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Insulin affordability and the Inflation Reduction Act: Medicare beneficiary savings by state and demographics
Insulin affordability and the Inflation Reduction Act: Medicare beneficiary savings by state and demographics
- Collection:
- Health Policy and Services Research
- Series Title(s):
- Data point (United States. Department of Health and Human Services. Office of the Assistant Secretary for Planning and Evaluation. Office of Health Policy)
- Author(s):
- Sayed, Bisma A., author
Finegold, Kenneth, 1957- author
Olsen, T. Anders, author
De Lew, Nancy, author
Sheingold, Steven, author
Ashok, Kaavya, author
Sommers, Benjamin D., author - Contributor(s):
- United States. Department of Health and Human Services. Office of the Assistant Secretary for Planning and Evaluation. Office of Health Policy, issuing body.
- Publication:
- Washington, D.C. : Office of the Assistant Secretary for Planning and Evaluation, Office of Health Policy, January 24, 2023
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Costs and Cost Analysis
Drug Costs -- legislation & jurisprudence
Drug Costs -- statistics & numerical data
Insulin -- economics
Medicare -- economics
State Government
Ethnicity
Racial Groups
United States
United States. - Genre(s):
- Technical Report
- Abstract:
- The Inflation Reduction Act (IRA) caps insulin out-of-pocket spending at $35 per month’s supply of each insulin product covered under a Medicare Part D plan, with similar limits for out-of-pocket costs for insulin supplied under Part B, and reduces out-of-pocket drug spending in Medicare in other ways. These provisions will make insulin more affordable for people covered by Medicare. We examined out-of-pocket spending on insulin using 2019 survey data for individuals with Medicare, Medicaid, or private insurance, and for those without health coverage. We then estimated the potential effects of the IRA’s insulin cap provisions on out-of-pocket spending for insulin among Medicare beneficiaries using 2020 Medicare claims data. Nationally, the average out-of-pocket cost was $58 per insulin fill, typically for a 30-day supply. The average cost per fill among people who were uninsured for the entire year was $123, more than double the national average. Patients with private insurance or Medicare paid about $63 per fill on average. About 37 percent of insulin fills for Medicare enrollees (Part B and Part D)required cost-sharing exceeding $35 per fill, including 24 percent that exceeded$70 per fill. About 36 percent of insulin fills for people without insurance and 35 percent for people with private insurance had cost sharing above $35 per fill. These estimates are only for enrollees who filled an insulin prescription and do not include potential costs for patients who did not fill their insulin due to cost or other reasons. We estimate that 1.5 million Medicare beneficiaries would have benefited from the new IRA insulin cost-sharing limits if they had been in effect in 2020, with savings to those beneficiaries of about $734 million in Part D and $27 million in Part B--or approximately $500 in average annual savings per person among those benefiting from the provision.
- Copyright:
- The National Library of Medicine believes this item to be in the public domain. (More information)
- Extent:
- 1 online resource (1 PDF file (15 pages))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 9918591688606676 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/9918591688606676