How Much Does Medicare Spend on Insulin?
| Table 1: Measures of Spending and Use of Insulin Products in Medicare Part D, 2007-2017 | ||||||
| Number of Part D enrollees using insulin (in millions) |
Total number of insulin prescriptions (in millions) | Total Part D spending on insulin (in billions) | Average per capita total Part D spending on insulin1 |
Total out-of-pocket spending on insulin by non-LIS enrollees2
(in millions)
|
Average out-of-pocket spending on insulin by non-LIS enrollees2 | |
| 2007 | 1.6 | 14.8 | $1.4 | $862 | $210.1 | $324 |
| 2008 | 1.8 | 16.9 | $1.9 | $1,059 | $269.9 | $368 |
| 2009 | 1.9 | 18.6 | $2.4 | $1,246 | $324.7 | $404 |
| 2010 | 2.1 | 20.1 | $2.9 | $1,424 | $384.9 | $447 |
| 2011 | 2.2 | 22.2 | $3.7 | $1,651 | $367.3 | $386 |
| 2012 | 2.4 | 24.5 | $4.8 | $1,972 | $466.1 | $429 |
| 2013 | 2.7 | 28.1 | $6.6 | $2,411 | $599.5 | $447 |
| 2014 | 2.9 | 30.1 | $9.0 | $3,116 | $735.9 | $513 |
| 2015 | 3.0 | 31.8 | $11.0 | $3,681 | $857.4 | $572 |
| 2016 | 3.1 | 33.3 | $12.1 | $3,949 | $911.5 | $588 |
| 2017 | n/a | n/a | $13.3 | n/a | n/a | n/a |
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NOTE: n/a indicates data not available. Total spending does not account for rebates; includes Medicare, plan, and beneficiary out-of-pocket payments. Number of prescriptions is standardized to a 30-day supply. 1Among all enrollees using insulin. 2Among non-LIS enrollees using insulin.
SOURCE: KFF analysis of 2007-2016 prescription drug event claims data from a 5% sample of Medicare beneficiaries from the Centers for Medicare & Medicaid Services (CMS) Chronic Conditions Data Warehouse, and 2017 data from the CMS Medicare Part D Drug Spending Dashboard.
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| Table 2: Medicare Part D Spending on Insulin Products, 2013-2017 | |||||||||||
| Average Spending Per Dosage Unit (Weighted) | Average Spending Per Claim | ||||||||||
| Drug name | Number of users in 2017 | First year of data1 | First year | 2016 | 2017 | Change, 2016-2017 | CAGR, first year-2017 | 2016 | 2017 | Change, 2016-2017 | |
| Afrezza | 639 | 2016 | $2.91 | $2.91 | $3.54 | 21.6% | 21.6% | $566 | $690 | $124 | |
| Apidra | 3,489 | 2013 | $12.35 | $23.94 | $25.02 | 4.5% | 19.3% | $636 | $713 | $77 | |
| Apidra Solostar | 7,740 | 2013 | $16.06 | $30.81 | $32.16 | 4.4% | 18.9% | $726 | $759 | $32 | |
| Humalog | 283,221 | 2013 | $14.43 | $23.74 | $25.73 | 8.4% | 15.5% | $452 | $488 | $36 | |
| Humalog Kwikpen U-100 |
414,797 | 2013 | $18.71 | $30.77 | $33.54 | 9.0% | 15.7% | $661 | $720 | $59 | |
| Humalog Kwikpen U-200 |
23,598 | 2015 | $57.96 | $62.64 | $67.97 | 8.5% | 8.3% | $1,036 | $1,134 | $98 | |
| Humalog Mix 50-50 | 3,089 | 2013 | $15.08 | $25.51 | $27.93 | 9.5% | 16.7% | $825 | $898 | $73 | |
| Humalog Mix 50-50 Kwikpen | 5,730 | 2013 | $18.93 | $31.06 | $33.85 | 9.0% | 15.6% | $1,020 | $1,122 | $103 | |
| Humalog Mix 75-25 | 33,042 | 2013 | $14.91 | $25.22 | $27.57 | 9.3% | 16.6% | $671 | $744 | $73 | |
