April 6, 2026 · JAMA internal medicine · DOI: 10.1001/jamainternmed.2026.0255

Out-of-Pocket Spending for Insulin by Medicare Beneficiaries After Monthly Caps

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This study aimed to evaluate the impact of the $35 monthly cap on out-of-pocket insulin spending for Medicare beneficiaries with type 2 diabetes, implemented in 2021 and expanded in 2023. The findings indicated that the cap significantly reduced insulin costs, increased insulin usage, and led to modest improvements in blood glucose levels, suggesting that such federal cost-sharing policies could enhance medication access and adherence for chronic disease management.

Dongzhe Hong, Krystal Cantos, Diana Morgenstern, Sonali Dasgupta, Aaron S Kesselheim, Zirui Song, Angela Y Tong, Rohit Chadaram, Danielle Potter, Elisabetta Patorno, Jerry Avorn, Benjamin N Rome

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