Counterpoint: Legislators should make insulin policy, not give medical advice

The Minnesota Legislature is having a serious debate about how to bring down the soaring cost of prescription drugs. Lifesaving drugs have become inaccessible to many because of their high cost. Insulin is a particularly egregious example, tragically brought into focus by the death of Alec Smith, a young man who died because he had to ration the insulin he could no longer afford. We are working to find a way to prevent another unnecessary tragedy by ensuring that people who live with diabetes have access to the insulin they need to survive.

As legislators, we should not dispense medical advice. Rep. Jeremy Munson, R-Lake Crystal, inserted himself ("Over-the-counter insulin is a viable option," Oct. 4) into the patient-physician relationship by recommending that insulin-dependent diabetics use a $25 insulin option from Walmart.

As the only physicians in the Minnesota House, we feel compelled to respond.

Suggesting that a person with diabetes who cannot afford the insulin their physician prescribed buy a cheap alternative from Walmart is irresponsible and potentially dangerous. People who live with diabetes should consult carefully with their physician before changing their insulin regimen, and in an emergency situation, they should not change that regimen abruptly. Hours can be the difference between life and death, which highlights the need for an emergency option.

Munson argues that $25 insulin should be part of the solution because it's better than none at all. That reveals a misunderstanding of the nuance that exists in the treatment of diabetes, and a tacit acceptance of a two-tiered system of health care — one for those who can afford to pay, and another for those who cannot. It is reasonable to ask the pharmaceutical companies that have profited from the need of people with diabetes to participate in a solution that will save peoples' lives. The DFL-proposed Alec Smith Emergency Insulin Act requires drug companies to dedicate a small portion of their profits to help Minnesotans who are in emergency need of insulin.

Our proposal holds the pharmaceutical companies that doubled the price of this life-sustaining medication over the past decade accountable — companies like Sanofi, which increased the cost of its insulin by 49% in 2014 alone. People need this medication to stay alive. They have no choice.

The House DFL recently held a series of listening sessions around the state about the cost of insulin and other prescription drugs. We heard heartbreaking stories from people who are stretching their medication doses thinner and thinner because they can't afford their prescription refill. In fact, a recent survey showed that one in four diabetics in Minnesota report rationing their insulin. This is unacceptable.

We must find a way to make life-saving mediations affordable to the people that need them. In the meantime, let's ensure that there is a safety net available to people who need insulin to survive. We have made substantial progress with Senate Republicans in creating a real solution for diabetics in emergency situations without access to insulin. Let's not derail the quest for a bipartisan fix with uninformed medical advice. As physicians, we took a solemn oath to tread with care in matters of life and death. And for people who have diabetes, insulin is life and death.

Alice Mann, DFL-Lakeville, and Kelly Morrison, DFL-Deephaven, are physicians and members of the Minnesota House.