Insulin Rationing Highlights Health Care Disparities

The results of a recent report published in Annals of Internal Medicine highlight the disparities that plague the US health care system. The analysis found an estimated 1.3 million US adults with diabetes rationed their insulin in the past year by delaying prescription refills, skipping doses, or using smaller doses. This number represents 16.5% of individuals who use prescribed insulin.

Insulin rationing is dangerous because it can lead to diabetic ketoacidosis. Rationing of insulin occurred in 15% of low-income individuals and 20% of middle-income individuals who took part in the research compared with 11% of high-income participants. There was also a racial discrepancy, with 23% of Black participants rationing their insulin compared with 17% of Hispanic or White individuals.

High co-pays drove rationing, with uninsured individuals rationing more frequently (29%) compared with 19% of those with private insurance, 14% of Medicare recipients, and 12% of Medicaid recipients. The report was based on data from a Centers for Disease Control and Prevention health research project in which investigators studied a nationally representative sample of 982 adults with diabetes who use insulin.

The pharmacy profession should take every opportunity to examine barriers to health care access and the causes of such disparities and produce practical solutions to address this public health problem. Pharmacy Times^® recently reported on study results showing that Black patients have a greater risk of all-cause mortality from diabetes and stroke and face disparities in heart failure treatment and receiving COVID-19 booster vaccines. We will continue to bring pharmacists the latest news on this important topic.

Meanwhile, we hope you find this issue valuable. Our Cover Feature looks at the common cold vs COVID-19. Other articles address treating children with diabetes, soothing a sore throat, and immunizing older patients.

As this year ends, we look forward to 2023 and continuing to bring pharmacy professionals the news and resources they need to deliver outstanding care to patients. Have a happy holiday season and a healthy and safe new year!

REFERENCE

Gaffney A, Himmelstein DU, Woolhandler S. Prevalence and correlates of patient rationing of insulin in the United States: a national survey. Ann Intern Med. 2022;175(11):1623-1626. doi:10.7326/M22-2477