Patients Report Skimping on Insulin Because of Cost

JAMA Internal Medicine

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, DECEMBER 3, 2018

Media advisory: To contact study author Kasia J. Lipska, M.D., M.H.S., email Ziba Kashef at ziba.kashef@yale.edu. The full study is available on the For The Media website.

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Bottom Line: In a small survey of patients at an urban diabetes center, 1 in 4 reported skimping on their prescribed insulin because of cost and this was associated with poor glycemic control. Insulin is lifesaving for people with diabetes and is listed as an essential medicine by the World Health Organization, which means that it should be available at a price individuals and the community can afford. Insulin prices have increased substantially in the past decade in the United States and so have out-of-pocket prescription costs. Of the 199 patients with type 1 or type 2 diabetes who were prescribed insulin and who completed the survey, 51 (25.5 percent) reported cost-related underuse of insulin. Underuse included using less than prescribed, trying to stretch out insulin, smaller doses, stopping insulin, not filling a prescription or not starting prescribed insulin. More than a third of the patients with cost-related underuse didn’t discuss the matter with their doctor. The single-center study may be limited in  its broader ability to be generalized but researchers conclude the results highlight an urgent need to address the affordability of insulin.

Authors: Kasia J. Lipska, M.D., M.H.S., of the Yale School of Medicine, New Haven, Connecticut, and coauthors

Related Material: The invited commentary, “When High Prices Mean Needless Death,” by Elisabeth Rosenthal, M.D. , of Kaiser Health News, Washington, D.C., also is available on the For The Media website.

To Learn More: The full study is available on the For The Media website.

(doi:10.1001/jamainternmed.2018.5008)

Editor’s Note: The article contains conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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