As insulin prices in the U.S. continue to surge, lower-income diabetics are struggling to afford a drug their life depends on, researchers report in a JAMA Internal Medicine study published Dec. 3.
The study, authored by Darby Herkert, BS, and colleagues at the Yale School of Medicine, involved surveying 199 patients about the affordability of their medication and the likelihood that theyâ€™d skimp on insulin to cut costs. Subjects were 51 percent female, 61 percent white and 42 percent type 1 diabetics, and Herkertâ€™s team considered insulin â€śunderuseâ€ť as taking less insulin than prescribed, trying to â€śstretch outâ€ť insulin doses, failing to fill insulin prescriptions or stopping use altogether due to cost.
Of the diabetics surveyed, more than 25 percent admitted theyâ€™d compromised their insulin regimen to save moneyâ€”a result that generated considerable buzz after Herkert et al. initially presented their findings at the American Diabetes Associationâ€™s annual conference in June. While patientsâ€™ type of prescription drug coverage wasnâ€™t linked to underuse, a lower income was.
Nearly 40 percent of lower-income patients said they hadnâ€™t discussed the cost of insulin with their clinician, and 15 percent changed insulin type due to prices. In multivariable analysis, participants who reported cost-related insulin underuse were more likely to have poor glycemic control (43.1 percent compared to 28.1 percent of regular-use patients).