Help for Medicare Patients to Avoid ‘Donut Hole’

Posted in News on 7.5.2018

Dr. Jing Luo, in-house Physician Advisor at Alosa Health and faculty member in the Division of Pharmacoepidemiology and Pharmacoeconomics at Brigham and Women’s Hospital, recently spoke at the American Diabetes Association’s 78th Annual Scientific Sessions on the comparative effectiveness and cost-benefit impact of using analogue versus human insulin for managing type 2 diabetes. Significantly, the cost of insulin drives many Medicare patients into the Part D coverage gap, which refers to the period of time after Medicare beneficiaries have outspent their initial coverage but before catastrophe coverage kicks in.

Luo and his colleagues analyzed prescription and claims data from thousands of Medicare participants and found that Medicate beneficiaries with type 2 diabetes switched from analogue to human insulin were less likely to reach the spending limit for their Part D drug plan. As Luo explains, “The unit price of insulin has risen dramatically across a variety of settings, and… newer analogue insulins are more expensive than comparable human insulin products.” This cost-savings was achieved at no expense to clinical outcomes. “They [analogue insulins] may not result in substantially improved clinical outcomes for most patients with type 2 diabetes.”

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