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More On The IRA And OOP Insulin Savings

Health and Human Services now estimates that 1.5 million people with Medicare would have saved approximately $500 on out-of-pocket (OOP) insulin expense if the Inflation Reduction Act (IRA) had been in effect in 2020.


Remember that the IRA caps the OOP cost of insulin per prescription fill to $35.


So, you are asking, why is an average OOP cost of $42 per month ($500 divided by 12 months = $42 per month) such a big deal ? Yes, that is a savings of $7 per month. Not much, huh. These numbers are based on filled prescriptions. What we don't know is the number of UNFILLED prescriptions that would drive the numbers higher.


In my healthcare practice, it was not unusual for people to slow down on insulin use and stretch that bottle further to afford the drug. This was true of many medications. God forbid that they drop and break a bottle of insulin or tip over a bottle of pills.


Many of my patients were pretty indigent with little money from Social Security or Disability to pay for food, housing, utilities, medications, healthcare visits, transportation and other basic needs. Remember that if you earn very little throughout your life then your Social Security benefit can be low.


So, yes, any amount that is saved is a good thing and even if it just allows a patient to fill the insulin on a regular basis then it is a win.


Also, remember that the IRA caps ALL OOP costs for medications for Medicare at $2000 !


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