| Anne Peters has been taking care of patients with diabetes since the 1980s. And for decades, the question her patients had was always the same: “Can I get the right insulin at a cost I can afford?” Insulin is a lifesaving medicine for people with type 1 diabetes, whose bodies don’t produce any insulin, and can be necessary for people with type 2 diabetes, whose bodies can’t use insulin properly. Drug companies have been raising the price of the medicine for decades and charging US customers much more. Some states had been capping out-of-pocket costs. Then in 2023, older people across the US covered by Medicare started seeing more relief — a federal law, the Inflation Reduction Act, mandated that these patients pay no more than $35 a month for insulin. “It made it possible to get insulin at a reasonable cost for most of my seniors,” says Peters, a professor and director of the clinical diabetes program at the University of Southern California’s medical school who treats about 3,000 patients a year in the Los Angeles area. Insulin prescriptions filled by Medicare patients increased after the policy was implemented, according to a published analysis. But it’s still an open question how that affected patients’ health. Rebecca Myerson, a professor of population health sciences at the University of Wisconsin-Madison, is working on an analysis to address that question. Along with colleagues, she plans to look at metrics like emergency room use, hospitalization and blood sugar levels to measure the effects of the policy change. “We’ll also be able to look at some of the more downstream health consequences you might expect for people for whom insulin was recommended, who were skipping doses because of cost, who are now able to fill their recommended doses,” Myerson says. Doctors like Peters already see improvements. She recalls a recent patient who had been taking a cheaper, lower quality version of insulin she purchased over the counter at a drugstore. The drug wasn’t working very well — the patient’s blood sugar spiked and plummeted, putting her at risk for eye and kidney disease, or even a coma — but it was all she could afford. Now, Peters says, her patient is able to get a better drug, and it’s helping. “She’s able to lose weight,” Peters says. “She smiles more. The price of insulin going down lets her get the kind of insulin she needed.” — Ike Swetlitz | 
