Experts: CMS Move to Cut Insulin Costs Has Limits

Recently, CMS unveiled a new program to reduce Medicare beneficiaries’ out-of-pocket costs for insulin (RDB 3/12/20, p. 8). The voluntary model aims to lower the cost of a 30-day supply to “no more than $35” and reduce annual insulin costs by an average of $446 per person. Industry experts say the program, called the Part D Senior Savings Model, should save patients money but will have a limited impact on overall drug spending.

“The goal of the program is a way of putting the rebates and additional pricing incentives up front to the member level,” Brian Anderson, an actuary at Milliman Inc., tells AIS Health via email. “This is not a direct point-of-sale rebate approach, but it is a similar strategy for this therapeutic category.”

© 2021 MMIT

Peter Johnson

Peter has been a reporter for nearly a decade. Before joining AIS Health, Peter covered a wide variety of topics in his hometown of Seattle, where he continues to live. Peter’s work has appeared in publications including The Atlantic and The Stranger. Peter attended Colby College.

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