Insulin Out-of-Pocket Spending Caps and Employer-Sponsored Insurance: Changes in Out-of-Pocket and Total Costs for Insulin and Healthcare.

ABSTRACT:

Objective

To estimate the impact of state-level insulin out-of-pocket caps on changes in out-of-pocket and total costs of insulin and healthcare for insulin users with employer-sponsored insurance.

Study setting and design

We evaluated changes in costs using a quasi-experimental (triple difference-in-differences; "DDD") design to analyze multi-carrier claims from insulin users enrolled in fully insured (state-regulated) and self-funded (generally exempt) employer-sponsored plans in 10 states with caps by January 2021 compared to no-cap states pre-/post-cap implementation. Primary outcomes were changes in insulin out-of-pocket spending, total (plan + member) paid for insulin, and total healthcare costs. Secondary outcomes were intermediary (e.g., pharmaceutical) changes in ou

SUBMITTER: Baig KA 

PROVIDER: S-EPMC12636258 | biostudies-literature | 2025 Dec

REPOSITORIES: biostudies-literature