Some patients struggling with the cost of medications like insulin and epinephrine just got a small-but-important break from one of the nation’s largest health insurers.
Starting Jan. 1, 2023, UnitedHealthcare will eliminate copays in standard, fully insured group plans for those two commonly used medications as well as albuterol, glucagon, and naloxone. The policy will affect about 8 million patients nationwide, the company says.
Any reduction in cost is a benefit, says Galveston endocrinologist Kevin McKinney, MD. About one-third of people with diabetes take insulin, which keeps people with type 1 diabetes out of the hospital and those with type 2 from developing complications.
“It is certainly a positive development but in a limited way because … it applies to fully insured plans and not all the other products that UnitedHealthcare has,” Dr. McKinney said. “There’s this whole other population that is underinsured or not in group plans … and for those patients it’s of no benefit.”
The price of insulin soared in recent years, prompting some states – including Texas – to cap copays. With the support of the Texas Medical Association and Texas Pediatric Society, the Texas Legislature in 2021 passed Senate Bill 827, which limited insulin copays to $25 for a 30-day supply.
UnitedHealthcare’s inclusion of glucagon – which treats people who have dangerously low blood sugar levels – is encouraging as well, Dr. McKinney says.
“Glucagon is just as essential to people with diabetes as epinephrine is to people with asthma,” he said. “Both of those medications keep people out of the emergency room.”
Like insulin, patients have struggled to afford epinephrine, with a single auto-injector costing more than $1,000 at times, says Keller pediatrician Jason Terk, MD, chair of the Texas Public Health Coalition, which includes TMA.
While prices have dropped in recent years, an epinephrine auto-injector can still cost several hundred dollars without insurance, he says. Such an injector may be much less with insurance, but UnitedHealthcare’s move to eliminate the copay will remove one more financial obstacle facing some asthma and allergy patients.
“I welcome the other major payers to match that policy,” Dr. Terk said.