Insulin-rationing Common among People with Diabetes Under 65

A recent study by Michael Fang, PhD, MHS and Elizabeth Selvin, PhD, MPH found that adults with diabetes younger than 65 were likely to ration insulin use due to out-of-pocket costs. The findings were published in a JAMA Research Letter on March 29, 2023 along with a Viewpoint and Medical News & Perspectives article related to insulin pricing. The researchers conducted telephone interviews from January to April 2021, followed by in-person interviews, which concluded in December 2021.

On August 16, 2022, President Biden signed the Inflation Reduction Act into law, capping the out-of-pocket cost of insulin to $35 a month for Medicare beneficiaries. However, the researchers found that 71% of all adults rationing insulin are under 65 and therefore would not be eligible for this new policy. This suggests most adults struggling to pay for their insulin will remain vulnerable to rationing, despite the passage of this new policy.

In March 2023 the three largest insulin manufacturers, Eli Lily, Sanofi, and Novo Nordisk, all decided to cap insulin prices at $35 a month and/or significantly reduce prices. These changes will likely improve insulin affordability for persons not covered by the Inflation Reduction Act.

“There have been major changes in policy and the private sector in the past few months that will likely improve insulin affordability substantially. It is important to celebrate major victories,” Fang noted. “However, these co-pay limits don’t fix the whole issue of insulin access. $35 a month is still not cheap, especially since people typically use insulin their whole lives. There is an opportunity to build on the current momentum and pass even broader reform for insulin access.”