New Bill in Nevada Spotlights Ambiguity in Insulin Pricing

The Nevada state senate passed a bipartisan bill (Senate Bill 265) that would force pharmaceutical companies that make diabetes drugs to disclose information on their insulin pricing, profits, and costs, and would require state government to publicly post the information online.

The bill passed by a 19 to 2 vote and now heads to the Nevada assembly. The measure, which focuses on transparency, contains some of the strictest regulation on pharmaceutical companies in the nation. The price of insulin has also been the subject of a class action lawsuit, which alleges price fixing among 3 insulin makers. Nevada Republicans said they joined the Democratic majority in favor of the bill because they support the notion of transparency. Nevada’s governor, Republican Brian Sandoval, has not ruled out signing the bill.

The bill’s sponsor, Senator Yvanna Cancela (D-Las Vegas), argues that, if nothing else, detailed pricing data would start a conversation among state and federal lawmakers as well as patients. Cancela said the disclosure process equips patients with information with which to ask questions and push back against price gouging. The bill’s sponsors removed a provision from the original proposal that would have required drug makers to publish their research and development costs. They also removed a provision to require insulin makers to issue refunds to insurance companies and patients who purchase insulin if annual price increases surpass inflation because they were concerned with its legality.

The Pharmaceutical Research and Manufacturers Association (PhRMA), a lobbying group, is opposed to the Nevada measure and says it is dangerous and will not do anything to help patients in the state access or afford their medications. A PhRMA spokesperson said drug rates constantly fluctuate and the market is much more complex than supporters of the bill claim. The organization believes the bill could backfire on patients.

The Nevada senate bill sets forth a number of requirements, including the annual publication of a list of prices the drug makers set, what profit they make from sales of insulin, and the total amount of insulin discounts given to market middlemen. The state’s HHS must place this information publicly on its website. The bill also requires that drug companies notify the state 90 days before making any changes in insulin prices.

In addition, nonprofit organizations operating in Nevada that advocate on behalf of patients or that fund medical research must report to the state HHS any information concerning contributions they received from drug manufacturers, insurance companies, or pharmacy benefit managers. The bill also authorizes the state’s HHS to impose an administrative penalty in certain circumstances and also requires private schools and employers to allow pupils and employees to keep and self-administer certain drugs.