Concerns over insulin pricing and access took center stage during the North Dakota House Government and Veterans Affairs meeting on February 7, 2025. Lawmakers discussed the monopolistic practices of major insulin companies, highlighting how these corporations have been accused of anti-competitive behavior that drives up costs for patients.

A key speaker pointed out that the three major insulin manufacturers have effectively created a monopoly, allowing them to raise prices without passing on any savings from rebate programs to consumers. This has led to significant financial burdens for those dependent on insulin, particularly individuals with type 1 diabetes, an autoimmune condition that requires consistent access to this life-saving medication.

The discussion also touched on the role of Pharmacy Benefit Managers (PBMs), which were originally intended to help manage drug costs. However, it was noted that PBMs often prioritize higher-priced medications over more affordable options, contributing to inflated costs and profits. The speaker emphasized that generic insulins have struggled to compete in the market, further limiting options for patients.

According to a recent actuarial report from Novarest, there are approximately 57,805 individuals with diabetes in North Dakota, with only 5 to 10 percent having type 1 diabetes. This statistic underscores the critical need for accessible insulin, as all individuals with type 1 diabetes rely on it for survival.

The report also estimated a modest increase in costs associated with insulin, projecting a rise of 30 cents to a dollar per member per month. This figure was seen as more favorable compared to earlier estimates from Sanford, suggesting potential for lower costs in the future.

In light of these discussions, the PERS board has recommended the continuation of a pilot program aimed at improving insulin access, while the insurance commissioner’s office has included insulin and diabetic supplies in the small group market benchmark plan. These steps signal a commitment to addressing the pressing issue of insulin affordability and accessibility in North Dakota.