Cost drives one in six US adults to ration insulin

Author: Eleanor McDermid

medwireNews: Findings from a nationally representative US survey show that a substantial minority of people with diabetes ration their use of insulin because of issues with affordability.

As reported in the Annals of Internal Medicine, Adam Gaffney (Cambridge Health Alliance, Massachusetts, USA) and colleagues looked at the responses of 982 people with insulin-treated diabetes who participated in the 2021 National Health Interview Survey.

In total, 16.5% of these people reported having rationed insulin use for financial reasons over the preceding 12 months. The researchers say this equates to 1.3 million adults with diabetes nationwide having rationed insulin during the study period.

The most common form of rationing to save money among people with type 1 diabetes was taking less insulin, at 16.5%, and 14.4% had at some point delayed buying insulin to save money.

People with type 2 diabetes were more likely to delay buying insulin, at 13.8%, than to reduce the amount used, at 9.5%.

Skipping an insulin dose to save money was the least frequent form of rationing; nevertheless, 8.1% of people with type 1 diabetes and 10.4% of those with type 2 diabetes reported having done this.

The highest rate of insulin rationing was seen among uninsured people, at 29.2%, but the researchers note that “it was also common among adults with private coverage [at 18.8%], which often requires higher cost sharing than public insurance.”

Other groups with high rates of rationing were people younger than 65 years, at 20.4% versus 11.2% of older people, and Black people, at 23.2% versus 16.0% of those with White or Hispanic ethnicity.

Finally, Gaffney and team found that rationing insulin was significantly and independently associated with a 1.48-fold increased likelihood of feeling overwhelmed by the demands of living with diabetes.

“By limiting insulin copays to $35 [€ 35.1] per month under Medicare, the 2022 Inflation Reduction Act may improve insulin access for seniors, who experienced substantial rationing in our study,” they conclude.

“However, a similar cap for the privately insured was removed from the bill, and copay caps do not aid the uninsured. Further reform could improve access to insulin for all Americans.”

medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2022 Springer Healthcare Ltd, part of the Springer Nature Group

Ann Intern Med 2022; doi:10.7326/M22-2477

Image Credits: © Karl-Hendrik Tittel / Getty Images / iStock

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medwireNews Deputy Bureau Chief