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https://www.kff.org/medicare/issue-brief/insulin-out-of-pocket-costs-in-medicare-part-d/

About a third of Medicare enrollees have diabetes. Medicare Part D out-of-pocket spending on insulin in 2020 was over 4x spending in 2007. 

The average price per insulin product in 2020 was about $54, but with a very large variance up to $116. The average price is up $15 from 2007. The annual out-of-pocket spending per person was $572 in 2020, but as high as $2,333 for some enrollees. The annual out-of-pocket spending per person is up $248 from 2007.

The $35 cap on insulin for Medicare enrollees in the Inflation Reduction Act would reduce the price by about ~35% from the 2020 average.

This is a band-aid to a systemic problem. There are 3 insulin manufacturers. 

Insulin analogs are still on patent. Insulin devices are also still on patent. Biosimilars for insulin glargine only just were approved and only one of them is interchangeable. There isn't really any competition for insulin on the supply side.

Anyways this cap is for out of pocket costs. Not total costs

If we were taking about ideal policy, I'd push for systemic changes, but I'm aware that ideal is not possible in this political environment. My second choice ideal would be public private insulin manufacturing like what California is trying. This cap is not my ideal, but there aren't many good politically realistic options for the insulin cost situation.


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