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Insulin co-pays nearly flat as prices rise over last decade

Insulin prices have nearly tripled since 2006, although out-of-pocket costs for diabetics with insurance have remained flat, a new analysis has found. Photo by Myriams-Fotos/Pixabay
Insulin prices have nearly tripled since 2006, although out-of-pocket costs for diabetics with insurance have remained flat, a new analysis has found. Photo by Myriams-Fotos/Pixabay

June 1 (UPI) -- Insulin prices nearly tripled between 2006 and 2017, an analysis published Monday by JAMA Internal Medicine has found.

Even with these increases, however, out-of-pocket costs for those with health insurance coverage remained flat over the same period, the researchers reported.

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"Among commercially insured patients, high insulin prices do not necessarily translate to high out-of-pocket costs," study co-author Dr. Amir Meiri, a research fellow with the Harvard Medical School Department of Population Medicine and a practicing internist, told UPI.

For these patients, "insulin out-of-pocket costs are generally lower than expected and declining, except among patients in high-deductible health plans with health savings accounts, who must pay for the full cost of medications -- including insulin -- until they reach their deductible," Meiri said.

More than 30 million Americans have diabetes and require insulin therapy, according to the U.S. Centers for Disease Control and Prevention. With insulin costs rising, President Donald Trump and the Centers for Medicare and Medicaid Services announced plans last week to cap costs of the drug for Medicare patients.

The plan will cap insulin copays for more than 1,750 standalone Medicare Part D prescription drug plans and Medicare Advantage plans for seniors at $35 for a month's supply, officials said.

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For the new study, Meiri and colleagues reviewed data on more than 612,000 people with diabetes who collectively filed nearly 11 million insulin claims with private insurance carriers.

Median insulin 30-day prescription reimbursement prices increased from $143 in 2006 to $394 in 2017, researchers found. However, mean out-of-pocket costs for a 30-day supply of the drug were $36 in 2006, $45 in 2012 and $38 in 2017, they found.

In addition, patients' share of insulin reimbursement prices decreased from 24 percent in 2006 to 10 percent in 2017, the researchers said. Among all insulin users, out-of-pocket costs per member per month increased from $52 in 2006 to a peak of $72 in 2013, before dropping to $64 in 2017, they said.

However, out-of-pocket costs per member per month for those with a high-deductible health plan or health savings account increased from $93 in 2006 to a peak of $150 in 2014, before declining to $141 in 2017, researchers said.

"Health insurers are absorbing most of the price of insulin, but this likely contributes to rising health insurance premiums, a burden that affects all of us, but especially the poor," Meiri said.

"Given what we know from our study of a commercially insured population, I estimate somewhat arbitrarily capping insulin out-of-pocket costs for [Medicare] beneficiaries will lead to higher premiums down the line if Medicare cannot negotiate better prices; otherwise they will just absorb that difference in price and $35 cap," he said.

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