDRF-- Juvenile Diabetes Research Foundation--and other diabetes advocacy groups. Second, our bill addresses one of the root causes of insulin price increases--ever-growing rebates collected by pharmacy benefit managers, or PBMs. Our bill mandates that PBMs pass 100 percent of rebates negotiated on the plan sponsors. So that benefits patients by lowering premiums. Finally, our bill takes several steps to increase biosimilar competition, which is proven to lower list prices and improve patient access to their medications. That includes legislation that I have championed for several years, the Ensuring Timely Access to Generics Act, which is designed to prevent pharmaceutical manufacturers from gaming the FDA's citizen petition process to delay generic drug approvals. Now, Senator Collins and I have developed what we believe is a good piece of bipartisan legislation, and it has been done in consultation with drug-pricing experts and with the diabetes advocacy community. Since 2019, we have been working on this. Last year, we invited input from lawmakers, stakeholders, and advocates, including the members of this Chamber. This bipartisan bill is the product of countless conversations and negotiations to produce a bill that will be the most effective in lowering costs and keeping them there. And it will entice, we believe, the broadest coalition of lawmakers to get behind it. In particular, I want to thank the American Diabetes Association, the JDRF, and the Endocrine Society for their input and for their endorsement of our legislation. I look forward to working with the diabetes community, with Senator Collins, and with the rest of the Members of this Chamber and Congress to finally pass this comprehensive bill to give financial relief to all Americans living with diabetes. There is no more time to waste. And I urge the HELP Committee and Senate leadership to bring this bill to the floor as soon as possible. I yield the floor.