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Research Letter
December 3, 2018

Cost-Related Insulin Underuse Among Patients With Diabetes

Author Affiliations
  • 1Yale College, New Haven, Connecticut
  • 2Yale School of Medicine, New Haven, Connecticut
  • 3Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
  • 4Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
JAMA Intern Med. Published online December 3, 2018. doi:10.1001/jamainternmed.2018.5008

Insulin is lifesaving for people with diabetes and is included on the Model List of Essential Medicines formulated by the World Health Organization.1 This means it should be available at all times at a price the individual and the community can afford.1 However, over the past decade, insulin prices have tripled in the United States, while out-of-pocket costs per prescription doubled.2,3 High costs of medications can contribute to nonadherence,4 but the prevalence of cost-related insulin underuse is unknown.

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