Cancela strips refund provision from insulin bill

CARSON CITY — State Sen. Yvanna Cancela and backers of a proposal to control insulin prices withdrew a key provision of the bill that would have made the state the first in the U.S. to mandate drugmakers refund diabetics or their insurance companies when the price of insulin rises more than inflation.

Cancela, D-Las Vegas, said the provision was removed from Senate Bill 265 after legislative attorneys warned her that the refunds could violate federal patent and interstate commerce laws.

“The idea is very simply that these transactions are dealt with out of state and so, as a state, we cannot regulate them,” Cancela said. “I am very thankful that it came out now rather than later. I think that it would have been really awful to pass this bill and have Nevada end up in a lawsuit with what is a very litigious industry.”

Under an amended version of the bill, drugmakers would have to notify state officials and insurance companies 90 days before increasing insulin prices by any amount.

The initial bill was an attempt to limit how much employers, insurers and corporate middle men pay for insulin, which is injected to manage blood sugar levels. It also intended to cap what people with diabetes pay out of their own pockets near their current cost levels — typically between $50 and $600 per month.

A vote was scheduled Wednesday for the pared-down version of the bill that will retain what would be the strictest drug-price disclosure rules in the nation.

The bill’s provisions also include a mandate for nonprofit organizations to disclose donations from pharmaceutical companies and licensing requirements for sales representatives who market prescription drugs.

Cancela said the legislative attorneys did not identify any problems with the bill’s other provisions.

The warning that the refund proposal would almost certainly give pharmaceutical companies strong legal grounds to contest an insulin refund law caught Cancela by surprise because, she said, previous legal questions turned up no problematic issues.

“I had no idea this was coming,” Cancela said. “I thought that we had a bill that was ready to go.”