Skip to main content
Subscribe
  • Sign Up Free
  • Login
  • Subscribe
  • News
    • Current News
    • Providers
    • Insurance
    • Government
    • Finance
    • Technology
    • Safety & Quality
    • Digital Health
    • Transformation
    • ESG
    • People
    • Regional News
    • Digital Edition (Web Version)
    • Patients
    • Operations
    • Care Delivery
    • Payment
    • Midwest
    • Northeast
    • South
    • West
  • Blogs
    • AI
    • Deals
    • Layoff Tracker
    • HIMSS 2023
  • Opinion
    • Breaking Bias
    • Commentaries
    • Letters
    • From the Editor
  • Events & Awards
    • Awards
    • Conferences
    • Galas
    • Virtual Briefings
    • Webinars
    • Nominate/Eligibility
    • 100 Most Influential People
    • 50 Most Influential Clinical Executives
    • Best Places to Work in Healthcare
    • Excellence in Governance
    • Health Care Hall of Fame
    • Healthcare Marketing Impact Awards
    • Top 25 Emerging Leaders
    • Top Innovators
    • Diversity in Healthcare
      • - Luminaries
      • - Top 25 Diversity Leaders
      • - Leaders to Watch
    • Women in Healthcare
      • - Luminaries
      • - Top 25 Women Leaders
      • - Women to Watch
    • Digital Health Transformation Summit
    • ESG: The Implementation Imperative Summit
    • Leadership Symposium
    • Social Determinants of Health Symposium
    • Women Leaders in Healthcare Conference
    • Best Places to Work Awards Gala
    • Health Care Hall of Fame Gala
    • Top 25 Diversity Leaders Gala
    • Top 25 Women Leaders Gala
    • - Hospital of the Future
    • - Value Based Care
    • - Hospital at Home
    • - Workplace of the Future
    • - AI and Digital Health
    • - Future of Staffing
    • - Hospital of the Future (Fall)
  • Multimedia
    • Podcast - Beyond the Byline
    • Sponsored Podcast - Healthcare Insider
    • Sponsored Video Series - One on One
    • Sponsored Video Series - Checking In with Dan Peres
  • Data & Insights
    • Data & Insights Home
    • Hospital Financials
    • Staffing & Compensation
    • Quality & Safety
    • Mergers & Acquisitions
    • Data Archive
    • Resource Guide: By the Numbers
    • Surveys
    • Data Points
  • Newsletters
  • MORE+
    • Contact Us
    • Advertise
    • Media Kit
    • Jobs
    • People on the Move
    • Reprints & Licensing
MENU
Breadcrumb
  1. Home
  2. Insurance
July 15, 2022 09:56 AM

UnitedHealthcare to set $0 copay for insulin, other medications

Nona Tepper
  • Tweet
  • Share
  • Share
  • Email
  • More
    Reprints Print
    insulin_getty_sized_i_i_i.jpg
    Getty Images

    UnitedHealth Group will eliminate cost-sharing for insulin and certain other prescription drug for many policyholders as soon as next year, CEO Andrew Witty said during an earnings call Friday.

    The company's UnitedHealthcare subsidiary will no longer require out-of-pocket spending from fully insured group members for the following medications:

    • Insulin for diabetes;
    • Epinephrine for severe allergic reactions;
    • Albuterol for acute asthma attacks;
    • Glucagon for hypoglycemia; and
    • Naloxone for opioid overdoses.

    "While this is an important step for vulnerable people's health, the larger and longer-term cost containment of drugs depends upon manufacturers restraining and lowering the list price of their products, which is a fundamental driver of costs," Witty said during the call. The company expects the change in its pharmacy benefits to reduce overall spending by preventing patients from becoming sicker, he said.

    The average cash price for a single unit of insulin rose 41% between 2014 and 2021, data from the prescription drug discount company GoodRx show. Prices fell between 2019 and 2021 in part because the Food and Drug Administration approved several generic versions of the biologic drug, according to GoodRx.

    UnitedHealthcare's announcement demonstrates that insurers ultimately decide what patients pay out-of-pocket for prescription drugs, a Pharmaceutical Research and Manufacturers of America spokesperson wrote in an email.

    About 688,000 of UnitedHealthcare's 8 million fully insured group members use these medicines, a spokesperson wrote in an email. UnitedHealthcare plans to encourage its self-funded employer customers to consider including this benefit in their plan designs for 2023, a UnitedHealthcare spokesperson said.

    More than 37 million Americans, or 11% of the population are diagnosed with diabetes, and 8.4 million rely on insulin to survive, according to the American Diabetes Association. The disease cost $327 billion in 2017, the organization said. One in four insulin users report rationing the medication–by skipping doses or taking less than they need–because of cost.

    Other insurers and pharmacy benefit managers have policies designed to reduce insulin costs for patients.

    Insulin and other glucose-lowering agents were the most common items covered pre-deductible among 300 businesses the Employee Benefit Research Institute surveyed in 2019. Two-thirds of employer-sponsored health plans paid the full cost for enrollees, according to the report. Forty-three percent also covered inhaled corticosteroid inhalers for asthma before their deductibles, the survey found.

    In 2020, CVS Health's Caremark PBM began allowing plan sponsors to offer all categories of diabetes medications at zero cost for members without raising premiums. The year before, Cigna and its PBM Express Scripts began capping out-of-pocket costs for insulin at $25 per month.

