New government act to limit the cost of insulin for people on Medicare starting in January

byMark Richardson
Illinois News Connection

CHICAGO -- Last month was National Diabetes Awareness Month. With almost 1.3 million Illinoisans diagnosed with the disease, people with diabetes make up 10% of the population, and another 3.4 million people have prediabetes, according to the American Diabetes Association.

Dr. Nicole Brady, chief medical officer for employer and individual business at UnitedHealthcare, said the rising cost of insulin is putting many patients in a bind.

"Many of them may even have to make decisions such as, 'Am I gonna buy food for my family this week or am I gonna spend money on my insulin?' So it puts them in a very precarious position," Brady observed.

A study published last month in the Annals of Internal Medicine showed one in five adults with diabetes is rationing insulin to save money, a practice which can damage his or her eyes, kidneys, blood vessels and heart.

The Biden administration's Inflation Reduction Act, which passed this summer, caps the cost of insulin for people on Medicare at $35 a month starting in January. It also caps Medicare recipients' out-of-pocket costs for prescription drugs at $2,000 a year, and allows Medicare to negotiate the cost of some drugs.

Brady added starting Jan. 1, UnitedHealthcare will offer zero-dollar cost sharing for people enrolled in standard fully insured group plans, which would eliminate out-of-pocket costs for certain prescription medications, including preferred brands of insulin.

"This should reduce the risk of expensive hospitalizations and of complications from the high blood sugars that can be an effect of diabetes," Brady emphasized. "And overall should make people just feel better."

In the meantime, Brady has some tips on improving your quality of life while on an insulin regimen. She advised reducing sugary processed foods, limiting alcohol and avoiding tobacco.

"Smoking and tobacco actually decrease the effectiveness of insulin," Brady pointed out. "We can better manage our stress because stress can raise our blood-sugar levels."

She added regular exercise can improve your blood-sugar levels because working out causes your muscles to use more glucose for energy.