Viral Post Wrongly Ties Cost Drop to Trump’s ‘Prescription Bill’
By Angelo Fichera
Posted on September 25, 2020
A Facebook user claims the cost of her insulin dropped 75% thanks to “Trumps Prescription Bill.” There has been no such legislation passed, and actions by the Trump administration aimed at lowering prescription drug costs have yet to take effect.
President Donald Trump issued several executive orders over the summer aimed at lowering prescription drug prices — efforts that he emphasized during an event Sept. 24 event in North Carolina. Experts told us when he first issued the orders that the scope of their effects remained to be seen since the orders first required further action by the administration.
On Facebook, however, one user’s viral text post — published Sept. 15 and shared by more than 260,000 users — suggests that Trump’s policies have already resulted in a 75% drop in her cost for insulin.
“I just returned from Walmart Pharmacy. If anyone wants to know who benefited from Trumps Prescription Bill you can ‘quote’ me,” the post says “I picked up my Insulin (3 month supply) and the cost has dropped from $173.86 down to $42.88……big saving…….and my test strips (2 boxes/100 per box) dropped from $10.00 per box to $1.00 per box. Promises made Promises Kept.”
But Trump’s orders haven’t gone into effect.
Rachel Sachs, an associate professor at the Washington University in St. Louis School of Law who has followed the administration’s proposals, pointed out there is no such thing as Trump’s “Prescription Bill,” adding, “I can’t think of any legislation that would’ve had this effect.”
And “the administration hasn’t implemented any of the executive orders the President issued in July,” she told us in an email. “There’s a voluntary insulin program that’s going to go into effect next year (which is to say that it isn’t in effect now), but it will only assist a subset of Medicare beneficiaries.”
Erin Trish, associate director of the University of Southern California’s Leonard D. Schaeffer Center for Health Policy & Economics, also told us by email that Trump’s order and that insulin program “have not yet been implemented, so they cannot be directly responsible for her reduced out-of-pocket spending.”
In May, the Centers for Medicare & Medicaid Services announced that a number of Medicare Part D and Medicare Advantage plans would voluntarily participate in a program to set the maximum copay for a month’s supply of insulin at $35 per month.
That program begins Jan. 1, 2021, and will apply to “a subset of plans and enrollees, and not all insulin products have to be covered by all participating plans,” according to a Kaiser Family Foundation analysis. It does not affect costs for people who are uninsured or have other coverage.
Then in July, as we’ve previously explained, Trump announced several executive orders that are aimed at lowering prescription drug prices.
Among the orders is one relating specifically to insulin and epinephrine. It seeks to compel Federally Qualified Health Centers, which provide primary care in underserved areas, to make the drugs available at low prices to low-income individuals. The centers already provide a sliding scale based on income, though, so how much the costs would go down for those recipients depends on how the Department of Health and Human Services ultimately defines “low-income.”
Another order calls for increasing drug importation since drugs, including insulin, can be found significantly cheaper in other countries. (Though experts say how that will be achieved — or what prices the U.S. will be able to secure — isn’t clear yet.) Yet another order instructs the HHS secretary to test a payment model that ties Medicare prices for certain drugs to the lowest price paid among a number of other countries.
But Juliette Cubanski, deputy director of the Program on Medicare Policy at KFF, said that there are “definitely more administrative steps [that] need to be taken before any of those proposals can take effect and translate” to any potential cost savings.
An “executive order isn’t the same thing as concrete action when it comes to lowering prices,” Cubanski said in a phone interview.
The next steps for some of the orders — such as proposing rule-making, accepting public comments and issuing final rules — could take months or longer, Cubanski said. The actions could also be the subject of legal challenges by pharmaceutical companies, she said. And how exactly the policies affect prices will largely depend on the details of the rules.
The administration did on Sept. 24 take a further step on the drug importation order by publishing a Food and Drug Administration regulation to allow states and others import drugs from Canada. But “states would still need to apply to participate and then would have to set up new programs to actually begin importing drugs,” according to STAT, a health-focused news site.
Trump also announced that day that the administration plans to send $200 gift certificates to some 33 million Medicare beneficiaries to help pay for prescription drugs. The exact details of who will get them and when aren’t clear.
The Facebook user behind the claim about her insulin cost told us in a phone interview that she actually wasn’t quite sure what caused the change in price.
“I honestly don’t know — I renewed my prescription. They said that’s what the price is,” Katharine Wade, 71, who lives in Albuquerque, New Mexico, said. “It was a pleasant surprise.”
“I don’t care where [the cost reduction] came from, I just appreciate it,” she added.
But Wade, who said she has Type 2 diabetes, confirmed that she received a five-pack of Novolin human insulin pens. Walmart sells those pens for $42.88 under the brand Relion — the same price Wade noted in her Facebook post and a price that has been in place since at least early 2019.
That’s a human insulin — as opposed to the more expensive insulin analog, which is often needed by patients with diabetes, especially Type 1 — and it can be purchased at Walmart pharmacies without a prescription. (Note: This type of insulin is older and can take longer to metabolize than newer versions and experts advise that people should consult a doctor before taking or switching medications.)
A Walmart spokeswoman, Marilee McInnis, told us the company was not aware of any changes that would’ve led to the type of decrease in costs described in the Facebook post.
“Generally, the price of medications and devices often depend on the type of insurance being used, as well as the products themselves and cost differences when switching between brands,” she said in an email.
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Cubanski, Juliette. Deputy director, Program on Medicare Policy, Kaiser Family Foundation. Phone interview. 23 Sep 2020.
Cubanski, Juliette, et. al. “Insulin Costs and Coverage in Medicare Part D.” Kaiser Family Foundation. 4 Jun 2020.
Facher, Lev and Nicholas Florko. “Trump promises seniors $200 prescription drug gift certificates, but questions abound.” STAT. 24 Sep 2020.
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McInnis, Marilee. Spokeswoman, Walmart. Email to FactCheck.org. 24 Sep 2020.
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“Relion Novo R Flexpn.” Walmart. Accessed 24 Sep 2020.
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Trish, Erin. Associate director, Leonard D. Schaeffer Center for Health Policy & Economics, University of Southern California. Email to FactCheck.org. 22 Sep 2020.
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