A summary of insulin coverage in Medicare Part D
Understanding beneficiaries’ formulary coverage for insulin products in 2020, 2021, and 2022
Insulin products are widely covered on Part D formularies. All beneficiaries enrolled in an individual Medicare Part D plan have coverage for the insulin types in this analysis, with a range of coverage options by manufacturer and drug type. Formulary coverage for brand insulin products by manufacturer has been relatively consistent from 2020 to 2022 for each of the classes included in the analysis. As biosimilars and authorized generics gain FDA approval, they are generally covered less frequently than brand products on Part D formularies. Key findings include a summary of formulary coverage, tier placement, and Senior Savings Model participation. The report also covers background on insulin types, formulary coverage, and cost sharing.
This report was commissioned by the Pharmaceutical Care Management Association (PCMA)
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A summary of insulin coverage in Medicare Part D
Insulin products are widely covered on Part D formularies. In this analysis, all beneficiaries enrolled in an individual Medicare Part D plan have coverage in the classes noted, with a range of coverage options by manufacture and drug type.