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Out-of-pocket insulin cost has nearly doubled

For adults with type 2 diabetes, the out-of-pocket cost of each insulin prescription and refill nearly doubled during a 10-year period, rising from $19 to $36, according to a research letter to the editor published online June 11 in JAMA.

Using information from the Optum Labs Data Warehouse, an administrative claims database of privately insured patients throughout the United States, investigators calculated the proportion of 123,486 adults with type 2 diabetes who purchased every type of insulin each year from 2000 through 2010.

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The use and cost of analog insulins rose significantly from 2000 to 2010.

"We found a large increase in the prevalent use of insulin analogs," said Dr. Kasia J. Lipska, an endocrinologist in the department of internal medicine, Yale University, New Haven, and her associates.

In 2000, only 18.9% of these patients filled (and refilled) prescriptions for insulin analogs. By 2010, that proportion had risen to 91.5%. Correspondingly, out-of-pocket expenditures for insulin therapy increased from $19 to $36. However, the rate of severe hypoglycemic events in insulin users did not decline significantly in that time, going from 21.1 to 17.7 events per 1000 person-years. "The clinical value of this change is unclear," they noted (JAMA 2014;311:2331-3).

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For adults with type 2 diabetes, the out-of-pocket cost of each insulin prescription and refill nearly doubled during a 10-year period, rising from $19 to $36, according to a research letter to the editor published online June 11 in JAMA.

Using information from the Optum Labs Data Warehouse, an administrative claims database of privately insured patients throughout the United States, investigators calculated the proportion of 123,486 adults with type 2 diabetes who purchased every type of insulin each year from 2000 through 2010.

© crazydiva/Thinkstock
The use and cost of analog insulins rose significantly from 2000 to 2010.

"We found a large increase in the prevalent use of insulin analogs," said Dr. Kasia J. Lipska, an endocrinologist in the department of internal medicine, Yale University, New Haven, and her associates.

In 2000, only 18.9% of these patients filled (and refilled) prescriptions for insulin analogs. By 2010, that proportion had risen to 91.5%. Correspondingly, out-of-pocket expenditures for insulin therapy increased from $19 to $36. However, the rate of severe hypoglycemic events in insulin users did not decline significantly in that time, going from 21.1 to 17.7 events per 1000 person-years. "The clinical value of this change is unclear," they noted (JAMA 2014;311:2331-3).

For adults with type 2 diabetes, the out-of-pocket cost of each insulin prescription and refill nearly doubled during a 10-year period, rising from $19 to $36, according to a research letter to the editor published online June 11 in JAMA.

Using information from the Optum Labs Data Warehouse, an administrative claims database of privately insured patients throughout the United States, investigators calculated the proportion of 123,486 adults with type 2 diabetes who purchased every type of insulin each year from 2000 through 2010.

© crazydiva/Thinkstock
The use and cost of analog insulins rose significantly from 2000 to 2010.

"We found a large increase in the prevalent use of insulin analogs," said Dr. Kasia J. Lipska, an endocrinologist in the department of internal medicine, Yale University, New Haven, and her associates.

In 2000, only 18.9% of these patients filled (and refilled) prescriptions for insulin analogs. By 2010, that proportion had risen to 91.5%. Correspondingly, out-of-pocket expenditures for insulin therapy increased from $19 to $36. However, the rate of severe hypoglycemic events in insulin users did not decline significantly in that time, going from 21.1 to 17.7 events per 1000 person-years. "The clinical value of this change is unclear," they noted (JAMA 2014;311:2331-3).

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Out-of-pocket insulin cost has nearly doubled
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type 2 diabetes, insulin, prescription, refill, JAMA, Optum Labs Data Warehouse, diabetes, Dr. Kasia J. Lipska, endocrinology,
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type 2 diabetes, insulin, prescription, refill, JAMA, Optum Labs Data Warehouse, diabetes, Dr. Kasia J. Lipska, endocrinology,
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Key clinical point: The use and cost of analog insulins rose significantly from 2000 to 2010.

Major finding: Only 18.9% of patients filled (and refilled) prescriptions for insulin analogs in 2000, a proportion that rose to 91.5% by 2010; correspondingly, out-of-pocket expenditures for insulin therapy increased from $19 to $36 per prescription/refill during the study period.

Data source: A retrospective analysis of time trends from 2000 to 2010 in insulin use among 123,486 adults with type 2 diabetes.

Disclosures: This study was supported by the Agency for Healthcare Research and Quality. Dr. Lipska reported no potential financial conflicts of interest; her associates reported ties to FAIR Health, Medtronic, Johnson & Johnson, and Optum Labs.