New York State lawmaker proposes no-cost Inhalers

State Assemblywoman Jessica Gonzalez-Rojas, D-East Elmhurst, speaks on the Assembly floor earlier this year.

Insurance companies could be required to cover asthma inhalers at no cost in New York state.

Assemblywoman Jessica Gonzalez-Rojas, D-East Elmhurst, has introduced legislation (A.10692) that would require the state Insurance Law to require every insurance policy include coverage for inhalers for the treatment of asthma. That coverage would not be allowed to include a deductible, copayment, coinsurance or any other cost-sharing requirement.

According to state Health Department data, there are an estimated 1.4 million adults and more than 315,000 children with asthma.

“According to the U.S Food and Drug Administration in 2022 more than 20 million adults and over 4.5 million children were living with asthma – but this reality has done nothing to reduce the cost of asthma inhalers with the price of each life-saving device being as high as $640 a month in some instances,” Gonzalez-Rojas wrote.

The price cap announced earlier came after the drug companies faced pressure from the Biden administration to alleviate the financial burden on millions of Americans suffering from asthma and chronic obstructive pulmonary disease (COPD). Prior to the price cap, an investigation by the Democratic-led Senate Committee on Health, Education, Labor and Pensions noted AstraZeneca charges $645 in the U.S. for the same inhaler it charges $49 for in the U.K. Teva Pharmaceuticals, another major inhaler manufacturer, charges $286 in the U.S. for an inhaler that costs $9 in Germany.

Price caps also work differently depending on the inhaler manufacturer. The maker of AstraZeneca, for instance, has made its $35 price cap available for both privately insured and uninsured patients in the United States. A spokesperson for Boehringer Ingelheim said its $35 cap will be automatically applied at the pharmacy counter for the majority of eligible patients with commercial insurance. Those without insurance or who don’t use a participating pharmacy can visit the company’s website to enroll in a co-pay card that will cut the price of the company’s inhaler to $35.

But, those enrolled in government insurance programs, such as Medicare and Medicaid, aren’t eligible for any of the price cap programs because of federal restrictions.

Legislation has been introduced in recent years in the Illinois, Rhode Island, New Jersey and Minnesota state legislatures to limit the cost of asthma inhalers to $25 for a 30-day supply. The Illinois proposal was signed into law in August and states health insurance providers cannot deny or limit coverage for prescription inhalers, and insured individuals will pay no more than $25 for a 30-day supply of their inhaler.

“Illinois continues to be a leader in tackling rising medical costs,” said Sen. Mattie Hunter, D-Chicago. “This is one more step toward eliminating the barriers individuals face when managing long-term health conditions.”

Gonzalez-Rojas is looking to go one step further than the Illinois bill.

“Recently, manufacturers AstraZeneca, Boehringer Ingelheim, and GlaxoSmithKline committed to capping the out-of-pocket cost at $35 a month,” Gonzalez-Rojas wrote in her legislative justification. ” This bill will cap the cost of inhalers in New York state so we can treat asthma and save lives.”