Tag: Insulin

State Lawmakers Grapple With Rising Cost Of Insulin As Bill To Cap Copays Heads To House Floor

A bipartisan bill seeking to cap what some insured West Virginians pay for insulin is going to the full House of Delegates for consideration. This comes after eight amendments and several hours of discussion in the House Judiciary Committee on Friday.  

Delegates in committee agreed that the soaring cost of insulin is a real problem for West Virginians, but they questioned what authority the state has over manufacturers who establish the drug’s initial cost, and how limiting co-pays might negatively impact small insurance businesses and mom-and-pop pharmacies. 

House Bill 4543 would mandate that a 30-day supply of prescribed insulin cannot exceed $25, “regardless of the quantity or type of prescription.”  

The bill only applies to insured West Virginians under the state’s jurisdiction, through programs like the West Virginia Public Employees Insurance Agency (PEIA) or individuals who pay for their own private insurance. The bill doesn’t do anything for West Virginians covered by Medicare, Medicaid or private employment-based health benefits, which are all regulated by the federal government.   

“This is a step forward and I wholeheartedly support it,” Del. Barbara Evans Fleischauer, D-Monongalia, said before Friday’s vote. “I wish we had jurisdiction over all the other insurance plans, but we don’t. And I think we should take a step forward on what we are able to do as a state.” 

Fleischauer is one of the bill’s sponsors. The bill’s lead sponsor is the chair of the House Health and Human Resources Committee, Republican Jordan Hill from Nicholas County.  

Many of the changes made to the bill Friday were technical and dealing with unintended language. An amendment from Del. Andrew Robinson, D-Kanawha, could extend some of the benefits of the bill to uninsured and underinsured West Virginians, as well, by incentivizing pharmaceutical manufacturers — the companies producing insulin — to lower their prices, by eliminating the rebate process. 

Manufacturers get their drugs to insurance agencies with help from pharmaceutical benefit managers, which negotiate between the two sides to establish “rebates” requiring manufacturers to lower their prices to a certain point, as long as insurers include that type of drug on their health plan for their consumers. 

Rebates don’t benefit people without insurance who are trying to buy insulin. According to Robinson, pharmaceutical manufacturers will increase the out-of-pocket cost of their drug that these uninsured and underinsured consumers end up paying, to make up for the cost that comes with negotiating rebates.  

“Really, it doesn’t go into action unless we can actually reign in pharmaceutical manufacturers,” Robinson said after the vote. “If we can reign in those pharmaceutical manufacturers it would just help everyone.” 

If the bill passes both chambers and garners Gov. Jim Justice’s approval, West Virginia wouldn’t be the first to cap insulin copays. Colorado agreed in 2019 to set a $100 cap for insured consumers, and the governor of Illinois signed a similar bill in January. 

House Bill 4543 passed out of the House Banking and Insurance Committee earlier this week, where legislators questioned what message this bill will send to manufacturers, and whether this bill might dissuade them from making their insulin accessible to the West Virginians who need it.  

No one at the House Judiciary meeting on Friday spoke on behalf of manufacturers. 

Emily Allen is a Report for America corps member.

Fourth Possible Victim Identified In Suspicious VA Hospital Deaths

A fourth person has been named as a potential victim in the ongoing investigation of suspicious deaths at a Clarksburg, West Virginia veteran’s hospital. 

Attorney Dino Colombo said Thursday an autopsy has revealed Army veteran Archie D. Edgell died in March 2018 as a result of an unneeded insulin injection. 

“The autopsy shows that Mr. Edgell had multiple injection sites in the back of his arms and in his thighs,” Columbo said by phone.

Edgell, a Doddridge County native who lived in Barbour County later in life, died at the age of 85 at the Louis A. Johnson VA Medical Center. The results of a December 2018 autopsy were made available in June 2019, Colombo said. 

Edgell’s death follows a similar pattern seen in other suspicious deaths at the Clarksburg hospital in recent years. Elderly patients who were not terminally ill suddenly took a turn for the worst as a result of a hypoglycemic event.  

At least two of those deaths — including Felix McDermott and George Shaw, Sr. — are being treated as homicides. A possible third victim, John Hallman, was identified last week. 

Colombo noted there are multiple similarities between Edgell’s death and the other victims. 

“[Edgell] was on the same floor as everybody else, 3-A, at the VA hospital in the same general time frame,” he said.

Colombo said Edgell’s autopsy shows the veteran had injection marks that were consistent with other victims. 

“Number three — and, I think in this case, is the most telling thing — is the crash of his blood sugars for absolutely no reason,” Colombo said.

The FBI and the VA’s Inspector General have been investigating multiple suspicious deaths at the facility for more than a year.

Although federal officials have yet to release much information about the investigation, prosecutors said earlier this month they have identified a person of interest. They have said they are at “the beginning of the end” of their work on the case. 

Colombo said he believes investigators working are meticulously to close the case and hopes they will soon announce charges. He also noted that insulin can be purchased over the counter at a pharmacy, further complicating the investigation. 

“I know everybody would like to have this investigation resolved by tomorrow, or even yesterday. But those guys do a great job of uncovering every piece of evidence they can in putting this together,” Colombo said.

A spokesperson for the VA hospital said that a reported person of interest has been removed from their position. 

“Immediately upon discovering these serious allegations, Louis A. Johnson VA Medical Center leadership brought them to the attention of VA’s Inspector General while putting safeguards in place to ensure the safety of each and every one of our patients,” the VA hospital spokesperson said in an email to West Virginia Public Broadcasting. 

Still yet, Colombo said the Edgell family is preparing to notify the government of their intent to file a wrongful death lawsuit against the hospital. 

“We have veterans that fought for our freedom and they were vulnerable people who couldn’t protect themselves and who couldn’t speak for themselves,” Colombo said. “They were counting on the VA to protect them and they failed miserably. We’re not going to let that go.”

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