In Reply As acknowledged in our Research Letter,1 our analysis did not account for manufacturer rebates in estimating health insurers’ financial liability for insulin; we lacked these data, which are proprietary and nontransparent. Meadows et al imply that the health insurer represented in our data did not pay increased net insulin prices between 2006 and 2017. We disagree based on research that has accounted for manufacturer rebates; for example, Hernandez and colleagues2 found that net insulin prices increased by 51% from 2007 to 2018 using national data and adjusting for inflation.