Establishes an emergency insulin program

• Democratic6

◆ The sponsor's argument

Why Gustavo Rivera says this is needed

In December 2022, Governor Kathy Hochul declared a diabetes health emer- gency in New York State to tackle an epidemic that affects over 2 million state residents, and in the SFY 2024-25 budget we completely eliminated cost sharing for insulin. When not managed properly, diabetes can have serious and debilitating health effects, including heart disease, kidney failure, blindness, and lower limb amputation. Severe complications of diabetes include Diabetic Ketoacidosis, also referred to as DKA, and even death. In recent years, New York has seen a signif- icant increase in leg and foot amputation and eye disease. In New York City alone, there was a 356% increase in diabetes-related deaths during the early months of the COVID-19 pandemic. Diabetes management is important in preventing further complications. Type 1 and some Type 2 diabetics depend upon insulin for their survival. The recent increase in the cost of insulin made it difficult for some diabetics to obtain their necessary medication. When patients can't afford insulin, which can cost thousands of dollars even for those who are insured, they have resorted to rationing the little medication they can afford. In fact, one study found that 20 percent of people under the age of 65 diagnosed with diabetes admitted to not taking their insulin as prescribed, or rationing, due to the cost. This legislation creates an Emergency Insulin Program, modeled after New York State's Opioid Overdose Prevention Program which has expanded access to life-saving Naloxone to reverse an opioid overdose widely available in our state. Under the Emergency Insulin Program, individuals who are uninsured or underinsured would be able to get analog insulin through a non-patient specific prescription at certain pharmacies, including clinic and hospital pharmacies. The Department of Health (DOH) would be able to establish a sliding scale for certain cost sharing, which would be capped at $100 per month for a thirty-day supply of insu- lin and supplies. The bill directs DOH to immediately engage analog insulin manufacturers to support the state program and facilitate quick access to affordable analog insulin in emergency situations through a public private partner- ship to streamline existing patient support programs such manufacturers have. The three manufacturers of analog insulin each have programs designed to help people access their products at a reduced rate or for free, however, each program is different and advocates argue that they are difficult to access, especially in emergency situations. Recogniz- ing that manufacturers want to make sure everyone can access the life- saving medications they offer to patients, this bill establishes an Emergency Insulin Program Trust fund to accept funds for the statewide program. Like New York's highly successful Opioid Overdose Prevention Program, this program would allow for non-patient specific prescriptions for analog insulins and utilize chain pharmacies and 340B pharmacies, which are able to provide the lowest cost medications, to distribute the insulins and supplies to recipients who qualify. While it is true there are some types of human insulin that can be accessed over the counter and for a relatively low fee, these are often referred to as "dead in bed" insulin because they do not provide the level of support many type 1 and some type 2 diabetics require. These low cost human insulins are less commonly prescribed by doctors precise- ly because of their unpredictable rate of absorption, which can result in more frequent low and high blood sugars. They require more monitoring and more supplies and, according to advocates, when people transition from the newer and more costly analog insulins the risk of "dead in bed" syndrome is greatly increased. In recent years, the Opioid Overdose Prevention Program has been expanded to provide access to life-saving medication in pharmacies, not just through community-based organizations. Like overdose, the risk of

This is the sponsor's own case for the bill, quoted from their memorandum. It is not Agora's description of what the bill does.