New state program to provide affordable insulin starts Wednesday

A woman reacts after a bill passed in the state House.
Nicole Smith-Holt reacts in the gallery after the Minnesota House passed a long-awaited insulin affordability bill championed by Smith-Holt, in St. Paul on April 14, 2020. Her 26-year-old son Alec, of Minneapolis, died of diabetic complications in 2017 because he was forced to ration his supply of the drug.
Jim Mone | AP Photo file

Updated: 9:41 p.m.

Minnesotans with diabetes who need emergency insulin supplies but can't afford them will be able to get the drug starting Wednesday under a new state law.

The safety net program within the Alec Smith Insulin Affordability Act, which the Legislature passed in April, will allow qualifying people with diabetes with less than seven days worth of the lifesaving drug left to pay no more than $35 to get a one-time 30-day supply from their pharmacy.

The law is named for Alec Smith, an uninsured 26-year-old Minneapolis man who died in 2017 of complications from rationing his insulin — a common but dangerous strategy among those who lack sufficient coverage. He couldn’t afford the $1,300 per month he needed for the drug and test supplies after he aged off his mother's insurance. His mother, Nicole Smith-Holt, was a leading campaigner to get the legislation passed.

To qualify for the urgent need program, people with diabetes must need an emergency refill to avoid the likelihood of suffering significant health consequences if they run out. They must meet income qualifications, be Minnesota residents and have a valid prescription. They must be paying more than $75 monthly for insulin and must not be enrolled in the state's Medical Assistance or MinnesotaCare public health insurance plans, which already cover insulin. Manufacturers will either reimburse pharmacies for the costs or replace the insulin.

The state has set up a website for the Minnesota Insulin Safety Net Program at that includes information on how to apply and a downloadable application to take to the pharmacy.

Patients who need longer-term help with insulin costs may qualify for the state's continuing need program, which requires manufacturers to provide insulin to eligible people for up to one year, with an option to renew annually. Drugmakers will provide the insulin for a copay of no more than $50 for each 90-day supply, and potentially less if the patient has insurance.

The family income threshold to qualify is 400 percent of the federal poverty level, meaning about $51,000 for an individual and about $105,000 for a family of four. People in most public programs, which cover insulin, don’t qualify.

Meanwhile on Tuesday, the Pharmaceutical Research and Manufacturers of America, a trade group that represents the pharmaceutical industry, said it has filed a lawsuit in the U.S. District Court in Minnesota to challenge the law, claiming that the act violates the Constitution.

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