ArticleJournal of general internal medicine2025
Insulin Rationing Persists Despite Policy Changes: Repeated Cross-Sectional Studies, 2017 vs 2024.
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.
What it found
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Who cites it
1 citing paper in PubMed.
- Response to a Critique: Errors with Acri's Opinion Piece Defending IP, While Premature Deaths Pile Up from Patents.Health care analysis : HCA : journal of health philosophy and policy · 2026Article
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Authors and funding
6 authors.
Funding
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.
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