Nevada coalition seeks unprecedented insulin refund law

CARSON CITY, Nev. -- Aiming to rein in soaring prescription drug prices, an unlikely Nevada coalition is trying to force pharmaceutical companies to disclose how they set insulin prices and issue refunds to diabetics or their insurance companies if annual price hikes surpass inflation.

Las Vegas casino owners have banded with their employees' unions of cooks, servers and other resort workers to support the unprecedented legislation in their effort to control their own medical insurance costs.

The bill expected to face its first vote in early May would attempt to cap how much employers, insurers and corporate middle men pay for insulin, which is injected to manage blood sugar levels.

Lawmakers also hope the bill would cap what diabetics pay out of their pockets near their current cost levels -- typically between $50 and $600 per month, depending on diabetics' insurance coverage.

It remains far from clear the bill, if passed, would survive legal challenges or have the intended effect.

But it would make Nevada the first U.S. state to force detailed release of drugmakers' proprietary information and effectively establish a price control on prescription drugs via the refund plan.

The bill is expected to pass in both houses of Nevada's Democratic-controlled Legislature. Republican Gov. Brian Sandoval did not rule out signing it.

The move in Nevada illustrates public ire reaching critical mass over price hikes on insulin, epinephrine, antibiotics and other common prescription medicines, said Steve Brozak, president of the New Jersey-based WBB Securities investment-banking firm, which focuses on health care.

Brozak and other industry experts warned against assuming government intervention would result in lower pharmacy bills and said drugmakers likely would sue to block the law. They said price constraints could have unintended consequences.

"I don't think this will work in the way people think it will, but this could be the shot across the bow," Brozak said.

The bill would trigger reimbursements to insurers and others who pay for diabetes-related drugs when price increases outpace the national Consumer Price Index Medical Care Component, which rose between 2 percent and 5 percent each of the last 10 years.

"There is no question that lives are at stake and that every day that people have to make the choice between their medicine and putting food on the table, we go further down the road to reaching a true public-health crisis," said bill sponsor Sen. Yvanna Cancela, former political director with the Culinary Union 226 lobbying for the bill's passage.