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State Out-Of-Pocket Caps On Insulin Costs: No Significant Increase In Claims Or Utilization.

Kelly E Anderson1, Nathorn Chaiyakunapruk2, Eric J Gutierrez3

  • 1Kelly E. Anderson (Kelly.E.Anderson@cuanschutz.edu), University of Colorado Anschutz Medical Campus, Aurora, Colorado.

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Summary
This summary is machine-generated.

State caps on insulin out-of-pocket spending did not increase insulin use among commercially insured patients. This may be because out-of-pocket costs were often below the capped amounts.

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Area of Science:

  • Health Economics
  • Diabetes Management
  • Pharmaceutical Policy

Background:

  • Insulin is crucial for managing type 1 diabetes and is used by 20-30% of type 2 diabetes patients.
  • High insulin costs lead to underuse in about 25% of insulin-using patients.
  • Over twenty states have enacted monthly insulin out-of-pocket spending caps ($25-$100) to address affordability.

Purpose of the Study:

  • To evaluate the impact of state-level insulin out-of-pocket spending caps on insulin usage.
  • To determine if these caps influence medication adherence among commercially insured individuals.

Main Methods:

  • A difference-in-differences analysis was employed.
  • The study included 33,134 commercially insured individuals aged 18-64 with type 1 or insulin-treated type 2 diabetes.
  • Data were sourced from a 25% sample of the IQVIA PharMetrics database between 2018-21.

Main Results:

  • State-level insulin out-of-pocket caps did not significantly increase quarterly insulin claims.
  • No significant change in insulin usage was observed for patients with type 1 or type 2 diabetes.
  • The lack of increase may be attributed to out-of-pocket expenses frequently being below the implemented cap amounts.

Conclusions:

  • State-level caps on insulin out-of-pocket spending did not demonstrably increase insulin use among commercially insured enrollees.
  • Further research may be needed to explore alternative strategies for improving insulin access and affordability.
  • Policy implications suggest that current cap structures may not be sufficient to overcome cost barriers to insulin use.