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President Joe Biden delivers the State of the Union address before a joint session of Congress on February 7, 2023

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President Joe Biden used the pulpit during his State of the Union address this week to call for a universal price cap on insulin for all diabetes patients, but the proposal is highly unlikely to pass the current Congress.

Biden’s signature legislative achievement, the Inflation Reduction Act, capped insulin prices for Medicare beneficiaries at $35 a month, but the law doesn’t protect younger diabetic patients with private insurance or no insurance from higher prices.

“Let’s finish the work this time. Let’s cap insulin costs to $35 for everyone,” Biden told Congress Tuesday night.

As the President spoke, Sen. Jeanne Shaheen, DN.H., called on Congress to pass the Insulin Act that would extend the $35 price cap to those with private insurance. Shaheen co-sponsored the bipartisan legislation with Sen. Susan Collins, R-Maine, last July.

According to a report by Rand Corp. from 2021, the average price of insulin in the US in 2018 was 10 times higher than the average price in other wealthy countries.

While there is some bipartisan support for a universal price cap on insulin, the proposal will face an uphill battle and is unlikely to pass in a tightly divided Congress, where Democrats hold a slim majority in the Senate and Republicans weakly hold the House of Representatives represent.

Even when Democrats controlled both houses last summer, Senate Republicans managed to stop a measure that would have capped insulin prices for people with private insurance at $35 a month. Should the Senate pass the insulin bill, it would still face a House that is now in the hands of the GOP.

Rep. Cathy Rodgers of Washington, the Republican chair of the House Energy and Commerce Committee, wasted no time in real-time rejecting Biden’s proposal and sweepingly condemning state insulin price caps as “socialist” and a “federal mandate” that encourages competition harms .

“It’s time for the president to abandon his socialist pricing schemes and work to make insulin products more affordable without jeopardizing insulin competition and innovation,” Rodgers said in a statement released during the president’s address Tuesday night.

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Lisa Murdock, chief policy officer at the American Diabetes Association, acknowledged that extending the insulin price cap to those with private insurance will be an uphill battle in the ongoing Congress. However, Murdock noted that in the previous Senate, seven Republicans had voted for the cap.

“We’ve seen Republicans come forward and champion this measure, so I don’t want to say we think it’s out of reach — we’re still very committed to working with members on both sides of the aisle to do so.” that,” Murdock said.

The insulin market is dominated by Eli Lilli, Novo Nordisk And Sanofi. Industry reaction to Biden’s proposal was mixed.

Lilly supports expanding the $35 price cap to all Americans, spokeswoman Kristiane Bello said. The company has a program to provide insulin to patients regardless of their insurance status for $35 or less a month, Bello said.

Sanofi also supports a universal price cap of $35 for insulin and is already offering the drug at that price to the uninsured through a savings program, a company spokesman said.

Novo Nordisk fears that government drug price fixing will eventually limit patient access to new therapies, spokeswoman Nicole Araujo said.

Stephen Ubl, CEO of Pharmaceutical Research and Manufacturers of America, called insulin cost caps “a patch on a broken system that’s forcing people to pay more for drugs than health insurers and pharmacy benefit managers are paying.”

Last month, California sued insulin manufacturers and pharmacy service administrators CVS Caremark, Cigna’s Express scripts And Optum by United Health They claim they are using their market power to overcharge patients.

CNBC has reached out to pharmacy performance managers for comment on the president’s remarks.

According to the American Diabetes Association, about 40% of people with diabetes have private insurance and 5% have no insurance. One in five privately insured diabetes patients pays more than $35 a month for insulin, according to a survey by the Kaiser Family Foundation.

Although insulin prices vary depending on a patient’s insurance policy, in some cases, Murdock says, people pay hundreds of dollars a month for drugs they need to survive.

According to an analysis by the Health Care Cost Institute, about 9% of people taking insulin with insurance through their employer paid more than $200 out of pocket in 2019. According to the analysis, these people spent an average of $403 per month.

According to a Harvard study published in the Annals of Internal Medicine, an estimated 1.3 million US adults will have to ration their insulin due to price in 2021. Patients rationed by skipping doses, taking less insulin, or delaying the purchase of injections to save money.

States have taken matters into their own hands in the absence of a federal price cap on insulin in all forms of insurance. So far, 22 states and Washington, DC have capped the price of insulin. The cap ranges from $25 in Connecticut for a month’s supply to $100 in other states.

Abortion pill maker GenBioPro sued Wednesday to overturn West Virginia’s abortion ban because it restricts access to a drug approved by the Food and Drug Administration.

The lawsuit, filed in federal court in West Virginia’s Southern District, argues that FDA regulations on drugs such as the abortion pill preempt state laws under the US Constitution.

Access to the pill, called mifepristone, has become a major legal battleground following the Supreme Court ruling overturning federal abortion rights last June. A dozen states, including West Virginia, have adopted near-total abortion bans that outright prohibit the use of mifepristone.

The FDA approved mifepristone as a safe and effective method of terminating an early pregnancy more than 20 years ago, despite the agency placing restrictions on how the pill is distributed and administered.

Mifepristone, when combined with misoprostol, is the most common method used to terminate a pregnancy in the United States, accounting for about half of all abortions nationwide in 2020.

The FDA has eased many of its restrictions to expand access to mifepristone. During the Covid-19 pandemic, the agency allowed patients to receive the pill in the mail. Earlier this month, the FDA allowed retail pharmacies to begin dispensing mifepristone for the first time, so long as they become certified to do so.

However, bans like the one in West Virginia conflict with FDA regulations on mifepristone, raising the question of whether federal or state laws take precedence. Although the FDA has a congressional mandate to approve drugs for use in the U.S. market, states generally license the pharmacies that dispense these drugs.

GenBioPro argues in its lawsuit that the West Virginia state ban is unconstitutional because it violates the primacy and trade clauses of the US Constitution, which give the FDA the power to regulate what drugs are sold across the country.

“The individual government regulation of mifepristone destroys the national common market and conflicts with the strong national interest in ensuring access to a government-approved drug to terminate a pregnancy, resulting in the kind of economic disruption that the Framers intended to prevent by the clause,” argued GenBioPro’s attorneys in the lawsuit.

“A state’s policing authority does not extend to the functional prohibition of an article of interstate commerce — the Constitution leaves that to Congress,” the company’s attorneys wrote.

In another case, a North Carolina doctor on Wednesday asked a federal court to overturn state restrictions on mifepristone because they go beyond FDA regulations. In North Carolina, patients must receive the pill in person from a doctor at a certified facility.

“North Carolina’s imposition of restrictions beyond those that the FDA believes to be warranted as part of its regulatory balance, including restrictions that the FDA has specifically rejected, thwarts the objectives of federal law,” the doctor’s attorneys wrote in the complaint.

Anti-abortion activists, on the other hand, are pushing for mifepristone to be completely removed from the US market. A coalition of anti-abortion doctors has asked a Texas federal court to overturn mifepristone’s more than two-decade-old approval as safe and effective.

A decision in this case could be made as early as February.