The Rising Cost of Insulin – How Medicaid Expansion Effects the Price of Diabetes Medication

 

In recent times, there has been an increase in the price of medication for diabetes. Insulin, specifically has seen a tremendous rise in cost, to the point where people have to ration their insulin because they cannot afford to buy any more. This can lead to devastating health consequences and complications with diabetes. Medicaid expansion has helped to make insulin more affordable and available for those who need it. In states that have adopted Medicaid expansion, those with diabetes, especially those with low income, are more likely to be able to afford their diabetes medication. A study released in 2018 showed that the states who expanded Medicaid in 2014-2015 found a 40% increase in filled insulin prescriptions. This indicates that medication is more affordable when a greater number of the population has insurance covered by Medicaid. Additionally, this indicates that the out of pocket cost for diabetes medication decreases through Medicaid. The number of filled prescriptions is expected to increase as more people are covered by Medicaid.

 

Making diabetes medication more affordable can have long lasting economic impacts to states as well. Diabetes medication is expensive but by making medication more affordable, more people will adhere to their prescriptions. This will reduce adverse health outcomes and reduce the financial burden of diabetes on health care. In 2017, the CDC released a study that claimed those who were treated for diabetes caused an approximate $6300 reduction in overall health care cost for their state. As Florida currently does not have Medicaid expansion, the state is not able to see these financial and health benefits that come with making insulin and other diabetes medication more affordable.

 

The Trump Administration has recently announced a reduction of out of pocket insulin costs for Medicare Part D recipients. This would reduce the cost of insulin and other diabetes medications for seniors that rely on federal and state funded insurance options to afford insulin. This plan will be in effect in 2021. This plan can help reduce the overall costs of insulin.

 

According to the Kaiser Family Foundation, “the Administration’s new model that allows participating Part D plans to cap monthly out-of-pocket insulin costs could help some beneficiaries with their insulin costs, if they are enrolled in a participating Part D plan and use an insulin product covered by their plan with a $35 copayment. But the new model applies to a subset of plans and enrollees (those without low-income subsidies in enhanced plans), and not all insulin products have to be covered by all participating plans. The new model also does not address underlying list price increases for insulin or affordability concerns for people who are uninsured or covered by other sources of coverage.”

While this plan does not include Medicaid recipients, it can potentially be expanded to further reduce costs for those with Medicaid insurance. Expanding Medicaid in Florida can reduce the cost of insulin and other diabetes medications. It can reduce the financial burden of diabetes and if the reduction to out of pocket costs for insulin proposed by the Trump Administration is extended to benefit Medicaid recipients the economic impact could be even bigger.

 

 

References:

 

Bartolone P. (2018) Medicaid Expansion Making Diabetes Meds More Accessible to Poor, Study Shows. The Washington Post. Retrieved from: https://www.washingtonpost.com/national/health-science/medicaid-expansion-making-diabetes-meds-more-accessible-to-poor-study-shows/2018/08/06/b8a1316c-99bb-11e8-a8d8-9b4c13286d6b_story.html

 

Myerson R, Lu T, Tonnu-Mihara I, and Huang E S. (2019). Medicaid Eligibility Expansions May Address Gaps in Access to Diabetes Medications. Health Affairs. 37(8).

 

President Trump Announces Lower Out of Pocket Insulin Costs for Medicare’s Seniors. (2020). Retrieved from: https://www.cms.gov/newsroom/press-releases/president-trump-announces-lower-out-pocket-insulin-costs-medicares-seniors

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