| Humalog Mix 75-25 Kwikpen | 67,462 | 2013 | $18.74 | $30.87 | $33.74 | 9.3% | 15.8% | $851 | $957 | $106 | |
| Humulin 70-30 | 89,109 | 2013 | $7.56 | $11.98 | $12.82 | 7.0% | 14.1% | $342 | $374 | $31 | |
| Humulin 70/30 Kwikpen | 25,412 | 2014 | $20.50 | $26.22 | $27.04 | 3.2% | 9.7% | $691 | $739 | $48 | |
| Humulin N | 131,313 | 2013 | $5.69 | $7.79 | $7.95 | 2.1% | 8.7% | $237 | $255 | $18 | |
| Humulin N Kwikpen | 27,261 | 2014 | $18.84 | $22.11 | $20.46 | -7.5% | 2.8% | $529 | $509 | -$20 | |
| Humulin R | 102,072 | 2013 | $6.54 | $9.47 | $9.74 | 2.9% | 10.5% | $180 | $193 | $13 | |
| Humulin R U-500 | 14,547 | 2013 | $39.90 | $63.96 | $70.65 | 10.4% | 15.4% | $1,838 | $1,990 | $153 | |
| Humulin R U-500 Kwikpen | 13,153 | 2016 | $86.90 | $86.90 | $91.14 | 4.9% | 4.9% | $1,461 | $1,533 | $72 | |
| Lantus | 614,743 | 2013 | $15.31 | $24.88 | $24.95 | 0.3% | 13.0% | $469 | $477 | $8 | |
| Lantus Solostar | 1,112,315 | 2013 | $17.09 | $24.60 | $24.82 | 0.9% | 9.8% | $502 | $503 | $0 | |
| Levemir | 188,078 | 2013 | $15.56 | $27.23 | $27.29 | 0.2% | 15.1% | $491 | $499 | $7 | |
| Levemir Flextouch | 509,282 | 2014 | $23.55 | $26.79 | $26.85 | 0.2% | 4.5% | $557 | $564 | $6 | |
| Novolin 70-30 | 113,491 | 2013 | $7.12 | $10.25 | $10.46 | 2.0% | 10.1% | $276 | $298 | $22 | |
| Novolin N | 78,553 | 2013 | $7.00 | $9.86 | $10.15 | 3.0% | 9.7% | $224 | $244 | $20 | |
| Novolin R | 90,692 | 2013 | $7.92 | $11.69 | $11.77 | 0.7% | 10.4% | $173 | $188 | $16 | |
| Novolog | 285,494 | 2013 | $15.21 | $25.01 | $27.68 | 10.7% | 16.2% | $471 | $548 | $77 | |
| Novolog Flexpen | 546,717 | 2013 | $19.18 | $31.74 | $35.23 | 11.0% | 16.4% | $617 | $701 | $84 | |
| Novolog Mix 70-30 | 42,341 | 2013 | $15.55 | $25.63 | $28.43 | 10.9% | 16.3% | $653 | $758 | $106 | |
| Novolog Mix 70-30 Flexpen | 96,569 | 2013 | $19.08 | $31.52 | $35.05 | 11.2% | 16.4% | $853 | $971 | $118 | |
| Toujeo Solostar | 190,489 | 2015 | $74.20 | $73.94 | $75.17 | 1.7% | 0.6% | $556 | $580 | $24 | |
| Tresiba Flextouch U-100 |
63,235 | 2015 | $28.63 | $29.57 | $29.79 | 0.8% | 2.0% | $499 | $512 | $12 | |
| Tresiba Flextouch U-200 |
89,703 | 2015 | $58.36 | $59.03 | $59.22 | 0.3% | 0.7% | $847 | $880 | $33 | |
| NOTE: CAGR is compound annual growth rate. 1For insulin products that were not yet available in 2013, the first year that they appear in the Part D dashboard is used as the first year for purposes of measuring change in spending per dosage unit. SOURCE: Centers for Medicare & Medicaid Services, Medicare Part D Drug Spending Dashboard, March 2019 update 2013-2017 data). |
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| Table 3: Out-of-Pocket Spending by Non-Low Income Subsidy (LIS) Medicare Part D Enrollees on Insulin Products, 2007-2016 | ||||||||
| Average out-of-pocket spending by non-LIS insulin users | Percent change in out-of-pocket spending by non-LIS insulin users |
