Colorado Insulin Copay Cap: Lower Out-Of-Pocket Payments, Increased Prescription Volume And Days’ Supply

Health Affairs August 1, 2024
Benjamin D. Ukert, Theodoros V. Giannouchos, Thomas C. Buchmueller, Kelly E. Anderson, Nathorn Chaiyakunapruk, Eric J. Gutierrez, H. Weston Schmutz, Michael R. Rose, Diana Brixner, R. Brett McQueen, Dana P. Goldman

Abstract

In 2020, Colorado became the first state to cap out-of-pocket spending for insulin prescriptions, requiring fully insured health plans to cap out-of-pocket spending at $100 for a thirty-day supply. We provide the first evidence on the association of Colorado’s Insulin Affordability Program with patient out-of-pocket spending, the amounts paid by plans per insulin prescription, and prescription filling. Using statewide claims data from the period 2018–21, we focused on the first two years that the copay cap law was in effect. We found that Colorado’s...

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