Association of State Insulin Out-of-Pocket Caps With Insulin Cost-Sharing and Use Among Commercially Insured Patients With Diabetes : A Pre-Post Study With a Control Group
An erratum to this article was published (Ann Intern Med, Jun 2026 ↗)
Authors' conclusion
Insulin OOP caps were associated with reduced insulin OOP costs but no overall increases in insulin use. A proposed national insulin cap of $35 for commercially insured persons might lead to meaningful insulin OOP savings but have a limited effect on insulin use.
Study context
- Population
- Commercially insured persons with diabetes and insulin users younger than 65 years; single national insurer
- Comparison
- States with insulin out-of-pocket (OOP) caps vs control states
- Outcome
- Mean monthly 30-day insulin fills and OOP costs
Methodological detailscontrolled pre-post, Single national insurer; 9-month follow-up
- Controlled pre-post
- Single national insurer; 9-month follow-up
Main finding
As reported in the abstract
Insulin use (relative change in fills per month), overall population
State insulin caps not associated with changes in insulin use in the overall population; relative change in fills per month
1.8%
95% CI −3.2% to 6.9%
Further findings
| Outcome | Insulin OOP cost reduction (CI) |
|---|---|
| Insulin OOP costs, states with $25 to $30 caps | 40.0% (−62.5% to −17.6%) |
- Insulin OOP costs, states with $25 to $30 caps: $25 to $30 caps; lower with caps; primarily driven by larger reduction in HSA subgroup
Original publication
Association of State Insulin Out-of-Pocket Caps With Insulin Cost-Sharing and Use Among Commercially Insured Patients With Diabetes : A Pre-Post Study With a Control Group. Ann Intern Med. Published 26 March 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →