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FILE - In this April 18, 2017 file photo, Soila Solano prepares to inject herself with insulin at her home in Las Vegas. Solano was diagnosed with Type 2 diabetes six years ago. State Sen. Yvanna Cancela, a Las Vegas Democrat, and backers of a proposal to control insulin prices on Tuesday, May 2, 2017, 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. (AP Photo/John Locher, File)
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Nevada lawmaker strips refund provision from insulin bill

FILE - In this April 18, 2017 file photo, Soila Solano prepares to inject herself with insulin at her home in Las Vegas. Solano was diagnosed with Type 2 diabetes six years ago. State Sen. Yvanna Cancela, a Las Vegas Democrat, and backers of a proposal to control insulin prices on Tuesday, May 2, 2017, 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. (AP Photo/John Locher, File)

CARSON CITY, Nev. (AP) — A Nevada state lawmaker and backers of a proposal to control insulin prices on Tuesday 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.

Sen. Yvanna Cancela, a Las Vegas Democrat, said the provision was removed from the bill she is sponsoring with backing from casino owners and unions representing casino workers after legislative attorneys warned her 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 in an interview. “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 still have to notify state officials and insurance companies 90 days before increasing insulin prices by any amount and disclose insulin list prices, manufacturing costs, research investments and profit details.

The original 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, depending on insurance coverage.

A pared-down version of the bill retains what would be the strictest drug-price disclosure rules in the nation.

The bill also includes 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 identified no problems with those 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.”

It was scheduled for a vote on Wednesday.

The bill enjoys support from Nevada’s legislature, dominated by Democrats.

Nevada Gov. Bill Sandoval, a Republican, has not ruled out signing the bill into law.

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