Medicare’s $35 Insulin Cap Lowered Beneficiary Costs, Increased Use for Some

The monthly spending limit improved adherence for insulin users who had especially high costs, new JAMA study finds

Medicare’s new out-of-pocket insulin cap reduced and stabilized beneficiaries’ monthly spending on the drug while increasing its use among those with previously high costs, according to a new JAMA study from researchers at the USC Schaeffer Center for Health Policy & Economics.

The Inflation Reduction Act (IRA) capped monthly insulin costs at $35 for Medicare beneficiaries amid concerns that seniors were rationing or skipping doses, increasing the risk of dangerous complications. Millions of Medicare beneficiaries use the life-saving drug, spending more than a combined $1 billion out of pocket annually before the IRA.

Authors of the study are Rebecca Myerson, John Romley, Dima Mazen Qato, Erin Trish and Anne Peters of USC and Ying Cao of the University of Wisconsin-Madison. See the study for author disclosures.

The research was funded by a grant from the National Institute of Diabetes and Digestive and Kidney Diseases (R01DK141885).

Read more at the Schaeffer Institute

USC Alfred E. Mann School of Pharmacy and Pharmaceutical Sciences
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