Colorado Insulin Copay Cap: Lower Out-Of-Pocket Payments, Increased Prescription Volume and Days’ Supply

Colorado’s cap on insulin costs was associated with significant reductions in out-of-pocket spending for insulin prescriptions, with the mean out-of-pocket payment per thirty day supply decreasing by almost half, according to a study in Health Affairs. Colorado was the first state to cap out-of-pocket spending for insulin prescriptions in 2020, requiring fully insured health plans to cap out-of-pocket spending at $100 for a thirty-day supply. Average out-of-pocket spending per prescription fell by roughly 40 percent, and patients filling insulin prescriptions saved an average of $184 per year. At the same time, prescription volume and days’ supply increased, suggesting that insulin use may have been rationed by some patients prior to the cap’s implementation.