Cost of Insulin May Affect Gaps in Insulin Supply

Patients with type 1 or type 2 diabetes were more likely to experience gaps in their insulin supply when they were paying more than $35 for a 30-day supply, according to a poster presented at AMCP 2021.

“This data supports continuing and expanding efforts to limit insulin out-of-pocket costs for Medicare Advantage beneficiaries, as initiated by the Medicare Part D innovations Senior Savings Model,” reported Carrie McAdam-Marx, of University of Nebraska Medical Center, and colleagues.

Insulin prices increased 15% to 17% from 2012 to 2016, including out-of-pocket (OOP) costs. Medicare Part D Innovations Senior Savings Model caps insulin OOP costs at $35 for a 30-day supply. The retrospective cohort study looked at real-world administrative claims data for Medicare Advantage beneficiaries with type 1 or type 2 diabetes from 2006-2018 and tried to identify the association between insulin OOP cost and gaps in insulin supply.

Among patients with type 1 diabetes, 16.7% were paying $0-$20, 6.1% paid >$20-$35, 14.8% paid >$35-$50, and 57.7% paid >$50 for a 30-day supply. For patients with type 2 diabetes, 24.0% paid >$0-$20, 6.5% paid >$20-$35, 11.8% paid >$35-$50, and 52.9% paid >$50 for a 30-day supply.

Gap in insulin therapy was associated with insulin OOP costs greater than $35 for a 30-day supply. After controlling for baseline age, gender, race, region, index date year, income, education and other factors, the odds ratio for having a 60-day gap in insulin versus insulin OOP cost >$0-$20 for a 30-day supply was 1.42 for >$35-50 and 1.28 for >$50 for type 1 diabetes and 1.58 for >$35-$50 and 1.33 for >$50 for type 2 diabetes.

The researchers noted that OOP cost is based on average amount paid by the patient and the dataset does not include details on part D patient cost chare.

McAdam-Marx C, et al. Relationship between insulin out-of-pocket costs and non-persistence in Medicare patients with type 1 or type 2 diabetes. Poster E4. Presented at AMCP 2021; April 12-16, 2021.