DM management by an endocrinologist was associated with greater HbA1C improvement and significantly lower medical costs. Total costs were higher with an endocrinologist, but for patients with T1D lower costs were seen, ranging from 2-9% regardless of insurance type.
The price of insulin has increased dramatically over the past two decades. Medicare reimbursement for insulin is based on the route of administration via syringe (Part D) or via pump (Part B). Recently, the Centers for Medicare & Medicaid Services (CMS) announced a voluntary model for Part D enhanced plans that lower out-of-pocket costs to a co-pay of ≤$35/month. Meanwhile, the 21st Century Cures Act and manufacturer price increases raised the cost of insulin for pump users by 304% in less than 2 years. Because insulin is a life-saving necessity and unlike other Part B infused drugs, we call on CMS to determine drug reimbursement on a drug-by-drug basis and to develop a payment model that lowers out-of-pocket costs for patients using insulin delivered via pumps.
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