If insulin copays were capped at $35, Part D enrollees would save 29% on average, according to new analysis from Kaiser Family Foundation.
Out-of-pocket spending by people with Medicare Part D for insulin products quadrupled between 2007 to 2019, while the number enrollees using insulin doubled, according to an updated analysis by the Kaiser Family Foundation (KFF). The number of enrollees using insulin increased from 1.6 million to 3.2 million, but out-of-pocket costs increased from $236 million to $923 million.
There is some good news, however. Between 2018 and 2019, aggregate out-of-pocket spending on insulin fell by 9%. This, KFF analysts said, reflects lower spending per prescription, as well as increased availability and use of lower-cost insulins.
Among insulin users without Part D low-income subsidies, average annual out-of-pocket spending on insulin per user increased by 60% between 2007 and 2019, from $324 to $520, but spending in 2019 was down 11% from 2018. Among these beneficiaries, 10% spent more than $1,200 on insulin in 2019 and 1% spent close to $2,100.
Among all insulin products available in 2019, average out-of-pocket costs per prescription across all insulin products was $49 in 2019, an increase of 28% since 2007, but a reduction of 13% from the average out-of-pocket cost per insulin prescription in 2018. (See Figure below.)
If insulin copays were capped at $35, Part D enrollees without subsidies would save 29% on average, based on spending of $49 per prescription in 2019, according to KFF.
Diabetes Management & Telehealth with Leslie Kolb
June 11th 2020Association of Diabetes Care and Education Specialists, chief science and practice officer, Leslie Kolb chats with MHE Associate Editor Briana Contreras in MHE's newest podcast Tuning into the C-Suite about diabetes management and how it's affected by the use of telehealth, especially during the current and trying times of the COVID-19 pandemic.
Listen
Are PBMs Putting GLP-1 Drugs on Their Formularies?
October 11th 2024PBMs are putting weight loss drugs, including Wegovy and Zepbound, on their national formularies, but coverage by plans is uneven. What is needed is more data about whether these drugs can lower overall healthcare costs.
Read More