Higher Cost Sharing Associated With Lower Insulin Adherence For Medicare Beneficiaries

Higher cost sharing for Medicare beneficiaries is associated with lower insulin adherence. When their average out-of-pocket costs for insulin increased because they hit the Medicare Part D coverage gap, beneficiaries in individual plans reduced their use of insulin by an average of 5.4 percentage points. Prior to hitting the coverage gap, their percentage of days covered (PDC) averaged 67.5%. Under the coverage gap, PDC averaged 62.1%. Average cost sharing for individual plan enrollees was $50.57 in the initial coverage phase. It rose to $117.10 in the coverage gap and fell to $36.86 . . .