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Insulin Affordability and the Inflation Reduction Act: Medicare Beneficiary Savings by State and Demographics

Publication Date
Jan 24, 2023
Authors
Bisma A. Sayed, Kenneth Finegold, T. Anders Olsen, Nancy De Lew, Steven Sheingold, Kaavya Ashok, and Benjamin D. Sommers.

Effective January 1, 2023, out-of-pocket costs for insulin are capped at $35 per monthly prescription among Medicare Part D enrollees under the Inflation Reduction Act (IRA). A similar cap takes effect in Medicare Part B on July 1, 2023. An estimated 1.5 million Medicare beneficiaries who use insulin would have saved $734 million in Part D and $27 million in Part B if these caps had been in effect in 2020.

*This content is in the process of Section 508 review. If you need immediate assistance accessing this content, please submit a request to Kenneth Finegold, (202) 557-9553, Kenneth.Finegold@hhs.gov. Content will be updated pending the outcome of the Section 508 review.

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**ALERT – ASPE is in the process of revising the race and ethnicity data in the Data Point. We caution users to wait for the revised data on race and ethnicity to be posted to the website. Note that the Data Point currently uses race and ethnicity information that CMS obtains from the Social Security Administration (SSA). This information has been shown to substantially undercount the number of Hispanic and Asian American/Pacific Islander beneficiaries. To address this undercount, CMS has developed the Research Triangle Institute (RTI) race and ethnicity recoding algorithm, commonly known as “RTI race.”

ASPE is in the process of revising the current results using the RTI race measure.

For further reading on race and ethnicity information in Medicare data, see: Filice, Clara E. MD, MPH, MHS; Joynt, Karen E. MD, MPH. Examining Race and Ethnicity Information in Medicare Administrative Data. Medical Care 55(12):p e170-e176, December 2017. DOI: 10.1097/MLR.0000000000000608. https://journals.lww.com/lww-medicalcare/abstract/2017/12000/examining_race_and_ethnicity_information_in.26.aspx

Product Type
ASPE Data Point
Populations
Older Adults
Location- & Geography-Based Data
National Data | State Data
Program
Medicare | Medicare Part B | Medicare Part D