Congressional Budget Office Confirms The Insulin Act Increases Health Care Costs

(Washington, D.C.) — The Pharmaceutical Care Management Association (PCMA) today released the following statement on the Congressional Budget Office’s (CBO) estimate that The INSULIN Act will increase taxpayer spending by approximately $23 billion over 10 years.

Pharmacy benefit managers, PBMs, support lower insulin costs and have taken a number of steps to reduce out-of-pocket costs for patients who rely on insulin. In fact, despite dramatic increases in list prices for insulin over the past several years, the net cost of insulin has remained flat largely due to PBM-negotiated rebates.

“As the CBO has confirmed, The INSULIN Act would not lower insulin costs. Instead, the legislation would allow pharmaceutical companies to game the system to maximize their profits while adding cost to taxpayers and risking further inflation of healthcare premiums. The sponsors of the INSULIN Act have the right objective – lowering insulin costs for patients – but unfortunately, the legislation does not address the root cause of high insulin costs, which is the drug manufacturers who are setting arbitrarily high prices. Policies to address rising drug prices, including the high price of insulin, must hold drug manufacturers accountable for continuing to hike prices while avoiding competition through unjustifiable patent extensions and blocking lower-cost generic and biosimilar insulins from reaching the market.” said PCMA President and CEO JC Scott.

“Given that PBMs are the only entities in the healthcare system dedicated to taking costs out of the system and make prescription drugs more affordable for patients, PCMA believes the best way to reduce insulin costs is to increase competition. We look forward to working with the Biden Administration and Congress to end misaligned incentives and further reduce prescription drug costs for all patients.”

As Congress considers proposals to reduce prescription drug costs for consumers, PCMA this week launched a new advertising campaign to raise awareness of the risks posed by The Insulin Act.

See PCMA Insulin Ads and learn how PBMs are working to reduce insulin costs

Drug manufacturers’ prices are the root cause of high drug costs. Evidence of drug manufacturer excessive prices includes:

  • recent study published in the Journal of American Medical Association (JAMA) found that for 500 drugs launched between 2008 and 2021, launch prices increased from an average $2,115 per year in 2008 to $180,000 per year in 2021.
  • separate study, in JAMA, found that list prices of brand drugs on the market increased by 159 percent from 2007 to 2018.
  • A recent analysis from the Kaiser Family Foundation (KFF) found Big Pharma hiked prices faster than the rate of inflation on 23 of the top 25 most popular prescription drugs in the Medicare Part D program in 2020.



PCMA is the national association representing America’s pharmacy benefit managers (PBMs).  PBMs administer prescription drug plans for more than 266 million Americans who have health insurance from a variety of sponsors including:  commercial health plans, self-insured employer plans, union plans, Medicare Part D plans, the Federal Employees Health Benefits Program (FEHBP), state government employee plans, Medicaid plans, and others.