More than 15% of U.S. insulin users had to ration in the past year, study finds

Rationing was more common among younger patients, Black patients, and uninsured patients, according to an analysis of the 2021 National Health Interview Survey.

More than 15% of insulin users in the U.S. rationed the drug in the last year, a study found.

Researchers analyzed the CDC's 2021 National Health Interview Survey, looking at how many of the responding adults with diabetes who used insulin answered yes to questions about whether they “skipped insulin doses,” “took less insulin than needed,” or “delayed buying insulin” to save money. Results were published as a letter by Annals of Internal Medicine on Oct. 18.

A total of 16.5% (95% CI, 13.8% to 19.6%) of respondents reported rationing insulin in the past year, which the researchers calculated would work out to 1.3 million U.S. adults. Delaying purchase was the most common form of rationing (14.2%) overall, but among those with type 1 diabetes, taking less insulin than needed was most common (16.5%). Rationing was more common among younger patients (11.2% of adults ≥65 years of age vs. 20.4% of those younger) and among Black patients (23.2% vs. 16.0% of White and Hispanic patients). Rationing was most common among the uninsured (29.2%), followed by those with private insurance (18.8%), other coverage (16.1%), Medicare (13.5%), and Medicaid (11.6%).

“The inventors sold the initial insulin patent for $1, yet today more than 1 million Americans ration insulin, including 258,965 adults with type 1 diabetes,” said the study authors, who called for additional reform to improve access to insulin for all Americans.