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National Diabetes Month: PA Insurers Focus on More Affordable Insulin

by Danielle Smith, Keystone State News Connection

National Diabetes Month: PA Insurers Focus on More Affordable Insulin

It is National Diabetes Awareness Month, and the American Diabetes Association said at least 1.2 million Pennsylvanians have been diagnosed with the disease.

Diabetes occurs when a person’s blood sugar is too high, which can lead to serious complications of heart and kidney disease, stroke and vision loss if left untreated.

Chronis Manolis, senior vice president of pharmacy for the University of Pittsburgh Medical Center Health Plan, said the high cost of insulin used to treat diabetes is often a barrier. So, the Center has moved all insulin products to the lowest, generic copay tier. He added they try to work with people to help manage their diabetes.

“It’s also about closing gaps, educating our members about diabetes and looking at how we connect our members to the right resources,” Manolis outlined. “For example, we take a whole-person approach to diabetes by connecting our members to health coaches, diabetes educators and pharmacists, as well as coordinating with their providers.”

He explained they look at any social determinants of health in their interactions with patients, in addition to cost and access issues. And the Inflation Reduction Act will cap the cost of insulin for people with Medicare coverage at $35 a month, starting in January. The law also caps their out-of-pocket costs for prescriptions at $2,000 a year, and allows Medicare to negotiate some drug prices with manufacturers.

Every day, 7.5 million Americans rely on insulin to manage their blood sugar levels and help prevent the complications of living with diabetes.

Dr. Nicole Brady, chief medical officer for employer and individual business at UnitedHealthcare, said beginning Jan. 1, UnitedHealthcare has decided its eligible members will also pay nothing out-of-pocket for insulin.

“So we’re really, really hoping that eliminating the out-of-pocket expense for insulin helps reduce that burden of paying for that insulin, and that cost and financial burden,” Brady emphasized. “And that people will be able to be better adherent to their medications and take them more regularly.”

If you are on an insulin regimen, Brady added it is even more important to reduce your intake of sugary, processed foods and alcohol, avoid smoking and get regular exercise.