
Although the cost of insulin has risen dramatically over the years and prompted a political furor, a new analysis contradicts the widely-held view that out-of-pocket spending is “excessive” – at least for many privately insured people with diabetes. But some experts say the situation is much more complicated.
Between 2006 and 2017, private health plans saw their costs nearly triple, from a median of $143 for a 30-day prescription to $394, according to the analysis published in JAMA Internal Medicine. But at the same time, overall out-of-pocket spending by patients did not show a similar increase.
Kudos to the authors for dispelling a false media narrative about “skyrocketing” out-of-pocket costs for insulin.
But this sentence is just crazy: “The analysis did not take into account any rebates or discounts that insulin makers gave health plans, which means insurer spending may have been overestimated. ”
May have?!? Insulin is perhaps the most highly rebated category in the U.S. market. Extensive evidence (including studies published in JAMA) shows that net, post-rebate insulin costs have been falling for years.
A drug’s list price does not equal its “cost” to anyone and has no impact on premiums. That’s especially true for insulin. A one-line disclaimer buried in the paper’s limitations section does not absolve the authors of responsibility for pushing a false narrative about the “root of the problem.” Their policy recommendations are ill-informed given the actual economic realities of insulin.