Insulin: More than one million people in the drug ration in the United States due to high costs

According to the results of a national survey, approximately 1.3 million adults with diabetes in the United States rationed their insulin supply in 2021 to save money.

Health


October 17, 2022

Insulin costs vary widely in the United States depending on the type of insurance someone has

Clynt Garnham Doctor / Alamy

An estimated 1.3 million adults in the United States are on an insulin ration for diabetes due to the high cost, increasing the risk of diabetes-related complications such as organ damage, blindness and even death.

In the United States, drug manufacturers charge nearly $ 100 on average for a standard unit of insulin compared to $ 12 in Canada or $ 7.52 in the UK. Depending on their health insurance, some people in the United States pay next to nothing for insulin, while others end up bearing the full cost.

Adam Gaffney of the Cambridge Health Alliance in Massachusetts and his colleagues looked at data from the 2021 National Health Interview Survey to see how those costs affect insulin use. Each year, the U.S. Centers for Disease Control and Prevention administers the adult survey of a sample of U.S. households to collect data on income, health status, insurance coverage, and more.

In 2021, 982 people who have diabetes and use insulin responded to the survey, which for the first time asked whether they had skipped their insulin doses, taken less insulin than needed, or delayed their insulin purchase in the past year to save money. money. About 16.5% of the group answered affirmatively to at least one of these questions. The CDC designed the survey to be nationally representative, so Gaffney and the team extrapolated it to estimate that about 1.3 million American adults on diabetes insulin ration.

“This says something very troubling about the state of our healthcare system,” says Gaffney. Without insulin, many people with diabetes cannot control their blood sugar levels, which increases the risk of chronic complications, she says.

People without health insurance had the highest rates of insulin rationing with nearly 30% restricted insulin use. About 19% of people with private health insurance also rationed insulin compared to 16% of those with Medicare, the federal health insurance program for people aged 65 and over. This is likely due to the high out-of-pocket costs associated with some private insurance plans, Gaffney says.

People who were black, under the age of 65, or considered low-to-middle income were also more likely to ration insulin than people from other socioeconomic groups. It is already known that these demographics face higher insulin costs due to health disparities, says Andrew Mulcahy of the RAND company in Washington DC.

Earlier this year, Congress passed legislation under the Inflation Reduction Act that capped insulin costs to $ 35 for Medicare beneficiaries. A previous provision of the bill included a similar cap for people with private insurance, but this was removed during the negotiations.

“I don’t think it will drastically move the needle because the Medicare population is already doing relatively well on this measure,” Mulcahy says. “To really address the root of the problem, you also need to think about how to reach patients with private coverage and, most importantly, patients without any coverage.”

Journal reference: Annals of Internal MedicineDOI: 10.7326 / M22-2477

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