HARRISONBURG, Va. (WHSV) — The new year also means new laws in Virginia. One of those laws revolves around the co-pay cap for insulin.
This new law will limit cost-sharing to $50 per 30-day supply of insulin for those with state-regulated commercial insurance.
Julie Pierantoni, a diabetes educator at Sentara RMH, says she has a few concerns.
“If they are gonna provide this cap, are they gonna choose an inferior insulin to have on their plan, and then they’re gonna say ‘well we’re not gonna cover the other insulins because that costs us too much,’” she said.
Pierantoni says part of her role is to help patients find affordable insulin.
“Not the top insulin out there, but it is life-saving. You can get the Walmart insulin for $25 a bottle or a pack of pens for $45,″ Pierantoni said. “That is like I say, it is life-saving, you do have more issues with having hypoglycemia.”
Pierantoni also says health insurance is an area of concern.
“Is the cap of insulin, is that gonna start before you meet your deductible, or is it still after you meet the deductible? So I don’t know that, and when I’ve looked in the legislation I haven’t seen if it talks about the deductible,” she said.
Pierantoni says it can be different for patients depending on what kind of healthcare plan they have.
“January’s always a difficult time because insurance plans do change their formulary, so I’m hoping that they will continue to have the up-to-date safer insulin, and not revert back to decades-old insulins,” Pierantoni said.
Despite how patients may be affected in cost, she says the new law is a start, but they have a long way to go when it comes to improving insulin therapy and curing diabetes.
“It’s a complex disease, and we as diabetes education care specialists can help with that, and we do a lot of assistance with the physicians,” Pierantoni said.
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