How Will the Insulin Price Cap Impact Plan Sponsors?

Managing diabetes in the United States is becoming increasingly expensive, putting lives on the line as patients struggle to afford necessary treatments and medications. To address this issue, lawmakers have enacted the Inflation Reduction Act, which sets a monthly out-of-pocket insulin cost cap of $35 for seniors on Medicare. This means insurers, including Medicare private plans and Part D plans, cannot charge more than $35 per month for insulin products.

While this may mean payers and insurers must cover a larger portion of the costs, Mark Campbell, Senior Vice President of Clinical Solutions at RxBenefits, suggests increased medication adherence and reduced hospitalization rates could offset some of these expenses, as well as some of the millions of dollars lost every year to workplace absenteeism and reduced productivity resulting from poorly controlled diabetes.

Although the insulin cap is a step in the right direction, additional measures are necessary to reduce diabetes treatment costs. Learn more about the impact of the Inflation Reduction Act for plan sponsors from Mark’s article in HR Digest.

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