As more features of the Inflation Reduction Act (IRA) are implemented, Medicare beneficiaries are seeing the benefits of the mandated changes. According to recent research, this includes better access to care. There have been thousands more insulin prescriptions filled for Medicare beneficiaries since the IRA’s insulin cost-sharing limits went into effect this year.
As of January 1, cost-sharing for insulin has been limited to $35 per month for a month’s supply of an insulin product covered under Part D. The new study compared changes in insulin fills for Part D enrollees aged 65 to 74 and found these beneficiaries filled nearly 4,000 more monthly prescriptions from January through April of 2023 than from September through December of 2022. This is an important improvement because previous research has shown that many insulin-dependent diabetics tragically ration their insulin due to high costs and that over 20% of older adults did not take one or more medications as prescribed in 2020 due to costs. (At the beginning of July, the cost-sharing limit also went into effect under Part B for insulin used with an infusion pump, but any resulting access changes were not included in the study.)
The IRA made other changes in 2023, including eliminating cost-sharing for all Medicare-covered vaccines and the implementation of a program to penalize drug companies for raising prices faster than inflation. Even more changes will take effect in January of 2024, including extended eligibility for the Part D Low-Income Subsidy (LIS) program (also called “Extra Help”), a cap on Part D out-of-pocket spending for enrollees, a lower cap in 2025, and drug price negotiation starting in 2026.