High Cost of Insulin Is Associated with Underuse and Poor Glycemic Control

Costs for some insulin preparations have increased threefold or more, with concomitant increases in out-of-pocket costs. Investigators asked 199 diabetic patients for whom insulin had been prescribed whether they practiced any cost-saving behaviors (e.g., using less insulin than prescribed, not filling insulin prescriptions, not starting insulin because of cost). Glycemic control within 3 months was assessed, with “poor control” defined as glycosylated hemoglobin level of ≥9.0%.

One quarter of patients reported cost-related insulin underuse. Those patients were more likely to report low incomes, but only 60% of low-income patients had discussed concerns about costs with their clinicians. Poor glycemic control was significantly more prevalent…