Policy Tools

Policy Positions

Diabetes management is preventive. Every person with diabetes needs affordable access to the medications, devices, supplies and services that work for them.

Non Medical Switching

Non-medical switching negatively impacts patients by disrupting their care and does not generate cost savings for the patient or the insurer.

Competitive Bidding Program

We believe that CMS must exempt diabetes testing supplies from the CBP until they can employ transparent, scientific-based methodologies for monitoring the safety of patients and ensuring adequate access to supplies.

Copay Accumulator Adjustment Programs

These programs prevent people from diabetes from using a manufacturer’s copay assistance card— coupons provided to patients to cover high copays on brand name and specialty drugs — toward their annual deductible.

Policies That Put Diabetes Patients First

Affordability

It’s no secret that insulin and devices are expensive. Those living with diabetes pay an additional $9,600 annually in medical costs and 12 percent of Americans with diabetes can’t afford their own prescriptions. Because of these growing costs, 1 in 4 diabetes patients rations their medication like insulin. There are policies that go beyond Medicare and Medicaid that can make treatments more affordable.

Access

Access to medication, devices and care providers remains a major issue for patients with diabetes. Lack of access leads to more hospitalizations and less care for those who need it most. Policies that support health care provider improvements, faster diagnosis and innovations like telehealth go a long way to help diabetes patients receive the care they need.

Quality

Quality of care remains a concern for those living with diabetes. Fee-for-service insurance plans and insurance policies like non-medical switching prioritize cost over patient care. We support a number of policies that ensure a consistent and improved quality of care for patients living with diabetes.

Rebate Pass-Through Policies

Since the introduction of Medicare Part D in 2006, pharmacy benefit managers with insurance companies have had a carte blanche to negotiate rebates on important medications like insulin. These rebates are pocketed by the insurance company and the benefit never reaches the patient at the pharmacy counter, where they need it the most. Rebate pass-through policies bring a 0.01% increase in cost for private insurers and have little to no impact on government spending.

DLC is in support of the following legislation: DLC also supports efforts from the Federal Trade Commission (FTC) to further investigate PBMs and their role in raising insulin pricing. See comments here.

Co-pay Adjustment Programs

Co-pay adjustment programs, offered by manufacturers, provide assistance directly to patients through copay assistance coupons. These coupons pass on savings that can be applied directly at the pharmacy counter or to their deductible. DLC supports these programs, which require no statutory interventions from state or federal level lawmakers.  

Patient Cost-Sharing Caps

Since the introduction of Medicare Part D in 2006, pharmacy benefit managers with insurance companies have had a carte blanche to negotiate rebates on important medications like insulin. These rebates are pocketed by the insurance company and the benefit never reaches the patient at the pharmacy counter, where they need it the most. Rebate pass-through policies bring a 0.01% increase in cost for private insurers and have little to no impact on government spending.

DLC is in support of the following legislation: DLC also supports efforts from the Federal Trade Commission (FTC) to further investigate PBMs and their role in raising insulin pricing. See comments here.

Policy Positions

Everyone in the United States should have affordable access to all medications, devices and services to ensure healthy daily diabetes management.
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Preventive/First Dollar Diabetes Coverage

Diabetes care is preventive care. Diabetes medications, supplies, devices and education should be covered without deductible or onerous patient cost sharing.

Issue Briefs
Testimony & Letters
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Co-pay Adjustment Programs

These programs prevent people from diabetes from using a manufacturer’s copay assistance card— coupons provided to patients to cover high copays on brand name and specialty drugs — toward their annual deductible.

Testimony & Letters
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Diabetes Technology Access & Equity

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Emergency Insulin Access

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Glucagon & Insulin Administration

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Insulin Affordability

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Insurance Coverage Expansion

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Non-Medical Switching

Non-medical switching negatively impacts patients by disrupting their care and does not generate cost savings for the patient or the insurer.

Presentations
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Patient Assistance Programs

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Patient Cost Sharing & Caps

Diabetes care is preventive care. Diabetes medications, supplies, devices and education should be covered without deductible or onerous patient cost sharing.

colton, bowshier
Colton
Issue Briefs
Presentations
Videos
Testimony & Letters
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Pharmacy Benefit Managers (PBM)

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Rebate & Discount Pass-through

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Step Therapy

Transparency & Reporting Requirements

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Testimony & Letters
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Value-based Diabetes Coverage

Test 1

Colton, Bowshier
Presentations
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Access & Affordability

DLC’s policy advocacy platform is firmly founded in the belief that diabetes management is preventive and should be covered accordingly in all health plans.

Testimony & Letters
Issue Briefs
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