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Objective: To identify the association between insulin out-of-pocket costs (OOPC) and adherence to insulin in Medicare Advantage (MA) patients. Data Sources and Study Setting: The study is based on Optum Labs Data Warehouse, a longitudinal, real-world data asset with de-identified administrative claims and electronic health record data. Study Design: Using descriptive and multivariable logistic regression analyses, we identified the likelihood of patients with diabetes having [greater than or equal to]60 consecutive days between an expected insulin fill date and the actual fill date (refill lapse) by OOPC, categorized by $0, >$0-$20 (reference), >$20-$35, >$35-$50, and > $50 per 30-day supply. Data Collection/Extraction Methods: The study included MA enrollees with type 1 or type 2 diabetes and prescription claims for insulin between 2014 and 2018. Principal Findings: Those with average insulin OOPC per 30-day supply >$35 or $0 were more likely to have an insulin refill lapse versus OOPC of >$0 to $20, with odds ratios ranging 1.18 (95% CI 1.13-1.22) to 1.74 (95% CI 1.66-1.83) depending on OOPC group and diabetes type. Conclusions: Capping average insulin OOPC at $35 per 30-day supply may help avoid cost-related insulin non-adherence in MA patients; efforts to address non-cost barriers to medication adherence remain important. KEYWORDS cost-share, diabetes, insulin, Medicare Advantage, medication adherence What is known on this topic * Insulin prices have increased dramatically over the past 15 years as have patient out-of-pocket costs (OOPC) for insulin. * OOPC is a known barrier to diabetes medication adherence, including insulin. * The Medicare Part D Innovations Senior Savings Model is a pilot program that limits insulin prescription OOPC to $35 per month for select insulins through participating enhanced Part D plans. What this study adds * Over 30% of Medicare Advantage enrollees taking insulin had a lapse of 60 or more consecutive days between the time an insulin prescription was due for a refill and the actual refill date. * Those with average insulin OOPC per 30-day supply of more than $35 were more likely to have an insulin refill lapse than those who paid out-of-pocket for insulin but at an amount of $20 or less. * Capping insulin OOPC to no more than $35 per 30-day supply may help to avoid cost-related non-adherence, but efforts to address other barriers to adherence continue to be important., 1 | INTRODUCTION In response to rising insulin prices and patient cost share, (1,2) states and payers have implemented policies limiting patients' share of insulin cost. By the end of [...]

OBJECTIVE--To determine the association between laboratory-derived measures of glycemic control ([HbA.sub.1c]) and the presence of renal complications (measured by proteinuria and estimated glomerular filtration rate [eGFR]) with the 5-year costs [...]

OBJECTIVE--To estimate the direct medical costs of hypertensive patients with type 2 diabetes by the level of proteinuria and to evaluate the differences between patients whose nephropathy did and did [...]

OBJECTIVE--To examine the effect of a lifestyle intervention to produce weight loss and increased physical fitness on use and cost of medications to treat cardiovascular disease (CVD) risk factors in [...]

According to the National Diabetes Statistics Report from the CDC, an estimated 30.3 million Americans had diabetes in 2017, 7.2 million of whom were undiagnosed. Approximately 5% had type 1 [...]

According to the 'National Diabetes Statistics Report' from the CDC, an estimated 30.3 million Americans had diabetes in 2017. 7.2 million of whom were undiagnosed. Approximately 5% had type 1 [...]

The Endocrine Society has issued a new position statement calling on all stakeholders, including clinicians, to play a role in reducing the cost of insulin for patients with diabetes in [...]

OBJECTIVE -- We examined whether cardiovascular disease (CVD) affects medical care costs differently in subjects with and without diabetes and explored the impact of CVD on costs across the dimensions [...]

OBJECTIVE -- To model the lifetime costs associated with complications of type 2 diabetes. RESEARCH DESIGN AND METHODS -- A cohort of 10,000 patients with diabetes was simulated using a [...]

Many people with diabetes benefited from the passage of the Affordable Care Act (ACA). It expanded their access to care and lowered their costs, says Derek S. Brown, PhD, assistant [...]

FROM THE ANNUAL MEETING OF THE AMERICAN ASSOCIATION OF DIABETES EDUCATORS LAS VEGAS--Insulin pump therapy may be cost saving compared with multiple daily injections for patients with type 2 diabetes [...]

WASHINGTON -- Americans living with undiagnosed diabetes incur about $18 billion in health care expenditures each year because of medical services and lost productivity from diabetes-related complications, or $2,864 per [...]

A new study found that health care for people with diabetes costs an average of $3,494 a year more than for those without the disease. Researchers at the northern California […]

Diabetes information centers can spur pharmacy growth Do a thorough analysis both of yourself and of your store if you are seriously thinking of setting up a diabetes information center. [...]