Impact of Insulin Cost Caps on Type 1 Diabetes Population

This white paper analyzes the effects of state and federal insulin out-of-pocket cost caps on the type 1 diabetes (T1D) population in the United States. It estimates that 45% of individuals with T1D benefit from these caps, while many remain vulnerable to high insulin costs. The paper details the chronic nature of T1D, which affects approximately two million people, and the critical role of insulin in managing the disease. It discusses the administrative claims and enrollment data from various health insurance sources, revealing that a significant portion of T1D patients are reliant on insulin fills. The report highlights the financial strain faced by patients, with many engaging in risky behaviors to manage costs. It also outlines legislative efforts, including the Inflation Reduction Act, aimed at reducing insulin costs for Medicare beneficiaries. The analysis further examines the variability of state insulin caps and their implications for different insurance types, emphasizing the ongoing challenges in achieving affordable insulin access for all individuals with T1D.