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| Drug name | First year of Part D data1 | First year | 2015 | 2016 | First year-2016 | 2015-2016 | Annual growth rate, first year-2016 |
|
| All non-LIS insulin users | 2007 | $324 | $572 | $588 | 81% | 3% | 7% | |
| Afrezza | 2015 | $153 | $153 | $226 | 48% | 48% | 48% | |
| Apidra | 2007 | $213 | $381 | $373 | 75% | -2% | 6% | |
| Apidra Solostar | 2009 | $131 | $345 | $354 | 170% | 3% | 15% | |
| Humalog | 2007 | $226 | $318 | $354 | 56% | 11% | 5% | |
| Humalog Kwikpen U-100 | 2015 | $328 | $328 | $358 | 9% | 9% | 9% | |
| Humalog Kwikpen U-200 | 2015 | $105 | $105 | $339 | 222% | 222% | 222% | |
| Humalog Mix 50-50 | 2007 | $298 | $556 | $627 | 110% | 13% | 9% | |
| Humalog Mix 50-50 Kwikpen | 2015 | $456 | $456 | $455 | 0% | 0% | 0% | |
| Humalog Mix 75-25 | 2007 | $394 | $462 | $545 | 38% | 18% | 4% | |
| Humalog Mix 75-25 Kwikpen | 2015 | $508 | $508 | $546 | 7% | 7% | 7% | |
| Humulin 70/30 Kwikpen | 2014 | $343 | $431 | $481 | 40% | 12% | 18% | |
| Humulin 70-30 | 2007 | $228 | $301 | $326 | 43% | 9% | 4% | |
| Humulin N | 2007 | $204 | $156 | $183 | -10% | 17% | -1% | |
| Humulin N Kwikpen | 2014 | $234 | $336 | $337 | 44% | 0% | 20% | |
| Humulin R | 2007 | $109 | $115 | $140 | 29% | 22% | 3% | |
| Humulin R U-500 | 2015 | $798 | $798 | $822 | 3% | 3% | 3% | |
| Humulin R U-500 Kwikpen | 2016 | $344 | n/a | $344 | n/a | n/a | n/a | |
| Lantus | 2007 | $245 | $450 | $434 | 77% | -4% | 7% | |
| Lantus Solostar | 2007 | $106 | $420 | $413 | 291% | -2% | 16% | |
| Levemir | 2007 | $203 | $405 | $414 | 104% | 2% | 8% | |
| Levemir Flexpen | 2012 | $305 | $132 | $110 | -64% | -17% | -22% | |
| Levemir Flextouch | 2014 | $145 | $429 | $448 | 209% | 5% | 76% | |
| Novolin 70-30 | 2007 | $176 | $285 | $272 | 55% | -5% | 5% | |
| Novolin N | 2007 | $121 | $234 | $223 | 85% | -4% | 7% | |
| Novolin R | 2007 | $70 | $161 | $156 | 123% | -3% | 9% | |
| Novolog | 2007 | $192 | $325 | $342 | 78% | 5% | 7% | |
| Novolog Flexpen | 2012 | $245 | $316 | $346 | 42% | 10% | 9% | |
| Novolog Mix 70-30 | 2007 | $322 | $412 | $431 | 34% | 5% | 3% | |
| Novolog Mix 70-30 Flexpen | 2012 | $397 | $509 | $555 | 40% | 9% | 9% | |
| Toujeo Solostar | 2015 | $177 | $177 | $359 | 103% | 103% | 103% | |
| Tresiba Flextouch U-100 | 2016 | $220 | n/a | $220 | n/a | n/a | n/a | |
| Tresiba Flextouch U-200 | 2016 | $313 | n/a | $313 | n/a | n/a | n/a | |
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NOTE: LIS is low-income subsidy. n/a indicates data not available. 1For insulin products that were not yet available in 2007, the first year that they appear in the Part D claims data is used as the first year for purposes of measuring change in out-of-pocket spending.
SOURCE: KFF analysis of 2007-2016 prescription drug event claims data from a 5% sample of Medicare beneficiaries from the Centers for Medicare & Medicaid Services (CMS) Chronic Conditions Data Warehouse. |
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