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Insulin Rationing Persists Despite Policy Changes: Repeated Cross-Sectional Studies, 2017 vs 2024
Sefia Khan1, Nadera Rahman2, Laura M Nally3
1The University of Texas Medical Branch at Galveston, John Sealy School of Medicine, Galveston, TX, USA.
Journal of General Internal Medicine
|November 5, 2025
Summary
Despite policy changes, one in four patients rationed insulin due to cost in 2024, unchanged from 2017. Over a third faced broader rationing barriers, highlighting ongoing insulin access challenges.
Area of Science:
- Endocrinology
- Health Services Research
- Public Health
Background:
- Insulin is crucial for diabetes management but faces access barriers like high costs, leading to rationing.
- Recent policies aimed to reduce out-of-pocket insulin expenses.
Purpose of the Study:
- Compare cost-related insulin rationing rates in 2024 versus 2017.
- Examine broader insulin rationing linked to cost, insurance delays, or pharmacy shortages.
Main Methods:
- A 22-item cross-sectional survey was administered to adults with diabetes prescribed insulin.
- Data from 2024 (n=199) was compared to data from 2017 (n=199).
- The study assessed rates of cost-related and broader access barrier-related insulin rationing.
Main Results:
- Cost-related insulin rationing remained stable at approximately 24-25% between 2017 and 2024.
- In 2024, 37.7% of patients reported rationing due to cost, insurance delays, or pharmacy shortages.
- Type 2 diabetes patients had lower odds of rationing compared to type 1 diabetes patients.
Conclusions:
- Cost-related insulin rationing persists despite policy interventions.
- Over one-third of patients experienced rationing due to various access barriers.
- Comprehensive strategies are needed to improve insulin affordability and access.
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