to the editor: I applaud California's bold decision to offer CalRx brand insulin at lower prices (“Cheaper insulin will soon be available through California's state prescription program.” October 16). But for this effort to succeed, the state must address the middlemen and supply chain pressures that often wipe out patients' savings.
While pharmacies will buy a five-pack for $45 and sell it for $55, pharmacy benefit managers may still impose hidden fees or restrictive contracts that shift costs to the patient or put pressure on small pharmacies. Many independent pharmacies in California they have already closed after being reimbursed at a price below cost, creating access deserts.
To safeguard CalRx, the state should require transparency in pharmacies' fair reimbursement and benefit management practices. Senate Bill 41 It's a good start. California's insulin initiative is a big step forward, modeling an approach that can be successful nationwide if it protects both patients and the pharmacies that serve them.
Padmashree Muralidharan, San Diego
