Evidence map›Paper›PMID 42428250›Full record

ArticleHealth affairs scholar2026

Out-of-pocket insulin spending before and after the Inflation Reduction Act across demographic subgroups.

Caroline G Borden, Renhao Wang, Alexander O Everhart, Pinar Karaca-Mandic, Stacie B Dusetzina, Rozalina G McCoy, Kasia J Lipska

Abstract read
In one paragraph

Article in Health affairs scholar, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Caroline G BordenYale School of Medicine, New Haven, CT 06510, USA.ORCID https://orcid.org/0000-0001-9360-5049
Renhao WangUniversity of Maryland Institute for Health Computing, North Bethesda, MD 20852, USA.ORCID https://orcid.org/0000-0002-4979-5321
Alexander O EverhartDivision of General Medicine & Geriatrics, John T. Milliken Department of Medicine, Washington University School of Medicine in St.Louis, St. Louis, MO 63110, USA.ORCID https://orcid.org/0000-0001-5192-6557
Pinar Karaca-MandicDepartment of Finance, Carlson School of Management, University of Minnesota, Minneapolis, MN 55455, USA.ORCID https://orcid.org/0000-0002-6682-1982
Stacie B DusetzinaDepartment of Health Policy, Vanderbilt University Medical Center, Nashville, TN 37203, USA.ORCID https://orcid.org/0000-0002-3907-9196
Rozalina G McCoyUniversity of Maryland Institute for Health Computing, North Bethesda, MD 20852, USA.ORCID https://orcid.org/0000-0002-2289-3183
Kasia J LipskaDepartment of Internal Medicine, Section of Endocrinology, Yale School of Medicine, New Haven, CT 06520, USA.ORCID https://orcid.org/0000-0002-0348-742X

Funding

"Insulin Affordability: Unpacking the Impact of the Inflation Reduction Act on Diabetes Outcomes in Medicare."R01DK141666 · NIDDK · YALE UNIVERSITY · PI Kasia Joanna Lipska, Rozalina Grubina McCoy · 2025 to 2026
$1.5M
NIDDK NIH HHS R01 DK141666
6 · The paper itself

Abstract

Introduction: The Inflation Reduction Act (IRA) capped out-of-pocket (OOP) insulin spending at $35 for Medicare Part D beneficiaries in 2023. Studies have shown lower per-prescription insulin spending after the IRA but less is known about annual OOP insulin spending. We examined whether beneficiaries' annual insulin spending fell below $420 (ie, $35/month) and whether savings differed across demographic subgroups. Methods: Using nationally representative data from the Medical Expenditures Panel Survey, we estimated survey-weighted two-part models comparing annual per-person OOP insulin spending in 2022 and 2023 overall, and by sex, race and ethnicity, income, education, insurance type, and number and type of insulin prescriptions. Results: Annual per-person OOP spending on insulin decreased from $359.95 in 2022 to $214.11 in 2023 ( Conclusion: The IRA's universal cap on insulin for Medicare beneficiaries was associated with reductions in annual OOP spending across demographic subgroups, highlighting its potential to improve equitable access to insulin. However, persistent spending above the annualized cap for 1 in 7 patients suggests gaps in protection and the need for additional solutions.

Indexed as

Inflation Reduction ActinsulinMedicaremedication affordabilitymedication nonadherencemedication rationingout-of-pocket spendingPart D

Identifiers

PMID42428250
PMCPMC13348714

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.