Trends in insulin out-of-pocket costs and use disparities, 2008-2021

Am J Manag Care. 2025 Aug;31(8):408-412. doi: 10.37765/ajmc.2025.89773.

Abstract

Objective: To assess trends in insulin out-of-pocket (OOP) costs, use, and disparities among commercially insured patients from 2008 to 2021.

Study design: Retrospective time series from a national insurance database, with members in all US states, including data from 2008 to 2021.

Methods: Insulin OOP costs and 30-day equivalent fills per year were quantified among insulin users aged 12 to 64 years, stratified by income (low- vs high-poverty zip code) and health plan type (high-deductible health plans with savings options [HDHP/SO] vs not). Participants were commercially insured insulin users aged 12 to 64 years with at least 1 full enrollment year. Characteristics of interest for disparities analysis included income level (low- vs high-poverty zip code) and health plan type (HDHP/SO vs non-HDHP/SO plan).

Results: After increases in adjusted mean annual insulin OOP costs from 2008 ($221 per non-HDHP/SO member and $313 per HDHP/SO member) to 2014 ($280 and $496, respectively), HDHP/SO members had persistent relative reductions in insulin use. In 2014, HDHP/SO members had 0.17 fewer annual fills, a disparity that increased until 2019 (0.79) before decreasing slightly by 2021 (-0.55). Lower-income members consistently had fewer insulin fills.

Conclusions: Insulin OOP cost reduction policies would be more efficient if they targeted HDHP/SO plan members and low-income patients.

MeSH terms

  • Administrative Claims, Healthcare / statistics & numerical data
  • Adolescent
  • Adult
  • Child
  • Diabetes Mellitus / drug therapy
  • Diabetes Mellitus / economics
  • Fees, Pharmaceutical* / statistics & numerical data
  • Fees, Pharmaceutical* / trends
  • Female
  • Health Expenditures* / statistics & numerical data
  • Health Expenditures* / trends
  • Healthcare Disparities* / economics
  • Healthcare Disparities* / statistics & numerical data
  • Healthcare Disparities* / trends
  • Humans
  • Hypoglycemic Agents* / economics
  • Hypoglycemic Agents* / therapeutic use
  • Insulin* / economics
  • Insulin* / therapeutic use
  • Insurance, Health / economics
  • Insurance, Health / statistics & numerical data
  • Male
  • Middle Aged
  • Retrospective Studies
  • United States
  • Young Adult

Substances

  • Insulin
  • Hypoglycemic Agents