North Dakota lawmakers pass bill to cap insulin price for public employees

The bill brought by Sen. Tim Mathern, D-Fargo, would cap the price of a 30-day supply of insulin at $25 for residents who are covered by the North Dakota Public Employees Retirement System.

A woman with diabetes holds an insulin pen.
A woman holds an insulin pen.
Michael Vosburg / Forum Photo Editor

BISMARCK — The price of insulin products may soon be limited by North Dakota law for members of a public employee insurance plan.

The North Dakota House of Representatives voted 57-33 on Monday, April 10, to approve Senate Bill 2140. The bill, which already won approval in the Senate, will go to Gov. Doug Burgum's desk.

The Republican governor can sign the bill into law, veto the proposal or allow it to take effect without acting on it. A spokesman for Burgum declined to comment on the legislation.

The bill brought by Sen. Tim Mathern, D-Fargo, would cap the price of a 30-day supply of insulin at $25 for residents who are covered by the North Dakota Public Employees Retirement System, or PERS. Co-payments for related medical supplies, including blood glucose meters, insulin pen needles and syringes, also would be capped at $25 per 30 days.

About 60,000 current and retired public employees and their dependents are covered by PERS. State law requires legislators to run insurance mandates through a PERS trial before expanding the policies statewide.


A fiscal note estimates that instituting the price cap would cost the state about $900,000 over the next two-year budget cycle, while cities, counties and school districts would see a $150,000 financial hit.

If the bill becomes law, PERS would be required to submit legislation for consideration in 2025 to extend the price cap to all insured North Dakotans who qualify. The proposed price cap for public employees would expire in July 2025 if lawmakers don’t extend it.

The original bill submitted by Mathern sought to extend the price cap to all eligible North Dakotans, but the Senate Human Services Committee amended the proposal to only apply to PERS.

If North Dakota implements a statewide insulin price cap in 2025, it would join nearly two dozen states that have taken the same step in recent years.

Supporters of the price cap say drugmakers and middleman companies called pharmacy benefit managers, or PBMs, drive up the cost of life-saving insulin products to increase profits. The formation of virtual monopolies in the American pharmaceutical realm have resulted in a lack of price competition, hurting diabetic consumers, they contend.

“On behalf of more than 54,000 North Dakotans — your constituents that have diabetes — I ask you to choose patients over the PBM gangsters," said Rep. Carrie McLeod, R-Fargo, on Monday.

The average manufacturer price of insulin in the U.S. was about 10 times higher than in other developed countries as of 2018, according to a 2020 report prepared by nonprofit think tank RAND Corporation.

The AARP and its members persistently lobbied legislators this year to address high prescription drug costs. The organization representing older adults celebrated Monday's vote and urged Burgum to sign the bill.


AARP State Director Josh Askvig said the bill's passage is "an important step toward more extensive relief for people suffering and dying due to outrageous prescription drug costs.”

Opponents of the bill, including insurance lobbyists, say capping the price of insulin would raise insurance premiums and fail to tackle the market problem at the heart of high drug prices.

Rep. Brandon Prichard, R-Bismarck, said the price cap would be a "cash cow" for drugmakers and PBMs since the companies could charge the state whatever they want for insulin products.

Rep. Todd Porter, R-Mandan, said the bill amounts to a form of "socialized medicine" that hampers free-market capitalism. He said creating more insurance mandates, like the insulin price cap, would increase insurance costs for everyone in the market, hurting consumers and small business owners.

Jeremy Turley is a Bismarck-based reporter for Forum News Service, which provides news coverage to publications owned by Forum Communications Company.
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