Insulin Prices Fell For Medicare Patients Under Biden-Era Caps, Study Finds

Key TakeawaysInsulin prices for Medicare patients have fallen due to Biden-era policies3 of 4 Medicare patients paid $35 or less for insulin in 2023, due to out-of-pocket cost capsAverage costs dropped overall to about $22 a month.TUESDAY, March 24, 2026 (HealthDay News) — Biden-era policies have reined in insulin prices for Medicare patients, a new study says.Roughly 3 out of 4 (75%) Medicare prescription beneficiaries were paying $35 or less for each month’s supply of insulin within a year of price caps enacted under President Joe Biden, researchers reported in the Journal of the American Medical Association.Overall, average out-of-pocket monthly costs for insulin dropped from just over $50 in 2019 to about $22 in 2023, with decreases seen in every U.S. state, researchers found.“This is compelling evidence that Medicare policies in recent years have done what they were meant to do — improve insulin access and affordability,” said lead researcher Michael Fang, an assistant professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health in Baltimore.“Insulin costs are now at historically low levels for people on Medicare,” he said in a news release.The Inflation Reduction Act of 2022 mandated an out-of-pocket cap for a 30-day insulin supply for people on Medicare Part D, the plan’s prescription program, starting in January 2023.This is the first time the federal government has imposed caps on insulin prices for all Medicare beneficiaries, researchers noted.To see whether this made insulin more affordable, researchers analyzed Medicare claims covering nearly 3.8 million patients who had at least one prescription for insulin between 2019 and 2023.These patients need insulin to treat either type 1 or type 2 diabetes, researchers said.Results showed that about half (48%) were paying $35 or less for their monthly supply of insulin in 2019, but by 2023 that had increased to 75%.Although the price drops were encouraging, the team said they were surprised to see that 25% of Medicare patients were still paying more than $35 for a month’s supply of insulin.These folks had at least one prescription that hadn’t been prorated to the price cap, because the rules say that the $35 cap can only be applied to full multiples of 30 days, researchers found.“If the prescription falls in between, the patient can be charged up to the next full multiple of a month,” Fang said. “For example, health plans can treat a 45-day supply the same as a 60-day supply and charge up to $70.”The study found that while all states had a decline in insulin out-of-pocket charges, prices varied widely between states.Out-of-pocket costs ranged from a little over $10 in Washington D.C., to more than $31 in Minnesota in 2023, results revealed.More informationThe American Diabetes Association has more on state-level insulin copay caps.SOURCE: Johns Hopkins University, news release, March 19, 2026 .What This Means For YouInsulin out-of-pocket caps have reined in costs for people on Medicare..Sign up for our weekly HealthDay newsletter

Insulin Prices Fell For Medicare Patients Under Biden-Era Caps, Study Finds

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