    Waiving cost-sharing for drugs doesn't lead to higher spending or premium increases, said Paul Fronstin, director of health benefits research at the Employee Benefit Research Institute. Because people with chronic conditions are likely to reach their out-of-pocket maximums each year, covering the insulin costs will not raise expenses for health plans, he said.

    Fifteen states have adopted insulin copay caps and legislation is pending in 22 others, according to the diaTribe Foundation, a diabetes patient advocacy group.

    The high cost of insulin has attracted intensifying political attention. President Donald Trump and President Joe Biden both promoted policies to make the medication more affordable. The House passed a bill in March that would cap monthly out-of-pocket insulin costs at $35 for those with private health insurance and Medicare.

    Differing regulations governing drug rebates likely led UnitedHealthcare to limit its new policy to fully insured plans, as opposed to government-sponsored products such as Medicare Advantage, said Antonio Ciaccia, CEO of drug pricing research firm 46brooklyn Research and president of the consulting firm 3 Axis Advisors. "There are better and more stricter regulations in the Medicare space that require most of those rebates to essentially be passed through," he said.

    During the second quarter, UnitedHealth Group reported $80.3 billion in revenue, up 13% from $71.3 billion. Net income rose 18.9% to $5.1 billion. UnitedHealthcare membership grew from 49.6 million to 51.2 million compared to the year-ago quarter.

    Letter
    to the
    Editor

    Send us a letter

    Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.

    Recommended for You
    legal money settlement.png
    Bon Secours seals Anthem contract, drops pay lawsuit
    Centene Corporation_i copy_i.png
    Centene to lay off 2,000 workers
    Most Popular
    1
    Centene to lay off 2,000 workers
    2
    How health systems are battling price-gouging allegations
    3
    Senate advances bill to temporarily aid hospitals, health centers
    4
    Elevance, Blue Cross Louisiana halt $2.5B proposed deal
    5
    Tower Health to sell urgent care centers, close others
    Sponsored Content
    Daily Finance Newsletter: Sign up to receive daily news and data that has a direct impact on the business and financing of healthcare.
    Get Newsletters

    Sign up for enewsletters and alerts to receive breaking news and in-depth coverage of healthcare events and trends, as they happen, right to your inbox.

    Subscribe Today
    MH Magazine Cover

    MH magazine offers content that sheds light on healthcare leaders’ complex choices and touch points—from strategy, governance, leadership development and finance to operations, clinical care, and marketing.

    Subscribe
    Connect with Us
    • LinkedIn
    • Twitter
    • Facebook
    • RSS

    Our Mission

    Modern Healthcare empowers industry leaders to succeed by providing unbiased reporting of the news, insights, analysis and data.

    Contact Us

    (877) 812-1581

    Email us

     

    Resources
    • Contact Us
    • Help Center
    • Advertise with Us
    • Ad Choices
    • Sitemap
    Editorial Dept
    • Submission Guidelines
    • Code of Ethics
    • Awards
    • About Us
    Legal
    • Terms and Conditions
    • Privacy Policy
    • Privacy Request
    Modern Healthcare
    Copyright © 1996-2023. Crain Communications, Inc. All Rights Reserved.
    • News
      • Current News
      • Providers
      • Insurance
      • Government
      • Finance
      • Technology
      • Safety & Quality
      • Digital Health
      • Transformation
        • Patients
        • Operations
        • Care Delivery
        • Payment
      • ESG
      • People
      • Regional News
        • Midwest
        • Northeast
        • South
        • West
      • Digital Edition (Web Version)
    • Blogs
      • AI
      • Deals
      • Layoff Tracker
      • HIMSS 2023
    • Opinion
      • Breaking Bias
      • Commentaries
      • Letters
      • From the Editor
    • Events & Awards
      • Awards
        • Nominate/Eligibility
        • 100 Most Influential People
        • 50 Most Influential Clinical Executives
        • Best Places to Work in Healthcare
        • Excellence in Governance
        • Health Care Hall of Fame
        • Healthcare Marketing Impact Awards
        • Top 25 Emerging Leaders
        • Top Innovators
        • Diversity in Healthcare
          • - Luminaries
          • - Top 25 Diversity Leaders
          • - Leaders to Watch
        • Women in Healthcare
          • - Luminaries
          • - Top 25 Women Leaders
          • - Women to Watch
      • Conferences
        • Digital Health Transformation Summit
        • ESG: The Implementation Imperative Summit
        • Leadership Symposium
        • Social Determinants of Health Symposium
        • Women Leaders in Healthcare Conference
      • Galas
        • Best Places to Work Awards Gala
        • Health Care Hall of Fame Gala
        • Top 25 Diversity Leaders Gala
        • Top 25 Women Leaders Gala
      • Virtual Briefings
        • - Hospital of the Future
        • - Value Based Care
        • - Hospital at Home
        • - Workplace of the Future
        • - AI and Digital Health
        • - Future of Staffing
        • - Hospital of the Future (Fall)
      • Webinars
    • Multimedia
      • Podcast - Beyond the Byline
      • Sponsored Podcast - Healthcare Insider
      • Sponsored Video Series - One on One
      • Sponsored Video Series - Checking In with Dan Peres
    • Data & Insights
      • Data & Insights Home
      • Hospital Financials
      • Staffing & Compensation
      • Quality & Safety
      • Mergers & Acquisitions
      • Data Archive
      • Resource Guide: By the Numbers
      • Surveys
      • Data Points
    • Newsletters
    • MORE+
      • Contact Us
      • Advertise
      • Media Kit
      • Jobs
      • People on the Move
      • Reprints & Licensing