Out-of-Pocket Spending on Insulin Tripled in 11 Years

Written by Sari Harrar

Commentary by lead researcher Philip Clarke, Ph.D., professor of Health Economics at the University of Melbourne, Australia.

People with type 2 diabetes who use insulin saw out-of-pocket expenses for this essential blood sugar-lowering drug triple between 2002 and 2013, according to a new study published today in the Journal of the American Medical Association. In contrast, prices for other widely-used diabetes medications rose slightly or even dropped.

Spending for insulin in the United States increased from $231 a year in 2002 to $736 a year in 2013 for people with type 2 diabetes. They spent more on insulin, per person, than on all other diabetes drugs combined. Lead researcher Philip Clarke, Ph.D., professor of Health Economics at the University of Melbourne, Australia, told EndocrineWeb.com in an email interview that the rise could make it difficult for people on a tight budget to stick with their insulin treatment as prescribed by their doctor. “When a patient pays for a significant proportion of the cost of insulin, price changes may impact compliance and this may have negative impact on a patient’s health,” he says.

The researchers analyzed prescription-drug information from 27,878 Americans with type 2 diabetes who had participated in the U.S. government’s huge, annual Medical Expenditure Panel Surveys. Nearly 30% used insulin. The researchers did not include people with type 1 diabetes, who typically use more insulin than those with type 2 diabete. The study is notable because it looks at what people with and without health insurance actually paid for their diabetes medications. It found that:

Dr. Clarke says doctors and other healthcare practitioners should take a second look at these and other diabetes drugs for those who are struggling to afford insulin. “A key factor behind the increased prescribing of insulin has been its use in treating people with type 2 diabetes,” he says. “There are now a wide range of treatment options for people with type 2 diabetes including several types of new oral therapies. Some of these newer therapies such as empagliflozin (Jardiance, Glyxambi, Synjardy)2 have recently been shown to have significant benefits including lowering the risk of cardiovascular disease and mortality. The incremental benefit and cost of using insulin should be assessed alongside other treatment options.”




Hua X, Carvalho N, Tew M, Huang ES, Herman WH, Clarke P: Expenditures and Prices of Antihyperglycemic Medications in the United States: 2002-2013. JAMA April 5, 2016 Volume 315, Number 13. http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.2016.0126


1. US Food and Drug Administration: List of FDA-approved DPP-4 inhibitors


2. MedlinePlus: Empagliflozin. Revised February 15, 2016. Accessed April 5, 2016



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