OBJECTIVES: The insulin price tripled from 2002 to 2013. A recent congressional hearing expressed immense frustration at big increases in insulin prices and its damaging impact of the rising insulin prices in the United States. This study is aimed to document ten year increasing trend on insulin cost among diabetes patients.

METHODS: Ten-Year individual and prescription data of the Medical Expenditure Panel Survey (MEPS) 2007 to 2016 were extracted to describe and compare trends in expenditure of insulin and insulin analogs among patients with diabetes. Insulin cost was categorized by different sources, including Medicaid/Medicare, other public insurances (Veterans/CHAMPVA, Tricare, State & local government, other federal and other public), commercial insurances (private insurance, workers company insurance and other private insurance), out of pocket (Self/Family). The mean cost and the median cost of above categories were demonstrated.

RESULTS : After adjusted by the inflation rate, the insulin costs of all categories increased significantly during the decade. Specifically, compared with the mean insulin cost per person by the same category in 2007, insulin cost in 2016 on Medicaid/Medicare increased approximately 4 times, insulin cost of other public insurance increased 7 times and for commercial insurance category, the cost increased 2.5 times. The median insulin expenditure per person on Medicaid/Medicare, other public insurance and commercial insurance in 2016 are 4, 6, and 2 times the expenditures in 2007, respectively. However, the OOP cost for insulins did not changed much fluctuating around $400, suggesting that the patients payment by themselves did not changed much. The largest cost increase for Public insurance (Medicare/Medicaid & other public insurance) happened in 2014 possibly due to Obamacare.

CONCLUSIONS: While the reasons for this rapid increase in insulin cost are unclear, policy makers should take some actions to slow down the trend and improve the transparency of insulin rebate process.