Millions of people with diabetes once faced an impossible choice; pay expensive out‑of‑pocket costs for insulin or ration doses of a medication they need to survive. Some patients faced monthly insulin costs exceeding $2,000, putting their health, and lives, at risk.
This Evidence Effect story highlights research led by Dr. Carrie McAdam-Marx that examined how insulin copays, from $0 to $50 per month, affected patients’ adherence to treatment. The study identified a clear tipping point: when monthly costs exceeded $35, patient adherence dropped sharply.
These findings arrived at a critical moment, as Congress and federal agencies were actively debating how to lower insulin costs. With support from AcademyHealth’s advocacy team, the research was translated into clear, actionable evidence for Congressional staff, and helped shape the $35 monthly insulin copay cap for Medicare patients, improving affordability and health for millions.
Learn More:
- Watch the full interview with Dr. McAdam-Marx to see how this research helped drive policy change.
- Read Dr. McAdam-Marx's article in the Journal of Managed Care & Specialty Pharmacy
The Evidence Effect: Health Services Research in the Real World is AcademyHealth’s new storytelling series that highlights how research answers real-world problems, what changed because of the evidence, and who benefited from the research or policy change. Learn more about the Evidence Effect and discover other examples of what HSR does, why it matters, and the impact it creates for people and communities here.
Support for Dr. McAdam-Marx’s research was provided by a grant from the Robert Wood Johnson Foundation’s (RWJF) Health Data for Action program. The views expressed here do not necessarily reflect the views of RWJF.