Evidence mapPaperPMID 41193794Full record

ArticleJournal of general internal medicine2025

Insulin Rationing Persists Despite Policy Changes: Repeated Cross-Sectional Studies, 2017 vs 2024.

Sefia Khan, Nadera Rahman, Laura M Nally, Darren B Warren, Megan E Branda, Kasia J Lipska

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Article in Journal of general internal medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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

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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

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Sefia Khan *The University of Texas Medical Branch at Galveston, John Sealy School of Medicine, Galveston, TX, USA.
Nadera Rahman *Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA.
Laura M NallyDepartment of Pediatrics, Section of Pediatric Endocrinology, Yale School of Medicine, New Haven, CT, USA.
Darren B WarrenDepartment of Pediatrics, Section of Pediatric Endocrinology, Yale School of Medicine, New Haven, CT, USA.
Megan E BrandaDivision of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN, USA.
Kasia J LipskaDepartment of Internal Medicine, Section of Endocrinology, Yale School of Medicine, New Haven, CT, USA. kasia.lipska@yale.edu.ORCID http://orcid.org/0000-0002-0348-742X

Funding

Division of Diabetes, Endocrinology, and Metabolic Diseases NIDDK Summer FellowshipDivision of Diabetes, Endocrinology, and Metabolic Diseases R01DK129616NIDDK NIH HHS R01 DK129616
6 · The paper itself

Abstract

backgroundInsulin is a life-saving medication for people with diabetes, but access barriers, such as high costs, can result in rationing. Multiple policies have been introduced to limit insulin out-of-pocket costs over the past 5 years.

objectiveTo compare rates of cost-related insulin rationing among patients prescribed insulin in 2024 vs. 2017, and to examine broader insulin rationing due to cost-related barriers, insurance delays, or pharmacy shortage

designA 22-item cross-sectional survey conducted from April to July 2024 compared with a survey conducted from June to August 2017.

settingYale Diabetes Center

participantsAdults with type 1 or type 2 diabetes prescribed insulin, with 199 (60.1%) completing the survey in 2024 and 199 (56.2%) in 2017. MAIN MEASURES: Rates of cost-related insulin rationing and broader rationing due to access barriers, including cost, insurance delays, and pharmacy shortages. KEY

resultsIn 2024, among 199 respondents (mean age of 52.4 years, 47.7% female, 58.3% white, and 47.2% type 1 diabetes), 48 (24.1%) reported cost-related insulin rationing compared to 51 (25.5%) of 199 respondents in 2017 (p = 0.41). Characteristics of participants who reported cost-related insulin rationing were similar between 2024 and 2017, but with a higher proportion of adults with type 1 diabetes in 2024 (63.0%) compared to 2017 (43.1%, p = 0.05). In 2024, 75 participants (37.7%) reported insulin rationing due to cost, insurance delays, or pharmacy shortages. In a multivariable model, age, sex, race, ethnicity, income, and insurance coverage were not significantly associated with rationing, but patients with type 2 diabetes had lower odds (OR 0.34, 95%CI 0.13-0.87) compared with type 1 diabetes patients.

conclusionsDespite new policies addressing insulin costs since 2017, one in four patients at Yale Diabetes Center rationed insulin due to cost in 2024, unchanged from 2017. Over one-third reported rationing due to broader access barriers. These findings highlight the ongoing need to comprehensively address insulin affordability and access.

Identifiers

PMID41193794
PMCPMC12895931

What Socratic holds

Textmetadata
LicenceTDM
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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 Socratic graph.