About nine percent of Americans–30 million people in the US–have diabetes. A new Yale study finds that 14 percent of insulin users—-almost one in seven of them–struggle to pay for insulin. Democrats in Congress tried to include a provision in the Inflation Reduction Act that would have limited the cost of insulin to $35 a month for everyone, but only the limit on insulin costs for people with Medicare survived.
Seven million Americans use insulin every day. Its price has doubled in the last ten years. After covering costs for food and housing, 14 percent of diabetics must spend at least 40 percent of their remaining income on insulin.
The Yale researchers found that 1.2 million diabetics reached “catastrophic spending” on insulin in a single year. Of those, 800,000 were people with Medicare.
Insulin is not the only health care cost for people with diabetes. Among other things, they need glucose monitors and insulin pumps. These costs are too often prohibitive.
Notably, the researchers found that people with Medicaid, who have more comprehensive coverage than people with Medicare, were less than half as likely to reach catastrophic spending on insulin.
Prices for insulin have soared since Eli Lilly launched Humalog, an insulin brand. Back in 1996, a vial cost $21. Today, that same vial costs more than $210. The Yale study’s lead author believes that insulin prices are likely to keep rising.
The researchers also found that people with Medicare felt the burden of high insulin costs more than any other cohort of people with diabetes because their average annual income is lower. Provisions in the Inflation Reduction Act are intended to keep insulin prices from rising more than the rate of inflation for people with Medicare as well as to cap out-of- pocket insulin costs at $35 a month. Already, at least one Medicare Part D prescription drug plan in every state covers insulin at $35 a month. But, $35 a month for insulin alone is prohibitively expensive for a lot of people with Medicare.
The researchers argue that any government savings from not making insulin affordable to people with Medicare in the short-term will mean much higher health care spending in the long-term. We can expect to see greater disabilities among people with diabetes who can’t afford their insulin, more hospital admissions, and more emergency room visits stemming from complications.
Here’s more from Just Care:
- You might pay less for insulin through Medicare Part D, beginning in 2021
- Drug provisions in the reconciliation bill should lower your costs
- Congress proposes reforms to ensure timely access to care in Medicare Advantage
- Four things to think about when choosing between traditional Medicare and Medicare Advantage plans
- The deadly consequences of out-of-pocket drug costs
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