nothin Fair Haven Health Pushes State On Telehealth,… | New Haven Independent

Fair Haven Health Pushes State On Telehealth, Insulin Caps

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Insulin: soon to cost less in CT?

Six cents per dose.

That’s how much some of the most commonly used injectible diabetes medications cost when the government is allowed to negotiate insulin prices, according to a top local community health center doc who threw her support behind the state legislature’s bid to cap insulin costs and broaden access to government-negotiated savings.

Fair Haven Community Health Care CEO Suzanne Lagarde offered that testimony early Tuesday afternoon during a virtual public listening session hosted by the state legislature’s Insurance and Real Estate Committee. A video feed of the hearing was broadcast live on CT‑N’s website.

Tuesday’s committee hearing focused on two of the four proposed bills that the state legislature will be considering and voting on during the special summer session that kicked off this week.

One of those bills, An Act Concerning Diabetes and High Deductible Health Plans, would cap monthly insulin costs at $25 per patient and would cap monthly insulin supply costs at $100 per patient for people insured through state-regulated health plans.

It would also create a working group charged with making recommendations on whether or not to create a statewide program that would encourage more Connecticut diabetics to seek treatment at one of the state’s 17 federally qualified community healthcare centers so that they can take advantage of discounted prices afforded by the federal government’s Section 340B program (more on that below.)

The second bill discussed Tuesday, An Act Concerning Telehealth, would require health insurance companies to cover telehealth visits — that is, medical advice, diagnosis, care or treatment provided remotely, as defined in the bill — at the same levels that they cover in-person visits, through June 30, 2021.

Another Fair Haven Community Health Care doctor, Director of Telemedicine Madhuri Sharma, turned out for Tuesday’s virtual hearing to testify in support of that latter proposed bill. She argued that telehealth treatment represents a critical and innovative way for community health centers like Fair Haven to promote social distancing, decrease emergency room visits, and encourage proactive monitoring of one’s health for patients unable or unwilling to make regular in-person visits during the ongoing Covid-19 pandemic.


We cannot simply go back to what was normal, because we know that normal was not working for many people in this state and in this country,” Branford-Guilford State Rep. and Committee House Chair Sean Scanlon (pictured) spoke at the top of the hearing about the urgency of passing these two bills. He described them both as just the beginning of a long term effort” to reform how Connecticut residents receive and pay for health care.

Scanlon later told the Independent that state legislators rewrote the bill as first presented earlier this year as to drop the monthly insulin cost cap from $50 to $25. He said the new cap, if passed, would be the lowest of any in the country.

The two other bills slated to be taken up by the legislature during this special session cover police accountability and absentee ballots.

The Cost To The Patient Can Be Incredibly Diminished”

While Sharma directed her three minutes of testimony at backing the telhealth bill, Lagarde (pictured) focused her time before the committee legislators on backing the insulin price cap bill.

She praised in particular the bill’s bid to have the state take greater advantage of low insulin prices as negotiated by the federal government through the 340B program.

That program is administered by the federal Office of Pharmacy Affairs (OPA), and allows certain health care organizations — including federally qualified health centers, like Fair Haven — to provide uninsured and underinsured patients with insulin and other drugs at significantly reduced prices.

We cannot allow patients to go without life-saving medications,” Lagarde said.

The 340B program requires a patient to be an active patient of an eligible federally qualified health center, she said. It requires the prescribing health care provider to be actively employed by an eligible federally qualified health center. And it requires the visit that results in such a prescription to have taken place at an eligible federally qualified health care. It’s a tightly regulated program with many layers of rules and regulations,” she said.

The benefits for patients, she said, are well worth the bureaucratic red tape. Each month, they can save hundreds of dollars — sometimes even thousands of dollars — on medication compared to what they might otherwise pay at a retail pharmacy.

She said health centers like Fair Haven can purchase commonly used brand name insulin medications like Levemir for as little as 20 cents a dose through the 340B program. Other commonly used injectible diabetes medications cost as little as six cents per dose, she said. There are remarkably inexpensive.”

Earlier in the day’s hearing, Kristen Whitney Daniels (pictured) from the state chapter of #Insulin4All said that she was paying $2,400 a month for insulin before she learned that she could find cheaper doses at a federally qualified health center because of 340B. Now, she said, she pays $14 a month.

Lagarde said that type of cost disparity between retail and 430B-enabled insulin prices is not uncommon thanks to this program.

I think people on this hearing today are probably surprised to hear you say that a drug they take can be six cents per dosage,” Scanlon said. It strikes me as something we should be talking about more.” In a lot of other parts of the world, he said, governments negotiate directly with pharmaceutical companies on drug prices. That is largely verboten in the U.S., with the 430B program being a rare exception.

Lagarde agreed. She said that patients won’t pay 6 cents per dose even for 430B-purchased insulin, because of added-on pharmacy dispense and switch fees. But $14 per month, she reiterated, is not an uncommon final cost. At the end of the day, the cost to the patient can be incredibly diminished.”

Insurance Industry Pushes Back

The only person to testify against both the insurance cost cap and telehealth bills during the first three hours of Tuesday’s virtual hearing was Susan Halpin (pictured), the executive director of the Connecticut Association of Health Plans, which includes such members as Aetna, Connecticare, Cigna, and United Health.

She said that it’s just too early to evaluate the cost and quality impacts of telehealth services,” and urged the committee to hold off on writing into law any price parity mandate for covering telehealth services through next June.

And she opposed the insulin bill because she said that reducing co-pays for insulin will simply spread out the cost of coverage across more patients through higher premiums.

The root cause” of high insulin costs, she said, are the prices charged by pharmaceutical companies.

It’s an overpriced product,” she said. We have to get at that piece before we get at” the prices that patients pay at the pharmacy.

Until we address the underlying cost of insulin or related products, we’re just going to be moving the deck chairs. We’ve got to get to the root cause at some point.”

East Hartford State Sen. and doctor Saud Anwar (pictured) countered Halpin’s testimony with his own skepticism of her push to delay action on these two health care matters.

One way to delay something is to say we need more data,” he said. And another way to delay something is to say there are unintended consequences.”

He said that telehealth is a critical method of providing healthcare during this pandemic, and should be encouraged by the state and paid for by insurance companies to make sure that people don’t forgo checking in with health care providers during the ongoing public health crisis.

As for whether or not capping insulin co-pays for patients will result in higher premiums, he said, the data he has seen is quite clear: If insulin access is improved, the long term cost of health care is reduced very much.”

That’s because diabetic patients don’t ration insulin supplies out of a concern for cost, and then suffer more serious adverse health impacts that land them in the emergency room — requiring much more expensive treatment than the cost of insulin.

Your concern about cost for insulin long-term is short-term thinking,” he said.

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